Module 9

Question 1

AANA standard #_____ addresses monitoring and alarms

Answer 1

9

Question 2

Document blood pressure, heart rate, and respiration at least every ____ minutes for all anesthetics

Answer 2

5 minutes

Question 3

What is the standard initial medication (name & dosage) used for the treatment of MH?

Answer 3

Dantrolene 10mg/kg

Question 4

Electrical depolarization with systolic contraction

Answer 4

HR

Question 5

Detectable peripheral arterial pulsation

Answer 5

Pulse rate

Question 6

pulse rate is less than heart rate (Afib, PVCs, PEA)

Answer 6

Pulse deficit

Question 7

Tall ____ waves can be mistaken for R waves and “double count” HR

Answer 7

T waves

Question 8

ST segment trending monitors have an average sensitivity of ___% and an average specificity of ___% in detecting myocardial ischemia.

Answer 8

74%

73%

Question 9

Approximately _______ of patients scheduled for noncardiac surgery have risk factors for coronary artery disease (CAD)

Answer 9

one-third

Question 10

The overall incidence of perioperative ischemia in patients with CAD scheduled for cardiac or noncardiac surgery ranges from ___% to ___%.

Answer 10

20% to 80%

Question 11

defined as where the QRS complex ends and the ST segment begins

Answer 11

ST junction

Question 12

ST junction is synonymous with the ___ point

Answer 12

J

Question 13

Two standard monitoring leads?

Answer 13

leads II & V5

Question 14

Which lead has the highest sensitivity for myocardial ischemia detection?

Answer 14

V5

Question 15

Which lead is the best for RV ischemia detection?

Answer 15

V4

Question 16

When V4 & V5 are used together, they have a ___% sensitivity for myocardial ischemia detection

Answer 16

90%

Question 17

best lead for monitoring P waves, enhancing diagnosis of dysrhythmias

Answer 17

Lead II

Question 18

Einthoven’s standard (limb) leads

Answer 18

I, II, III

Question 19

Goldberger’s augmented leads

Answer 19

aVR, aVF, aVL

Question 20

Precordial (chest) leads

Answer 20

V1-V6

Question 21

Name the 3 bipolar leads

Answer 21

I, II, III

Question 22

Name the 6 unipolar precordial leads

Answer 22

V1-V6

Question 23

Name the 3 modified unipolar leads

Answer 23

aVR, aVF, aVL

Question 24

With a 3-lead system, you cannot see the ______ portion of the heart

Answer 24

anterior

Question 25

A lead composed of two electrodes of opposite polarity is called ______ lead

Answer 25

bipolar

Question 26

A lead composed of a single positive electrode and a reference point is a _______ lead

Answer 26

unipolar

Question 27

How many leads for the standard of care for at risk pts?

Answer 27

5-lead

Question 28

In a 5-lead setup, which lead is preferred for arrhythmia monitoring?

Answer 28

V1

Question 29

In a 5-lead setup, which 3 leads are preferred for myocardial ischemia monitoring?

Answer 29

V3-V5

Question 30

In leads I, II, and III, all waveforms should be _______ deflected

Answer 30

positively

Question 31

In this augmented lead, all waveforms are positive

Answer 31

aVF

Question 32

In this augmented lead, all waveforms are negative

Answer 32

aVR

Question 33

In this augmented lead, the P wave & T wave are negative, and the QRS is biphasic

Answer 33

aVL

Question 34

In the precordial leads, the P wave and T wave are _______, and the QRS (in ascending order V1, V2, V3........) starts ______ and ends _______.

Answer 34

Positive Negative Positive

Question 35

The ___ wave represents atrial depolarization

Answer 35

P wave

Question 36

The _____ ______ represents the bridge between atrial and ventricle activation

Answer 36

PR interval

Question 37

Within the PR interval, name the electrical pathway (in order) from atrium to ventricles.

Answer 37

AV node Bundle of His Bundle branches Ventricles (purkinje fibers)

Question 38

A conduction delay within the PR interval likely represents slow ___ node conduction

Answer 38

AV node

Question 39

What is the normal PR interval duration?

Answer 39

0.12-0.2 seconds

Question 40

What is the normal QRS duration?

Answer 40

0.06-0.1 seconds

Question 41

This represents ventricular depolarization on an ECG

Answer 41

QRS complex

Question 42

The ___ wave represents ventricular repolarization

Answer 42

T wave

Question 43

What is the Q wave? Why is it there? Why do we care? (Probably not a test question, but important to know and will help in understanding pathological Q waves)

Answer 43

Physiologic activation of the ventricles begins at the left side of the interventricular septum. These early septal depolarization forces are oriented anteriorly and to the right. As a result, small (<0.04 sec in duration) "septal" Q waves typically occur in the lateral precordial leads (which have a left-right spatial orientation) and in one or more of the limb leads (except aVR). https://www.uptodate.com/contents/pathogenesis-and-diagnosis-of-q-waves-on-the-electrocardiogram?search=q%20wave&source=search_result&selectedTitle=1~125&usage_type=default&display_rank=1

Question 44

What segment represents ventricular repolarization?

Answer 44

ST segment

Question 45

The ____ segment is most sensitive to myocardial ischemia

Answer 45

ST segment

Question 46

With this type of ischemia, you will see ST elevation with/without tall T waves

Answer 46

Transmural ischemia

Question 47

This type of ischemia is secondary to acute coronary artery occlusion or spasm

Answer 47

Transmural ischemia

Question 48

With this type of ischemia, you will see ST depression

Answer 48

subendocardial ischemia

Question 49

This type of ischemia is secondary to stable angina or | significant but stable CAD

Answer 49

subendocardial ischemia

Question 50

decreased R wave amplitude, pathologic Q wave

Answer 50

MI

Question 51

abnormal Q wave

Answer 51

Transmural MI

Question 52

less likely to have Q wave

Answer 52

Subendocardial MI

Question 53

ST depression, flat T wave, prominent U wave Prolongs repolarization Long QT syndrome Torsades de points

Answer 53

hypokalemia

Question 54

Narrow, peaked T wave, short QT interval QRS widening, flat P wave, PR prolongation, 2nd & 3rd degree block ventricular flutter, asystole

Answer 54

hyperkalemia

Question 55

short QT, decreased T wave amplitude or inversion

Answer 55

hypercalcemia

Question 56

prolonged QT

Answer 56

hypocalcemia