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EMR - First on Scene - 9th Edition La Baudour - Bergeron > Caring for Cardiac Emergencies Chapter 13 > Flashcards

Caring for Cardiac Emergencies Chapter 13 Flashcards

0
Q 
You are caring for a 44 year old male patient who began experiencing chest pain & shortness of breath while jogging. His pain went away completely about 20 minutes after stopping to rest. The most likely cause of his chest pain is:
A. Myocardial infarction
B. Heart failure
C. Angina
D. Muscle strain
A

C. Angina

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1
Q 
Blood that is returning to the heart from the lungs enters the heart at the:
A. Right atrium
B. Left atrium
C. Right ventricle
D. Left ventricle
A

B. Left atrium

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2
Q 
Your patient is a 65 year old female who has a long history of cardiac problems. She is complaining of chest pain & difficulty breathing. You should:
A. Lay her in a supine position.
B. Administer oxygen
C. Obtain a past medical history
D. Take her vital signs
A

B. Administer oxygen

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3
Q

The myocardium receives it’s blood supply from:

A. Coronary arteries
B. Myocardial arteries
C. The conduction arteries
D. The aorta

A

A. Coronary arteries

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4
Q 
You have responded to a 53 year old male who suddenly collapsed while mowing his lawn. Your assessment reveals that he is pulseless & apneic. His condition is best described as:
A. Angina pectoris
B. Myocardial infarction
C. Cardiac arrest
D. Heart failure
A

C. Cardiac arrest

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5
Q

Which of hue following statements best describes the relationship between a heart attack and sudden cardiac arrest?
A. A heart attack & sudden cardiac arrest are the same thing.
B. Sudden cardiac arrest is a leading cause of heart attack.
C. Heart attack results in tissue damage, sudden cardiac arrest does not.
D. Heart attack is a leading cause of sudden cardiac arrest.

A

D. Heart attack is a leading cause of sudden cardiac arrest.

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6
Q

You have arrived on the scene of an unresponsive female who is pulse less & apneic. You should:

A. Begin CPR
B. Administer oxygen
C. Obtain a set of vitals
D. Place her in the recovery position.

A

A. Begin CPR

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7
Q

You are caring for a 52 year old female with a chief complaint of nausea & general fatigue. She is pale & sweaty & has a history of diabetes. You should:

A. Administer oxygen
B. Administer oral glucose
C. Obtain vital signs
D. Perform a secondary assessment

A

A. Administer oxygen

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8
Q

Your patient is experiencing chest pain & shortness of breath & has a history of angina. He took 1 nitroglycerin tablet 15 minutes ago. Vital signs are Respirations 20, Pulse 104, & BP 144/88. You should:
A. Have the patient rest until the pain subsides.
B. Assist the patient in taking another dose of nitro.
C. Do nothing until ALS arrives.
D. Apply the AED.

A

B. Assist the patient in taking another dose of nitro.

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9
Q 
You are caring for a 72 year old female with a chief complaint of shortness of breath. You observe pedal edema & distended neck veins. She states that it is more difficult to breath while lying down. Her signs & symptoms are most likely caused by:
A. A myocardial infarction 
B. Angina pectoris 
C. Heart failure
D. Congestive infarction
A

C. Heart failure

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10
Q

What is the cause of angina?

A

A lack of sufficient supply of oxygenated blood to the myocardium.

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11
Q

When does a myocardial infarction occur?

A

When a portion of the myocardium dies due to inadequate blood supply.

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12
Q

Heart failure, also known as congestive heart failure (CHF) occurs when the heart is weakened by illness such as a heart attack & can no longer pump blood efficiently. Blood & other fluids then back up in the system, causing pedal edema & fluid in the lungs. True or false?

A

True

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13
Q

Patients with signs & symptoms of cardiac compromise should be considered stable and transported normally. True or false?

A

False

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14
Q

How do you care for cardiac compromise?

A
  1. Support of ABC’s
  2. Supplemental oxygen
  3. Obtain a thorough medical history
    D. Monitor vital signs
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15
Q

When normal heart function is disrupted, the patient will exhibit signs & symptoms of cardiac compromise. True or false?

A

True

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16
Q

Describe blood flow through the heart.

A
  1. Begins in right atrium
  2. Then to right ventricle
  3. Then to lungs
  4. Returns to the left atrium
  5. Down to left ventricle
  6. Pumped out to the body
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17
Q

What is needed for a healthy cardiovascular syster?

A

A properly functioning heart.

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18
Q

How is each heartbeat generated?

A

By an electrical impulse that flows along the conduction pathway.

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19
Q

What are signs & symptoms of cardiac compromise?

A

Chest pain or discomfort that begins in the chest & may radiate to the shoulders, arms, neck, or jaw; shortness of breath, pale, moist skin; nausea; & weakness.

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20
Q

The heart beats an average of _________ times a day.

A

100,000

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21
Q

The heart circulates approximately _____________ liters of blood through the body each day.

A

6,000-7,500

22
Q

What is the conduction pathway?

A

The electrical pathway within the heart.

23
Q

What does the electrical impulse do?

A

It causes a coordinated contraction of the heart.

24
Q

What does damage to the conduction pathway cause?

A

An abnormal heartbeat and a cause of poor circulation & perfusion.

25
Q

Where does the heart muscle receive its oxygen from?

A

Coronary arteries

26
Q

What is cardiac compromise?

A

A general term used to describe specic signs & symptoms that indicate some type of emergency relating to the heart.

27
Q

What are the signs & symptoms of cardiac compromise?

