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Flashcards in OMSA Deck (316):
1

2 chambers of heart contain

Right and left atria (receive) and right and left ventricles (pump)

2

Function of the 2 heart chambers

Right pumps to lungs left pumps everywhere else

3

Valve found between right atrium and right ventricle

Tricuspid

4

What do valves do

Prevent back flow of blood and separates chambers

5

What valve lies between the left atrium and left ventricle

Mitral

6

What valve allows blood to flow through right ventricle to pulmonary artery

Pulmonary valve

7

What valve allows blood to flow from the left ventricle into the aorta

Aortic valve

8

What noise is the first sound of the heart beat (lub) caused by

Mitral and tricuspid valves closing

9

What is the second sound of a heart beat (dub) caused by

Aortic and pulmonic valves closing

10

Angina pectoris

Decrease in blood supply to heart causing chest pain

11

Myocardial infarction

Necrosis of the heart caused by deprivation of oxygen for too long or heart attack

12

What does the info on the EKG represent

Electrical activity of contraction of the myocardium

13

What is another term for negative myocytes

Polarized

14

Cells while resting are

Negative

15

Beta one controls

Heart

16

Name the two systems that comprise the autonomic nervous system

Sympathetic and parasympathetic

17

Follow the blood flow of the heart: superior and inferior vena cava to the ____ atrium, past the ___ valve and into the ____ ventricle. Past the ____ valve to the ____ artery to the lungs for oxygen

Right, tricuspid, right, pulmonic, pulmonary

18

Trace the path of the conduction system through the heart: ___ node to the ___ node to the bundle of his to the ___ and finally to the ___

SA, AV, bundle branches,purkinjie fibers

19

The ___ valve lies between the right atrium and right ventricle, while the ___ valve lies between the left atrium and left ventricle

Tricuspid, mitral

20

From the lungs blood travels through the ___ vein to the ___ atrium past the __ valve to the __ ventricle then through the __ valve into the __ where it is pumped into the rest of the body

Pulmonic, left, mitral, left, aortic, aorta

21

Stimulation of the vagus nerve will ___ the heart rate

Decrease

22

Another name for the sympathetic nerve is the cholinergic system

False

23

Insufficient blood flow through the coronary arteries can result in

Angina

24

What is the difference between angina and myocardial infarction

Angina is chest pain due to inadequate oxygenation while myocardial infarction is death of the actual heart muscle

25

What does ischemia mean

Inadequate blood supply

26

What causes a heart murmur

Turbulence in the blood flow across the heart valves

27

Symptoms of right sided heart failure

Ascities and pitting edema

28

What is the mnemonic for a patient having a myocardial infarction

MONA

29

Symptoms of left sided heart failure

Shortness of breath, pulmonary edema

30

What medication is used in the treatment for angina

Nitroglycerin

31

What do beta blockers do

Reduce the heart rate and blood pressure

32

What are the two kinds of heart failure

Right and left

33

Left sided heart failure often leads to

Right sided heart failure

34

Which patient needs antibiotic premedication

A 70 year old with a prosthetic valve

35

The first heart sound is caused by

Mitral and tricuspid valves closing

36

A patient that has a history of CABG (Coronary Artery Bypass Grafting) needs to be premeditated with antibiotics

False

37

Causes of hypotension include what

Excessive medication, allergic reaction and cardiac dysthymia but not seizures

38

Symptoms of severe hypotension include what

Dizziness, fainting, orthostatic hypotension but not chest pain

39

Your pt wonders if they should stop their blood pressure medication the morning of their surgery since they can’t have anything to eat or drink. What do u tell them

Take your meds with a small sip of water

40

The blood pressure that is considered the upper level of normal is

140/90

41

2 kinda of stroke include

Ischemic and hemorrhagic

42

Treatment for a hypertensive crisis include

A beta blocker and vasodilator

43

High blood pressure may increase a chance of heart attack and

Stroke

44

Pt in hypertensive crisis may complain of

Headache

45

The pneumonic for diagnosing a stroke is

FAST: Face, Arm, Speech, Time

46

Sinus arrhythmia is the same as asystole

False

47

What is the correct sequence of impulses through the heart

SA node-AV node-Bundle of His-perkinjie fibers

48

The best treatment for ventricular fibrillation is

Defibrillation

49

Ur pt has an irregularly irregular pulse. They most likely have

Atrial fibrillation

50

The most common rhythm of cardiac arrest is

Ventricular fibrillation

51

The T wave is caused by

Repolarization of the ventricles

52

The QRS complex is caused by

Depolarization of the ventricles

53

What is the intrinsic rate of the SA node

60-100 beats per minute

54

The P wave is caused by

Depolarization of the atria

55

___ is more dangerous than ___

Multifocal PVC; unifocal PVC

56

A pt who is in a narrow complex tachycardia is complaining of chest pain. U notice that the BP is falling and the pt has an altered level of consciousness. What do u do

Sedate then perform a synchronized cardioversion

57

Vagal maneuvers can be used in diagnosis and treatment in pts with what rhythm

Supraventricular tachycardia

58

The first medication for a pt in ventricular fibrillation is

Epinephrine 1 mg IV

59

U come across a pt that is not breathing and is without a pulse. What do u do next?

