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Mark K > Cardiac and chest tube > Flashcards

Cardiac and chest tube Flashcards

1
Q

What do Calcium Channel Blockers (CCB) do? What do they end in?

A

Slow and relax the heart (negative inotrope, chronotrope, and dromotrope)

-DIPINE (plus diltiazem)

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2
Q

What do CCB treat?

A

Antihypertensives
AntiAnginal drugs
AntiAtrialArrythmia

A, AA, AAA

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3
Q

What are the SE of CCB? What should you measure prior to giving it?

A

Headache and Hypotension

Check BP and hold if SBP is less than 100

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4
Q

QRS depolarization means….

P wave means….

A

QRS depolarization means ventricular

P wave means atrial

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5
Q

P wave in the form of saw tooth

A

Atrial flutter

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6
Q

Chaotic P Wave pattern

A

atrial fibrilation

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7
Q

Chaotic QRS complexes

A

ventricular fibrillation

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8
Q

Bizzare QRS complexes

A

Ventricular tachycardia

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9
Q

Periodic wide bizarre QRS complexes? When are these a low priority? When are they a moderate priority? When are they a high priority?

A

PVC

PVCs after an MI is common and is a low priority
Only a few

6 or more PVCs in a minute
More than 6 PVCs in a row
R on T phenomenon (a PVC falls on a T wave)

Never a high priority

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10
Q

What are the 2 lethal rhythms? Why?

A

Asystole and V-fib

Both are not giving very low or no CO –> confusion and death

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11
Q

What is a potentially lethal cardiac arrhythmia?

A

V-tach but only potentially b/c it has CO

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12
Q

When the pulse is present there is…. when the pulse is not present there is….

A

When the pulse is present there is CO, when the pulse is not present there is not CO

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13
Q

What is the treatment for PVCs and V-tach?

A

Amiodarone

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14
Q

What is the treatment for supra ventricular/atrial arryrthmias?

A

ABCDs
Adenosine - push in less than 8 seconds followed by 20 mL NS
Beta-blockers
CCBs
Digoxin/Lanoxin

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15
Q

What are the 2 treatments for A, AA, AAA?

A

CCB

BB

Both do the same thing with the same side effects

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16
Q

What is the treatment for V-fib?

A

Defib for V-fib

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17
Q

What is the treatment for Asystole?

A

Epinephrine FIRST then Atropine

18
Q

The purpose if a chest tube is to..

A

Reestablish negative pressure in the pleural space so that the lung expands when the chest wall expands

19
Q

A chest tube will remove what in a pneumothorax? Hemothorax? Hemopneumonthorax?

A

Removes air in a pneumothorax

Removes blood in a hemothorax

Removes air and blood in a hemopneumonthorax

20
Q

An apical chest tube removes… and a basilar chest tube removes…

A

Apical (top) - removes air therefore should bubble

Basilar (base) - removes blood or fluid therefore should not bubble

21
Q

If the question does not specifically state that it is unilateral or bilateral what do you assume?

A

ALWAYS assume it is unilateral

22
Q

If a closed drainage device (JP, hemovac, pneumovac, ect..) gets knocked over what do you do?

A

Ask the patient to take a few deep breaths
NOT a medical emergency so DONT call the Dr

23
Q

If the water seal of the chest tube breaks you should? How fast does this need to get done?

A

Clamp with rubber tooth double clamps, cut the tube, submerge tube in sterile water, unclamp

Needs to be done within 15 seconds b/c tube cannot be clamped for longer than that

24
Q

If the chest tube gets pulled out what is the first thing you should do? What is the priority if a chest tube gets pulled out?

A

Take a gloved hand and cover the opening (first step)

Take a sterile Vaseline gauze and tape 3 sides (best step)

25
Q

When should the water seal chamber bubble in a chest tube?

A

Should bubble intermittent

If there is a continuous bubble then there is a leak. Find it and tape it

26
Q

When should the suction control chamber bubble in a chest tube?

A

Should bubble continuously

If intermittent then suction is too low so increase it on the wall

27
Q

If a congenital heart defect is TRouBLe then that means you tell the parents..

A

Needs surgery now/soon to live
Has slowed/delayed growth and development (failure to thrive)
Has a shortened life expectancy
Parents will experience a lot of grief, financial and emotional stress
Pt is likely to be discharge home on a cardiac monitor
After, birth, pt will be in the hospital for weeks
Pediatrician or pediatric nurse will likely refer pt to a pediatric cardiologist

28
Q

A TRouBLe congenital heart defect will shunt blood _____ to _____ leading to ______

A

A TRouBLe congenital heart defect will shunt blood right to left leading to blue/cyanosis

29
Q

All TRouBLe heart defects start with the letter…

A

T

Tetralogy of Fallot
Truncus arteriosus
Transposition of the great vessels
Tricuspid atresia
Totally anomalous of pulmonary vasculature (TAPV)

30
Q

If a congenital heart defect does not start with a T, then what does that mean?

A

It is not trouble and it is a left to right shunt

31
Q

Whether or not a child has a TRouBLe congenital heart defect or a no TRouBLe congenital heart defect they will ALWAYS have what 2 things?

A

A Murmur d/t shunting of blood

An echocardiogram need to be done to find out the cause of the murmur

32
Q

What are the 4 defects of Tetralogy of Fallot?

A

Pulmonary artery stenosis
RVH (right ventricular hypertrophy)
Overriding aorta
VSD (ventricular septal defect)

Ways to remember: PROVe, VarieD, PictureS Of A RancH

33
Q

What diseases are on contact precautions?

A

Anything Enteric (GI/fecal/oral) - C.Diff, Hep A, E.Coli, cholera, dysentery
Staph
RSV (transmitted via droplet but pt touches object then mouth)
Herpes including herpes zoster (shingles)

34
Q

What is the PPE for contact precautions?

A

Private room preferred but can be in same room based on culture result NOT based on s/s
Disposable supplies like paper plates
Dedicated equipment (BP cuff, stethoscope)
Gown, gloves, hand wash

35
Q

What diseases are droplet precautions?

A

Anything traveling on large particles from coughing or sneezing less than 3 feet
Meningitis
H. influenza B (lead to epiglottis where nothing should be put down the throat)

36
Q

What is the PPE for droplet?

A

Private room preferred but can be in same room based on culture result NOT based on s/s
Handwashing, mask, goggle/face shield, gloves
Disposable supply
Dedicated equipment
Patient wear mask when leave room

37
Q

What diseases are airborne precautions?

A

MMR
TB
Varicella (chickenpox)

Air MTV

38
Q

What is the PPE for airborne precaution?

A

Private room preferred but can be in same room based on culture result NOT based on s/s
Handwashing, N95 respirator, goggle/face shield, gloves
Disposable supply - not essential
Dedicated equipment - not essential
Patient wear mask when leave room
Negative airflow room

39
Q

Order of putting on PPE

A

Gown
Mask
Goggle
Gloves

40
Q

What is the order of removing PPE?

A

Gloves
Goggle
Gown
Mask

Mark K (12 decks)

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