Cardiac rhythm monitors & equipment 2

Question 1

The heart depolarizes from the

Answer 1

base–> apex and the endocardium to epicardium

Question 2

The heart repolarizes from the

Answer 2

apex–> base and epicardium–> endocardium

Question 3

Which leads monitor the septum?

Answer 3

V1 & V2

Question 4

The mean electrical vector tends to point: (select 2)
a. towards areas of hypertrophy
b. towards areas of myocardial infarction
c. away from areas of myocardial infarction
d. away from areas of hypertrophy

Answer 4

a. towards areas of hypertrophy
c. away from areas of myocardial infarction

Question 5

The easiest way to determine axis deviation is to examine

Answer 5

lead I & aVF

Question 6

Normal axis shows lead 1 & aVF as

Answer 6

both positive

Question 7

Left axis deviation shows lead 1 & aVF as

Answer 7

lead 1= +
lead aVF= -

Question 8

Right axis deviation shows lead 1 & aVF as

Answer 8

lead 1= -
lead aVF= +

Question 9

Extreme right axis deviation shows lead 1 & aVF as

Answer 9

both negative

Question 10

Right axis deviation is typically caused by things that

Answer 10

affect the right heart
COPD
acute bronchospasm
cor pulmonale
pulmonary embolus

Question 11

Left axis deviation is typically caused by things that

Answer 11

affect the left heart
chronic HTN
left bundle branch block
aortic stenosis
aortic insufficiency
mitral regurgitation

Question 12

Normal axis is between

Answer 12

-30 and +90 degrees

Question 13

Left axis deviation is more

Answer 13

negative than -30 degrees

Question 14

Right axis deviation is more

Answer 14

positive than 90 degrees

Question 15

All of the following are effective for the treatment of atrial fibrillation EXCEPT:
a. verapamil
b. digoxin
c. metoprolol
d. adenosine

Answer 15

d. adenosine

Question 16

Sinus bradycardia is defined as

Answer 16

HR <60 bpm

Question 17

Sinus bradycardia is usually due to

Answer 17

increased vagal tone

Question 18

The first-line treatment for sinus bradycardia is

Answer 18

atropine

Question 19

Other treatments of sinus bradycardia include

Answer 19

external pacing or glucagon (useful for beta-blocker or CCB overdose)

Question 20

Sinus arrhythmia is usually the result of

Answer 20

SA node’s pacing rate varying with respiration

Question 21

Sinus tachycardia is defined as

Answer 21

HR >100 bpm

Question 22

Tachycardia reduces ___________ while increasing _________________

Answer 22

myocardial oxygen supply while increasing oxygen demand

Question 23

Causes of sinus tachycardia includes

Answer 23

SNS stimulation
hypovolemia
hypoxemia
infection
pain
thyrotoxicosis
malignant hyperthermia

Question 24

Treatment for sinus tachycardia includes

Answer 24

addressing the underlying cause and providing rate control with beta-blockers or calcium channel blockers

Question 25

Atrial fibrillation is the result of

Answer 25

chaotic electrical activity in the atrium conducted to the ventricle at a varied and irregular rate

Question 26

Atrial fibrillation results in _________________ which can reduce cardiac output in patients with poor ventricular compliance

Answer 26

loss of atrial kick

Question 27

Acute onset a-fib is treted with

Answer 27

cardioversion (start at 100 joules)

Question 28

If the onset of a-fib is >48 hours, then ___________ must be performed prior to cardioversion.

Answer 28

cardiac ultrasound such as TEE to rule out atrial thrombus

Question 29

Atrial flutter is an

Answer 29

organized supraventricular rhythm characterized by a "saw tooth" pattern

Question 30

Patients with atrial fibrillation are at risk for

Answer 30

atrial thrombus formation and stroke

Question 31

Treatment for atrial flutter includes

Answer 31

rate control medications and cardioversion

Question 32

Premature ventricular contractions originate from

Answer 32

foci below the AV node

Question 33

A PVC that lands on the second half of the T wave (during the relative refractory period) can precipitate

Answer 33

the R on T phenomenon

Question 34

Symptomatic PVCs can be treated with

Answer 34

lidocaine

Question 35

Treatment for PVCs includes the

Answer 35

reversal of hypoxia/hypercarbia, correction of electrolyte imbalances, discontinuation of QT-prolonging drugs, and repositioning a central line that's tickling the right atrium

Question 36

The initial dose of glucagon to treat sinus bradycardia is __________- followed by__________

Answer 36

50-70 mcg/kg q3-5 min followed by an infusion at 2-10 mg/hr.

Question 37

____________ is the most common postoperative tachydysrhythmia usually occurring between post-op day 2 and 4.

Answer 37

atrial fibrillation

Question 38

Junctional rhythm occurs when the

Answer 38

AV node functions as the dominant pacemaker

Question 39

Junctional rhythm can be caused by

Answer 39

SA node depression (volatile anesthetics), SA node block, or prolonged conduction at the AV ode

Question 40

Treatment for junctional rhythm includes

Answer 40

Atropine if hemodynamics are impacted by the slow rate

Question 41

Development of PVCs can include many things including

Answer 41

SNS stimulation myocardial ischemia and/or infarction valvular heart disease cardiomyopathy prolonged QT interval hypokalemia hypomagnesemia digitalis toxicity caffeine cocaine alcohol mechanical irritation (central line insertion)

Question 42

PVCs should be treated when

Answer 42

they are frequent (>6/min), polymorphic, or when they occur in runs of 3 or more

Question 43

The most common cause of sudden cardiac death is

Answer 43

ventricular fibrillation

Question 44

Treatment for ventricular fibrillation is

Answer 44

CPR with defibrillation

Question 45

Brugada syndrome is a

Answer 45

sodium ion channelopathy in the heart

Question 46

Brugada syndrome is the most common cause of

Answer 46

sudden nocturnal death due to ventricular tachycardia or fibrillation

Question 47

Diagnostic EKG findings of Brugada syndrome includes

Answer 47

a right bundle branch block and ST-segment elevation in the precordial leads (V1-V3)

Question 48

Patients with brugada syndrome may require

Answer 48

ICD or pad placement during surgery

Question 49

During sinus arrhythmia, heart rate increases during:

Answer 49

inhalation--> decreased intrathoracic pressure--> increased venous return--> increased heart rate

Question 50

What reflex may initiate sinus arrhythmia?

Answer 50

Bainbridge reflex