Cardiovascular/Respiratory

Question 1

What are some pre-procedure interventions for Cardiac Pharmacological stress test?

Answer 1

• Avoid smoking cigarettes, caffeinated or decaffeinated drinks
• Expect nausea and/or flushing. Report chest pain or dyspnea during test
• PVAD will be inserted
• Medications like beta blockers may interfere with test and should not be taken

Question 2

how much drainage from a chest tube is concerning?

Answer 2

more than 100ml/hr

Question 3

Is it concerning if drainage from a chest tube changed from 100ml to 20 ml within the last hour?

Answer 3

Yes, need to assess for cardiac tamponade

Question 4

What is cardiac tamponade?

Answer 4

medical emergency that takes place when abnormal amounts of fluid accumulate in the pericardial sac compressing the heart and leading to a decrease in cardiac output and shock

Question 5

What are the signs of cardiac tamponade?

Answer 5

muffled heart tones

pulsus paradoxus (abnormal drop in BP during inspiration)

hypotension

tachycardia

JVD

Question 6

Which one is good/bad when there is intermittent/continuousbubbling in the water seal chamber

Answer 6

Intermittent = good (document it)

Continuous = bad & indicates a break/leak in system (find it and tape it)

Question 7

Which one is good/bad when there is intermittent/continuous bubbling in the water seal chamber

Answer 7

Intermittent = suction pressure is too low (increase it at the wall until it is continuous)

Continuous = good (document it)

Question 8

Signs of Deep Venous Thrombosis

Answer 8

edema

localized pain or tenderness

warmth

erythema

Question 9

Is this signs of venous or arterial insufficiency?

brown, hardened skin, varicose veins, peripheral edema, pain improve with leg elevation

Answer 9

Venous

Question 10

Is this signs of venous or arterial insufficiency?

diminished/absent pulses, cold skin, no hair on lower extremities

Answer 10

Arterial

Question 11

T or F: in arterial insufficiency you should elevate your legs and use compression stockings

Answer 11

F

Question 12

T or F: in venous insufficiency, you should elevate your legs and apply compression stockings

Answer 12

T

Question 13

What are interventions to treat Disseminated Intravascular Coagulation (DIC)?

Answer 13

Initiate vasopressors (norepinephrine)

Monitor coagulation studies

Transfuse fresh frozen plasma and platelets

Question 14

What medication should you avoid when you have heart failure?

a. beta blockers
b. Calcium Channel blockers
c. digoxin
d. NSAIDs

Answer 14

NSAIDs (ex. ibuprofen)

Question 15

what is pleuritic chest pain and pericardial friction rub signs of?

Answer 15

pericarditis

Question 16

How can you relieve the pain in pericarditis? (position)

Answer 16

sitting up and leaning forward

Question 17

What is the treatment for pericarditis?

Answer 17

NSAIDs and colchicine

Question 18

Are premature ventricular contractions (PVCs) low or high priority?

Answer 18

low priority, after MI it is common

Question 19

What are the lethal arrhythmias?

Answer 19

Asystole

ventricular fibrillation

Question 20

What arrhythmia as the potential to become potentially lethal?

Answer 20

V-Tach

Question 21

What do you treat ventricular arrhythmias with?

Answer 21

lidocaine/amiodarone

Question 22

What do you treat asystole with?

Answer 22

epinephrine and atropine

Question 23

What is Guillain-Barre Syndrome?

Answer 23

Acute, immune mediated polyneuropathy accompanied by ascending muscle paralysis and absence of reflexes

Question 24

What do you treat atrial arrhythmias with? (hint: ABCD)

Answer 24

Adenocard (Adenosine)

Beta-blockers

CCBs

Digitalis (digoxin), Lanoxin (another digitalis analog)

Question 25

Which are symptoms of pneumonia? (more than 1) a. crackles b. pleuritic chest pain c. hyperresonance d. dyspnea

Answer 25

a,b,d

Question 26

are these signs left or right sided HF? weight gain, edema, JVD, increased BP and bounding pulse, ascites, hepatomegaly

Answer 26

right sided HF

Question 27

Are these signs of left or right sided HF? pulmonary edema, dyspnea, crackles, cardiomegaly

Answer 27

Left sided HF

Question 28

What is the priority concern after a bronchoscopy or lung biopsy?

Answer 28

Assess for pneumothorax and bleeding