Calcium Channel Blockers, Arrythmias, Chest Tubes, & Congenital Heart Defects

Question 1

Calcium channel blockers indications

Answer 1

Tachycardia, tachyarrythmias, post-myocardial infarction to rest heart

Question 2

Calcium channel blockers are given to _____ the heart

Answer 2

Relax

Question 3

What conditions do calcium channel blockers treat?

Answer 3

Hypertension, angina, atrial arrythmias (aflutter, afib, premature atrial contractions, supraventricular tachycardia)

Question 4

Calcium channel blockers side effects

Answer 4

Headache (d/t dilated vessels in brain), hypotension (d/t relaxation of heart and blood vessels)
MEMORY TRICK: think H&H

Question 5

Calcium channel blockers end in

Answer 5

-dipine (think “Dipin in the calcium channel)

Question 6

Calcium channel blockers that do not end in -dipine

Answer 6

Verapamil, Cardizem (given continuous IV drip)

Question 7

Calcium channel blocker nursing considerations

Answer 7

Measure BP before administration, hold if systolic BP is <100, monitor BP continuously if on cardizem drip (if SBP is below 100, slow down and titrate drip to keep SBP over 100)

Question 8

What four cardiac arrythmias should you be able to interpret?

Answer 8

Normal sinus rhythm, ventricular fibrillation, ventricular tachycardia, asystole

Question 9

Lethal arrythmias that have no cardiac output

Answer 9

Asystole and Vfib

Question 10

Arrythmia that has cardiac output, but can be potentially life threatening

Answer 10

V-Tach (can be w/ pulse or pulseless)

Question 11

Pharmacological treatment for PVCs and Vtach

Answer 11

Lidocaine, Amiodarone

Question 12

Pharmacological treatment for supraventricular (atrial) arrythmias

Answer 12

Adenosine (IVP less than 8 seconds w/ 20 mL of IV fluid flush after; pt may go into asystole for about 30 sec but they will come out of it), beta blockers, calcium channel blockers, digoxin

Question 13

Vfib treatment

Answer 13

Defibrillation

Question 14

Treatment for asystole

Answer 14

Epinephrine and atropine

Question 15

What is the purpose of a chest tube?

Answer 15

To reestablish negative pressure in the pleural space so that the lungs expand when the chest wall moves

Question 16

What should be reported in clients with chest tubes?

Answer 16

Chest tube is not bubbling, chest tube drained 800 mL in first 10 hours, the chest tube is not draining, the chest tube is intermittently bubbling

Question 17

Apical chest tubes remove _____, and basilar chest tubes remove _____.

Answer 17

Air; blood
MEMORY TRICK: A for A, and B for B

Question 18

What do you do if you knock over chest tube drainage water seal apparatus?

Answer 18

Set it back up and have the pt take deep breaths — NOT a medical emergency

Question 19

What do you do if the water seal breaks?

Answer 19

Clamp it, cut it away from broken device, stick end of tube in sterile water to reestablish water seal, unclamp it

Question 20

Intermittent bubbling in the water seal is _________

Answer 20

Good/normal/expected

Question 21

Continuous bubbling in the water seal is _____

Answer 21

BAD! Find leak and put tape over it until it stops leaking

Question 22

Intermittent bubbling in the suction-control chamber is _____

Answer 22

BAD! Suction in not high enough… turn up dial on wall so that bubbling becomes continuous

Question 23

Continuous bubbling in the suction-control chamber is _________

Answer 23

Good/Normal/Expected

Question 24

Rules for clamping tubes

Answer 24

Never clamp tube for longer than 15 sec w/o Dr. order, use rubber tipped double clamps so tube does not get punctured

Question 25

TRouBLe congenital heart defects characteristics

Answer 25

Shunts blood R to L, cyanotic, requires surgery, delayed growth and development, decreased life span, exercise intolerance, apnea monitoring,

Question 26

NO trouble congenital heart defects characteristics

Answer 26

Shunts blood L to R, no cyanosis, no big deal!

Question 27

All congenital heart defects that start with the letter ___ are trouble

Answer 27

T (Tetrology of fallot, truncus arteriosis, transposition of the great vessels, tricuspid atresia)

Question 28

Examples of NO trouble CHDs

Answer 28

Ventricular septal defect, patent ductus arteriosus, patent foramen ovale, atrial septal defect, pulmonic stenosis

Question 29

All congenital heart defect, whether trouble or not, will have

Answer 29

A murmur (d/t shunt of blood) and an echocardiogram done to find out why

Question 30

4 defects of Tetrology of Fallot mnemonic

Answer 30

“Valentines Day Pick Someone Out A Red Heart”: Ventricular Defect, Pulmonary Stenosis, Overriding Aorta, Right Hypertrophy

Question 31

What are the four transmission-based precautions?

Answer 31

Standard/universal, contact, droplet, airborne

Question 32

Examples of diseases requiring contact precautions

Answer 32

C.Diff, Hep A, Cholera, Staph infections, RSV, herpes zoster (shingles)

Question 33

Contact isolation precautions

Answer 33

Private room, cohort is acceptable, gown, gloves, handwashing, disposable supplies and dedicated equipment (stethoscope, BP cuff)

Question 34

Examples of infectious diseases that require droplets precautions

Answer 34

Meningitis, Influenza

Question 35

Droplet isolation precautions

Answer 35

Private room preferred, mask, gloves, handwashing, pt wears mask when leaving room, disposable supplies and dedicated equipment

Question 36

Examples of infectious diseases that require airborne precautions

Answer 36

Measles, mumps, rubella, TB, varicella (chicken pox)

Question 37

Airborne isolation precautions

Answer 37

Private rooms required w/ negative airflow, mask, gloves, handwashing, N-95 for TB, pt wears mask when leaving room

Question 38

Order for TAKING OFF PPE

Answer 38

Gloves, goggles, gown, mask MEMORY TRICK: take off in alphabetical order!

Question 39

Order for DONNING PPE

Answer 39

Gown, mask, goggles, gloves MEMORY TRICK: reverse alphabetical for G’s, but mask comes second

Question 40

Dosage calculation equation

Answer 40

Desired/Have x Available

Question 41

IV drip rate equation

Answer 41

Volume x DF / time in minutes (REMEMBER: mini/micro drips = 60 gtt/mL; macro drips = 10 gtt/mL)