Cardiac Assessment

Question 1

Treatment considerations for Cardiac Assessment

Answer 1

• O2 administration
• ASA administration
• Nitroglycerin administration
• Initiation of IV to left arm
• AED pads

Question 2

Priorities of reassessment for Cardiac patient

Answer 2

• Vital signs every 5 minutes
• Pain severity assessment
• Serial 12 lead ECGs every 5 minutes, with every spray of nitro
• Focused cardiac secondary assessment
• Checking for changes to signs and symptoms

Question 3

History of MI

Answer 3

• Pressure-like chest pain
• Chest pain that woke them from sleep
• Radiating chest pain to arms/back/jaw

Question 4

Risk factors for MI

Answer 4

• Smoking
• Sedentary lifestyle
• Poor dietary habits
• ETOH use or abuse
• Family history
• Hypertension, diabetes, high cholesterol

Question 5

Key Diagnostic Assessment for MI

Answer 5

• Dizziness/lightheadedness/presyncope
• Pain/discomfort in neck/jaw/arms/back
• Jugular vein distension
• Shortness of breathe
• Pain/discomfort in abdomen
• Peripheral edema
• Skin colour and condition changes

Question 6

Special considerations for Cardiac Assessment

Answer 6

If 12 lead shows “acute MI suspected” call OLMC for directions. Withold nitro until you have spoken to physician

Question 7

When to increases index of suspicion for MI

Answer 7

• Grey or pale skin
• Clammy or diaphoretic skin
• Clutching their chest
• Having difficulties breathing
• Vomiting
• Feeling weak/fatigued

Question 8

Risk factors for rhythm disturbance (HR >150 or <50)

Answer 8

• Smoking
• ETOH use
• Previous cardiac problems
• Uncontrolled AFIB
• Uncontrolled HTN

Question 9

Hallmark features of Ventricular Tachycardia

Answer 9

• HR >50
• Wide QRS

Question 10

Hallmark features for SVT

Answer 10

• HR > 150
• Narrow QRS

Question 11

Hallmark features for Toursades des Pointes

Answer 11

• HR > 150
• Wide QRS
• Twists over top and under the isoelectric line

Question 12

Hallmark features of Second degree HB, Type 2

Answer 12

• HR < 50
• Drops a QRS complex regularly

Question 13

Hallmark features of Third degree HB

Answer 13

• HR < 50
• No correlation between P waves and QRS complexes

Question 14

Key diagnostics for rhythm disturbance

Answer 14

• Chest pain
• Shortness of breathe
• Auscultation: crackles bilaterally
• Altered LOC
• Hypotension

Question 15

When is electrical intervention required?

Answer 15

When HR > 150 or < 50 with any one of the following:
- Chest pain
- Shortness of breathe
- Altered LOC
- Pulmonary edema
- Hypotension

Question 15

History for Pulmonary Embolism

Answer 15

• Sedentary for prolonged periods of time
• First 48 hours past any surgery
• Smoking and taking birth control
• Deep vein thrombosis
• Non-mediated atrial fibrillation
• Post-partum

Question 16

Key diagnostic assessment for Pulmonary Embolism

Answer 16

• Tachycardia and/or irregular heartbeat
• Anxiety
• SOB
• Chest pain (similar to MI)
• Pain or swelling in leg
• Clammy or diaphoretic skin
• Dizziness or lightheadedness