Circulation

Question 1

Electrical conduction of heart

Answer 1

1. SA node
2. AV node
3. Bundle of His
4. Left and right bundle
   branches
5. Purkinje fibres

Question 2

Reading ECG traces

Answer 2

P waves
QRS complex
T waves

You see these in ECG and known as Sinus rhytm and is the normal rhythm of the heart

Question 3

P waves

Answer 3

Atrial depolarisation and contraction. Blood moves from atria to ventricles

Question 4

QRS complex

Answer 4

Ventricular depolarisation and contraction. Blood moves from ven to aorta and pul artery and to body and lungs

Question 5

T waves

Answer 5

Relaxation of the ventricles and repolarisation. Atria refill with blood.

Question 6

Average HR for paediatrics

Answer 6

<1 year = 110-160bpm
1-2= 100-150 bpm
3-5= 95-140 bpm
6-12= 80-120bpm
>12= 60-100bpm

Question 7

How can pulses differ
(abnormal)

Answer 7

Irregular
Too slow( bradycardia)
Too fast (tachycardia)
Strong
Weak and thready
Full and bounding

Question 8

Main pulses in the body

Answer 8

Radial
Brachial
Carotid
Femoral
Dorsalis Pedis
Popliteal
Posterior Tibial

Question 9

How long should you count a pulse for

Answer 9

Minute

Question 10

Capillary refill time

Answer 10

Should be done peripherally and centrally

Done by:
1. Place finger on patient and press
2. Hold for 5 secs and then release
3. Count the time taken to return to original colour.

Cap refill should be less than 2 seconds

Question 11

What does a prolonged Cap refill time show

Answer 11

Reduced blood flow (perfusion) to that area.

This could be due to reduced blood circulation caused by dehydration and illness.

Question 12

Skin temp

Answer 12

Normal skin should be warm to touch.
When dehydrated, reduced circulating volume means blood vessels will constrict to divert blood to main organs.

Cool peripheries may be normal for some if the environment is cold.

Question 13

What should you be concerned about when carrying out a cardiac assessment

Answer 13

1. Cyanosis
2. Weak pulse
3. Low blood pressure
4. Cold hands and feet (not normal for the patient)
   5.Reduced urine output
   6.High heart rate for age
   7.Cap refill of longer than 2 seconds

Question 14

Assessing patient colour during cardiac assessment

Answer 14

Cyanosis- due to low O2 levels. usually seen in lips and tongue and around eyes.

Pallor- pale skin due to constriction of peripheral blood vessels or anaemia

Mottling- Patchy red and purple markings. usually seen in arms legs and upper body. Sign of poor perfusion. Also seen when babies are cold

Question 15

When taking blood pressure

Answer 15

The cuff should be in line with patient heart and perferably on the right arm.

Question 16

When taking blood pressure which korotkoff sound represents the systolic BP and Diastolic BP

Answer 16

Systolic BP= First sound

Dystolic BP= fifth sound

Question 17

Signs and symptoms of Low BP

Answer 17

• Fatgue
• Dizziness
• light headed
• Blurred vision
• Cold
• check colour
• Weak pulse

Question 17

Signs and symptoms of High Blood pressure

Answer 17

• Headache
• Chest pains
• Irregular heart rate
• Difficulty breathing
• Nose bleeds
• Blood in urine