Start chest compressions

60

All bradycardias with a rate lower than 50 beats should be given atropine
.5 mg

False

61

When doing CPR what is the rate of chest compressions per minute

100

62

A pt in ventricular fibrillation has a pulse

False

63

You can defibrillate asystole

False

64

The second medication used in the treatment for ventricular fibrillation is

Amiodarone

65

The hairlike projections on the cells within the trachea are called

Cilia

66

Foreign bodies that are aspirated usually go down the ____ mainstem bronchus

Right

67

Inspiration is more of a ___ process and expiration is more of a ____ process

Active; passive

68

The anatomic structure where a circothyrotomy is performed is

Through the circothyroid membrane

69

Oxygen is carried by the

Red blood cell

70

The order of airflow of the upper respiratory system is

Nasopharynx, oropharynx, larygopharynx, trachea

71

The __ bronchus is straighter and wider while the __ bronchus is narrower and at a more acute angle

Right, left

72

Gas exchange (where oxygen goes from the air to the blood and CO2 goes from blood to the air) takes place in the:

Alveoli

73

Control of respiration is dependent on

The level of carbon dioxide in the blood

74

The order of airflow in the lower respiratory system is

Trachea, right and left mainstream bronchi, bronchioles, alveoli

75

Asthma is a disease of

Bronchoconstriction

76

An LMA is the most ideal, preferred method to maintain airway

False

77

With nitrous oxide delivery systems, at the maximum nitrous oxide delivery rate, at least how much oxygen should be concurrently delivered

22%

78

Rescue inhalers are usually a

Bronchodilator

79

Ideally, how long should a patient stop smoking before a procedure

8 weeks

80

You can insert an LMA (laryngeal mask airway) on a conscience patient with an intact gag reflex

False

81

Normal adult patients should show a pulse oximeter reading of __% on room air

96

82

What medication is NOT used for asthma

A (alpha) agonist

83

What medications ARE used for asthma

Corticosteroids, B agonist (bronchodilator), antihistamines

84

Pulse oximeter readings can be affected by

Patient movement, nail polish, chronic exposure to nicotine, cold extremities, venous congestion

85

Treatment of emesis is to turn the patient to the

Right

86

Medication to treat persistent laryngospasm is

Succinylcholine (10-20mg)

87

Treatment for respiratory depression from an overdose of narcotics and benzodiazepines is __ and __ respectively

Naloxone, flumazenil

88

Initial treatment for laryngospasm is

Suction the oropharynx

89

The most common cause of airway obstruction is

Tongue

90

The symptoms of hyperventilation are caused by

The decrease in blood CO2

91

Medication to treat bronchospasm are usually

Beta agonists

92

If a patient hasn’t had asthma in year, you don’t have to have them puff their inhaler

False

93

The crowing sound indicating a laryngospasm is called

Stridor

94

Protective reflex closure of the vocal chord is

Laryngospasm

95

What is the danger of doing surgery on a patient who is adrenally suppressed

They may experience a drop in blood pressure and shock

96

What is the normal blood glucose level

70-100

97

What is the problem with performing surgery on a patient who’s blood sugar is too high

They will have difficulty with wound healing

98

What does the thyroid do

Produces hormones that control metabolism and growth

99

The two types of diabetes are

Type 1: beta cells don’t produce insulin at all
Type 2: insulin binds to cells but gates don’t open for glucose

100

What is the function of insulin

To drive glucose into the cells

101

What is the endocrine system

The study of glands that secrete hormones that regulate the body

102

What are symptoms of diabetes

Polyphagia (always hungry), polydypsea (always thirsty), polyuria (frequent restroom)

103

What is the function of glucagon

To release glucose from the cells into the bloodstream

104

Where is insulin produced

Pancreas

105

An important blood level count to inquire about in an HIV positive patient is

T helper cell count

106

What are signs of a true allergic reaction

Itchy rash

107

In a patient in anaphylactic shock, the two most important considerations are: 1-the drop in blood pressure and 2-

Laryngeal edema

108

An extreme allergic reaction is called

Anaphylactic shock

109

Patients with liver disease should be given high doses of anesthetic agents

False

110

Indications for patients to be on Coumadin are

Stroke or cerebral vascular accident

111

Your patient is in kidney failure and requires dialysis. He is on a Monday Wednesday Friday dialysis schedule. Which day do u want to do surgery on?