A

Chest discomfort (pain, dull pressure, tightness, or squeezing sensation)
Diaphoresis (sudden onset of sweating)
Dyspnea (shortness of breath)
Nausea/vomiting
Anxiety, irritability
Feeling of impending doom
Abnormal pulse (rapid, slow, or irregular)
Abnormal BP (high or low)
Note: always provide care for worst case scenario & call for an ALS ambulance.

28
Q

Always assume that chest pain is cardiac in origin. True or false?

A

True

29
Q

What is angina (aka angina pectoris)?

A

Pain in the chest caused by a lack of sufficient flow of blood & oxygen to the heart muscle (myocardium).
Note: there is no damage to the heart muscle. Usually triggered by exertion.

30
Q

Signs & symptoms of angina are nearly identical to those for a heart attack. True or false?

A

True

31
Q

Cardiac arrest is the ultimate form of cardiac compromise & results in _________.

A

Stoppage of the heart.

32
Q

Define infarction.

A

The deadening of tissue due to a loss of adequate blood supply.

33
Q

The medical term for heart attack is:

A

Myocardial infarction (MI).

34
Q

A heart attack(MI) is the same thing as cardiac arrest. True or false?

A

False

35
Q

Anyone suffering a cardiac arrest should receive:

A
  1. CPR immediately

2. Application of an AED (auto external defibrillator)

36
Q

2 major factors that contribute to whether a heart attack will result in cardiac arrest are:

A
  1. The location of the damage on the heart.

2. How much heart muscle actually dies.

37
Q

Define myocardial infarction (MI).

A

A condition that results when blood supply to a portion of the heart is interrupted. (Aka a heart attack)

38
Q

Women, diabetics, & the elderly may present ‘non-classic heart attack symptoms. True or false?

A

True, such as: flu like symptoms (nausea/vomiting, indigestion, feeling of general weakness).

39
Q

What is CHF?

A

Congestive heart failure, a condition that develops when the heart is unable to pump blood efficiently. It causes blood & fluids to back up in the circulatory system. It can develop suddenly after a heart attack.

40
Q

What is pedal edema?

A

A swelling of the lower extremities brought on by fluid back up in CHF.

41
Q

What is 1 of the most common complaints of congestive heart failure?

A

Fatigue

42
Q

What are signs & symptoms of heart failure?

A 
Shortness of breath
Chest pain/discomfort 
Rapid pulse
Pedal edema (ankles)
Jugular vein distention (JVD)
Pale moist skin
Altered mental status due to a decrease in perfusion to the brain
43
Q

What is OPQRST?

A

A mnemonic tool commonly used to assess chest pain.

44
Q

What does OPQRST stand for?

A

O -ONSET: what were you doing when the pain began?
P -PROVOCATION: does anything you do make pain/discomfort better or worse?
Q -Quality: what can you do to me so that I will feel your pain?
R -Region or radiate: Can you point with 1finger to where the pain/discomfort is the most intense?
S -Severity: On a scale of 1-10, with 10 being the worst pain you have ever had, how would you rate this pain? What was the level of pain when it first started? What was the worst pain you ever had?
T -Time When did the pain/discomfort begin?

45
Q

What is a good response when a patient asks if they are having a heart attack?

A

“Your pain could be a lot of things, but let’s not take chances.

46
Q

Oxygen is the only medication that an EMR can treat with. True or false

A

True

47
Q

What are the indications for nitroglycerin?

A
  1. Patient complains of chest pain.
  2. Patient has a history.
  3. Patient’s physician has prescribed nitroglycerin.
  4. Systolic blood pressure is greater thn 100 systolic
  5. Medical direction authorizes administration of the medication.
48
Q

What is the SOP for assisting patients to administer their prescription of nitroglycerin?

A
  1. One standard dose (1 pill) is .4 mg
  2. Can repeat it in 3-5 minutes.
  3. If no relief, & systolic BP remains above 100, & if authorized by medical direction, up to a maximum of 3 doses.
  4. If using spray, 1 metered spray followed by a 2nd in 15 minutes.
49
Q

What are the side effects of nitroglycerin treatment?

A
  1. Lowers BP (hypotension)
  2. Headache
  3. Pulse rate changes
  4. Dizziness, lightheartedness
50
Q

What are the steps for assisting patients with nitroglycerin administration?

A
  1. Perform focused assessment for the cardiac patient.
  2. Take BP (Systolic must be above 100)
  3. Contact medical direction if no standing orders.
  4. Ensure: right patient, right dose, right route, & right time. Check expiration date.
  5. Ensure patient is alert.
  6. Question patient on the last dose taken & effects.
  7. Ask patient to lift tongue & place a tablet or spray dose on or under the tongue. Make sure you are wearing gloves.
  8. Have patient keep mouth closed with tablet under tongue without swallowing until dissolved & stored.
  9. Recheck BP within 2 minutes.
  10. Record administration, route & time.
  11. Perform reassessment (don’t give additional dosage if BP will go under 100)
51
Q

Nitroglycerin dilates (enlarges) blood vessels, allowing an increase in blood flow to the heart muscle. True or false?

A

True

52
Q

Nitroglycerin in the form of transdermal patches passes through the skin & is picked up by the circulatory system. True or false?

A

True

53
Q

Nitro patches work quickly and are good to use in a cardiac emergency. True or false?

A

False, they are best prescribed for angina prevention, not the treatment of an angina attack.

EMR - First on Scene - 9th Edition La Baudour - Bergeron (26 decks)

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