Chest Pain and Injury

Question 1

Heart disease

Answer 1

includes congenital defects, hypertensive heart disease, angina, heart attacks, arrhythmias

Question 2

Antherosclerosis

Answer 2

Thickening of the artery wall from accumulation of fatty material

Question 3

Angina

Answer 3

Occurs when there is deficiency of O2 for heart, causes chest pain

Question 4

Stable angina

Answer 4

Follows same pattern for pt, typically lasts less than 5mins, usually relieved by rest

Question 5

Unstable angina

Answer 5

Doesn’t follow same pattern, not as easily relived by rest

Question 6

Angina treatment

Answer 6

Full assessment, O2, ASA, 12 lead, nitro, IV

Question 7

Acute coronary syndrome (ACS)

Answer 7

Results from prolonged cardiac disorder causing myocardial ischemia or infarction
STEMI, NSTEMI or unstable angina

Question 8

AMI s/s

Answer 8

Chest pain, nausea, jaw/neck pain, SOB, drop in CO, pallor, diaphoresis,

Question 9

ASA

Answer 9

Platelets aggregating inhibitor, orally administer, 160mg, one dose

Question 10

Nitro

Answer 10

Vasodilation, reduced after load, symptom relief, not life saving

Question 11

-lol ending

Answer 11

Beta blocker - decrease rate and strength of contraction for HTN, angina, heart failure

Question 12

-ine ending

Answer 12

Calcium channel blocker - block of calcium ions into cardiac muscle, prevents spasms

Question 13

-ide ending

Answer 13

Diuretics - can be used for HTN

Question 14

-pril

Answer 14

Anti HTN

Question 15

Chest pain directive considerations

Answer 15

ACS or MI
DAA
Pneumothorax
Pulmonary embolism
Pericarditis

Question 16

Chest pain directive assess chest for

Answer 16

Subcutaneous emphysema
Accessory muscle use
Urticaria
In drawing
Shape
Symmetry
Tenderness

Question 17

STEMI bypass protocol indications

Answer 17

Over 18 years old
Chest pain
Time of onset less than 12 hours
12 lead indicating STEMI

Question 18

STEMi bypass contraindications

Answer 18

CTAS 1
LBBB
Transport is more than 60mins
Patient is requiring PCP diversion

Question 19

Dissecting aortic aneurysm

Answer 19

Middle layer of aorta tears and blood flows between middle and outer layer until outer tears

Question 20

Pericardium

Answer 20

Sac consists of visceral and parietal layer

Question 21

Flail chest

Answer 21

Two or more adjacent ribs are broken creating free floating area, creating paradoxical movement

Question 22

Pneumothorax

Answer 22

Chest wall allows air to enter thoracic space creating pressure. Bubbling at sight

Question 23

Tension pneumothorax

Answer 23

Air accumulation in intrapleural space, one way valve, JVD, Trach deviation

Question 24

Hemothorax

Answer 24

Blood filling thoracic cavity, lack of JVD, hemoptysis, dull to percussion

Question 25

Pulmonary contusion

Answer 25

Capillary damage results in reduced area for gas exchange

Question 26

Pericardial tamponade

Answer 26

Excessive fluid in pericardial sac, reduced stroke volume

Question 27

Becks triad for pericardial tamponade

Answer 27

Muffled heart tones, Hypotension, JVD

Question 28

Traumatic asphyxia

Answer 28

Sudden forceful impact in thoracic cavity that causes pressure to be translated up

Question 29

Commotio cordis

Answer 29

Immediate cardiac arrest caused by blunt force trauma during depolarization period

Question 30

Chronic heart failure

Answer 30

Occurs when heart is unable to pump to meet bodies metabolic needs

Question 31

Left Sided Heart Failure

Answer 31

Left ventricle is unable to pump enough blood sufficiently from pulmonary vessels As result pulmonary veins become engorged with blood causing ACPE

Question 32

Causes LSHF

Answer 32

Left ventricle was damaged from MI Chronic HTN

Question 33

Results of LSHF

Answer 33

Fluid in lungs SOB Crackles in lungs Pt may cough up fluid

Question 34

How does body’s compensation mechanisms affect heart failure

Answer 34

Panic and SOB trigger SNS causing BP to rise and tachycardia causing heart to work harder

Question 35

Management of LSHF

Answer 35

O2 Decreasing workload on heart Reducing preload so LV is less burdened 12 lead Iv

Question 36

CPAP

Answer 36

Continuous positive airway pressure Holds alveoli open for gas exchange to happen normally Causes slight decrease in BP

Question 37

CPAP starting setting

Answer 37

5cmH2O

Question 38

Paroxysmal nocturnal dyspnea

Answer 38

Severe SOB and coughing that happens at night

Question 39

Conditions for ASA

Answer 39

Greater than 18 and able to swallow

Question 40

Conditions for nitro in cardiac ischemia

Answer 40

Greater than 18 years, HR 60-159, Normotension, prior history of nitro or IV

Question 41

Contraindications for ASA

Answer 41

Active bleeding, CVA in past 24 hours, if asthmatic no prior use of ASA

Question 42

Contraindications of Nitro

Answer 42

SBP drops by one third initial value after nitro administered, right ventricular MI, phosphodiesterase inhibitors in last 48 hours

Question 43

ASA Tx

Answer 43

PO 160mg 1 dose

Question 44

Nitro use for NO STEMI

Answer 44

SBP greater than 100 SL 0.3 or 0.4mg Every 5 mins 6 doses

Question 45

Nitro Tx for a STEMI

Answer 45

SBP greater than 100 SL 0.3-0.4mg every 5 mins Max of 3

Question 46

How long should it take to get first 12 lead

Answer 46

Less than 10 mins

Question 47

nitro Tx for ACPE if BP is between 100-140

Answer 47

IV Yes SL 0.3mg Every 5 mins 6 doses

Question 48

Nitro Tx for ACPE with no IV and BP greater than 140

Answer 48

SL 0.3mg Every 4 mins 6 doses

Question 49

Nitro Tx WITH IV and BP greater than 140

Answer 49

0.6mg Every 5 mins Max of 6 doses