Tuesday Thursday

112

The optimal time for elective procedures to be performed on a pregnant patient is

Second trimester

113

Medication for allergic reaction include Benadryl and

Decadron

114

Johnny’s mother states he is allergic to penicillin because he got sick to his stomach last time he took it. You calmly tell mom:

No Mom, Johnny had an adverse reaction not a true allergy

115

What is the preferred IV fluid

NS

116

The danger of an intra-arterial injection is

Intense chemical inflammation destroying the inner layer of the artery, preventing blood supply tot he limb

117

Which is the preferred vein for the IV site for oral surgery procedure

Antecubital fossa

118

Why must you run the IV fluid through the line before administering to the patient

To prevent air embolus

119

Treatment of an intra-arterial injection is

10cc 1% procaine

120

Less severe venipuncture complications include

Phlebitis and extravasation

121

The preferred method of starting an IV is to use

A catheter

122

When inserting the catheter which artery is at risk

Brachial artery

123

Treatment for phlebitis includes

Pressure, moist heat and elevation

124

Inflammation of the vein is called

Phlebitis

125

The stimulus for respiration is

Increasing CO2 levels

126

Increased heart rate and blood pressure are due to stimulation of the

Sympathetic system

127

Anesthetic agents act by

Interfering with the depolarization of the membrane

128

Increase in salivation is due to stimulation of the

Parasympathetic system

129

Normally a nerve cell is polarized. This means...

There are more positive ions on the outside of the cell membrane and more negative ions on the inside of the cell

130

Nerves conduct impulses by

Depolarization of the nerve membrane

131

The main organ that eliminates the drugs is

Kidney

132

The two components of the autonomic nervous system are

Parasympathetic and sympathetic

133

Your patient is very very nervous. You probably want to give them an anesthetic Agent targeted at

The center for emotion

134

The main organ that Processes the anesthetic drugs and changes the chemical Structure of the drug is

Liver

135

Nitrous oxide is

Stored in blue tanks, is a non-flammable gas, should always be administered with oxygen, Produces euphoria and promotes relaxation

136

Atropine or glycopyrrolate are sometimes given to

Reduce salivary secretions

137

Steroids are used to

Decrease swelling and inflammation

138

The function of a narcotic is to

Minimize or eliminate pain

139

Benzodiazepines are reversed by

Romazicon (flumazinil)

140

The most rapid an effective method of administering drugs is

Intravenously

141

Oxygen is

Stored in green tanks, Should be administered to every patient undergoing surgery with sedation, Should be administered at a concentration of 30%Or higher when given with other inhaled agents,Should be given with caution two patients with COPD

142

The action of benzodiazepines are

To relax and sedate the patient

143

Morphine is stronger than Fentenyl

False

144

Simply shutting off the nitrous oxide and allowing the patient to breathe room air can result in

Diffusion hypoxia

145

Early signs of a local anesthetic overdose include

Anxiety, Disoriented, talkative

146

Ketamine is classified as a

Disassociative anesthetic

147

Contra indications for use of propofol are allergies to

Soy, egg, sulfa

148

What category of patients will usually require more propofol

Children and women

149

Ketamine can cause respiratory depression

False

150

Acetaminophen toxicity affects which organ

Liver

151

Brevital is classified as a

Barbiturate

152

Propofol is classified as a

Sedative hypnotic

153

Brevital can cause respiratory depression

True

154

Brevital may predispose the patient to

Laryngospasm

155

It is easy to prevent the patient from progressing From a Moderate sedation to a general anesthesia

False

156

A 78-year-old female is given 5 mg of verse said and 50 µg of fentanyl. She now needs her chin tilted upwards to keep her airway openAnd she does not respond to verbal stimuli. Her level of sedation is

Deep sedation possibly general anesthetic

157

A target organ for anesthetic drugs is

Brain

158

Versed is classified as a

Benzodiazepine

159

ASA NPO Guidelines recommend Restriction of clear fluids __ hours Before the procedure and restriction of solid food for __ hours Before the procedure

2, 6

160

Agents that induce respiratory depression include

Opioids, benzodiazepines, alkylphenols

161

What agents do not induce respiratory depression

Disassociative anesthetics

162

838-year-old female presents for a consultation. Her past medical history includes asthma, for which she takes daily medication, Adviar, as well as a rescue inhaler. She also has diabetes for which she takes metformin And insulin. Her ASA classification is

