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PBL > Unit 4 Case 2 > Flashcards

Unit 4 Case 2 Flashcards

1
Q

What is Unit 4 Case 2 about?

A

A 17-year-old student presented in the ED with chest discomfort, shortness of breath and a ‘racing heart’. She had been drinking lots of energy drinks to revise for exams. She is sent for ECG examinations, and it is revealed she has supraventricular tachycardia (SVT). She had an intravenous injection of adenosine to normalise her heart rate and was told to avoid stress caffeine and alcohol

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2
Q

What is the neuroendocrine response to stress?

A

The stressor activates the release of corticotropin-releasing hormone (CRH) from the hypothalamus. This causes the synthesis and release of adrenocorticotropic hormone (ATCH) from the pituitary gland. This activates the release of cortisol and epinephrine from the adrenal glands

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3
Q

What is the effect of cortisol on the cardiovascular system?

A

Cortisol causes vasoconstriction and arteries to narrow which increases blood pressure

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4
Q

How does a lack of sleep affect the cardiovascular system?

A

A lack of sleep or insomnia increases blood pressure. As when you sleep blood pressure drops, so a lack of sleep keeps blood pressure higher for longer

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5
Q

What is an ECG?

A

An electrocardiogram is a test to check the heart’s rhythm and its electrical activity.

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6
Q

What are the 3 main components of an ECG?

A

P wave-atrial depolarisation
QRS complex- ventricular depolarisation
T wave- repolarization of the ventricles

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7
Q

What is the QRS complex?

A

A combination of 3 different electrical activities that accumulate to be the ventricular depolarisation

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8
Q

What is the QRS wave made up of?

A

The Q wave which represents the depolarization of the interventricular septum
The R wave represents the electrical stimulus as it passes through the main portion of the ventricular walls
The S wave represents depolarization of the Purkinje fibres

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9
Q

What is a 12 lead ECG and what is the benefit of it?

A

An ECG involving 12 leads, which are generated from 10 electrodes being placed on the body
Provides spatial information about the heart’s electrical activity

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10
Q

How many chest electrodes are there in a 12 lead ECG?

A

6

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11
Q

Where are the chest electrodes placed for a 12 lead ECG?

A

V1- 4th intercostal space at the right sternal edge
V2- 4th intercostal space at the left sternal edge
V3- between V2 and V4
V4-5th intercostal space at the midclavicular line
V5- left anterior axillary line at V4 horizontal level
V6- left mid-axillary line at V4 and V5 horizontal level

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12
Q

What 2 categories are the 10 electrodes on a 12 lead ECG split into?

A

Chest electrodes

Limb electrodes

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13
Q

How many limb electrodes are there on a 12 lead ECG?

A

4

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14
Q

Where are the limb electrodes placed in a 12 lead ECG?

A

Right arm- anywhere from right shoulder to elbow
Left arm-anywhere from left shoulder to elbow
Right leg- anywhere from right torso to ankle
Left leg- anywhere from left torso to ankle
(but must be in the same place on both arms and both legs)

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15
Q

What is meant by sinus bradycardia?

A

Slow heart rate

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16
Q

What is meant by sinus tachycardia?

A

Fast heart rate

17
Q

What is meant by sinus arrhythmia?

A

Irregular heart rate

18
Q

What are the characteristics of a normal ECG?

A

Normal heart rate- 60 to 100 beats per minute
Regular rhythm- less than 0.16-second variation in the shortest and longest durations
P wave- must be between +50 and +80 degrees

19
Q

What is a tympanic temperature?

A

The temperature obtained by placing an electrical probe in the ear canal.
This is done as the temperature in the capillary bed of the tympanic membrane is generally reflective of the core temperature.

20
Q

What is a triage nurse is what is their role?

A

A triage nurse is a registered nurse positioned in the ER or another health care facility. The murse is responsible for assessing patients and determining their level of need for medical assistance.

21
Q

What is a rapid intravenous injection of adenosine used to treat?

A

Used to bring the heart back to a normal rhythm in supraventricular tachycardia

22
Q

How does an intravenous injection of adenosine reestablish a normal sinus rhythm?

A

It binds to the AV node’s A1 receptors, inhibits adenylyl cyclase, increasing potassium efflux, causing hyperpolarisation.
This ‘blocks’ the AV node and results in a few seconds of asystole before a normal rhythm is then established

23
Q

What are some of the main causes of stress?

A

Work- pressure at work, unemployment or retirement
Family- relationship problems, divorce
Financial problems- unexpected bills or borrowing money
Health- illness, injury or losing someone

PBL (12 decks)

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