Class III

163

The function of a narcotic is

Analgesia or relief of pain

164

A Dr. request his assistant to take the patient’s vital signs Which include

Blood pressure, temperature, pulse

165

Examination of a patient with a protruded tongue reveals Visualization of the soft palate and the base of the uvula Only. This patient’s malampatti classification is

Class III

166

Eyelash reflex is a form of ___ reflex

Palpebral

167

It is OK to use the patient’s family to watch them during recovery while we deal with the next patient

False

168

Elderly patients require ___ medications than younger adults

Less

169

The most ideal airway management is

Endotracheal intubation

170

The following questions should be asked to a patient in recovery in the order of

Do they still need airway assistance, what is there oxygen saturation in room air, Is the patient awake

171

The trachea is ___ To the esophagus. This means that when the patient is laying supine The trachea will be __ To the esophagus

Anterior, superior

172

Johnny is a five-year-old male who requires extraction of four carious baby teeth. His mom calls the day before surgery stating he has come down with a cold. You should tell her

Wait until Johnny feels better and then we will schedule an appointment for two weeks after he is well

173

The stage of Anastasia or surgery can be Performed is

Stage three

174

Passage of the air into the lungs follows the course of

Nose/mouth, nasopharynx, oropharynx, larynx,trachea,

175

Children have __ Heart rates and __ blood pressure When compared to adults

Higher, lower

176

Your sedated patient vomits mid procedure. What do you do

Roll the patient to the right side and suction airway

177

Treatment for respiratory depression is

Narcan .4 mg IV

178

Laryngospasm is

Protective closure reflex of the vocal cords To prevent foreign material from Entering into lungs

179

The most common cause of airway obstruction is

Base of tongue falling back and occluding the airway

180

Bronchospasm occurs when

Constriction of smooth muscle walls of the bronchioles

181

The danger of administering Narcan For treatment of respiratory depression is

The Narcan may wear off before the respiratory depressive Effect of the narcotics wears off

182

Treatment of bronchospasm is

Suction airway, positive pressure ventilation

183

Bronchospasm could be diagnosed by

Expiratory wheeze and difficulty in positive pressure Ventilation

184

The side effect of succinylcholine to be careful of is

It’s a muscle relaxant and can cause the patient to stop breathing

185

Treatment for angina is

Nitroglycerin

186

The drug for treatment of a narcotic overdose is

Narcan

187

Preliminary treatment of a patient with hypotension is

Fluid challenge

188

The difference between angina and myocardial infarction is

Angina is caused by lack of oxygen in the coronary arteries while an MI implies necrosis or death of the heart muscle

189

MONA stands for

Morphine, Oxygen, nitroglycerin, aspirin

190

If a pt doesn’t take their antihypertensive medication before surgery it can result in

Rebound hypertension

191

Patients with ____ are more at risk of cardiovascular disease

Smokers, hypercholesterolemia, fam history, diabetes, obesity, sedentary life style, hypertension, advancing age, history of MI congestive heart failure, heart valve dysfunction

192

Treatment for a hypertensive crisis includes

Beta blocker

193

Symptoms of angina include

Crushing, squeezing chest pain

194

If your pt is determined to be in respiratory depression with a respiratory rate of 7 you

Head tilt to open the airway and apply full face mask with positive pressure O2

195

The medication used to treat overdose of a benzo is

Romazicon

196

What is more dangerous multifocal PVC or unifocal PVC

Multifocal

197

A patient is in asystole, your next move is to

Start CPR and give epinephrine 1mg

198

Is it possible to see a normal sinus rhythm on an EKG with no pulse

True

199

The cardiac rhythm in which the pt does not have a pulse are asystole, pulseless ventricular tachycardia, pulseless electrical activity and

Ventricular fibrillation

200

The drug of choice to speed up the heart in a symptomatic bradycardia is

Atropine

201

Pts with a dysrhythmia who are symptomatic will complain of chest pain, shortness of breath and

Dizziness and hypotension

202

The drug of choice used to treat a supraventricular tachycardia is

Adenosine

203

Your pt is extremely nervous and apprehensive. The EKG shows a sinus rhythm of 135 bpm. Your next step is to

Go ahead and sedate the pt because sinus tachycardia is normal to see in an anxious pt

204

An example of a vagal maneuver is

Have the pt bear down as if having a bowel movement

205

The most effective treatment for a pt in ventricular fibrillation is

Defibrillation

206

If a patient with a known seizure disorder doesn’t take his medication It can precipitate a seizure

True

207

For moderate allergic reactions in addition to Benadryl, This drug is often added

Decadron

208

Treatment of a mild allergic reaction Usually is prescribing

Benadryl

209

Treatment for syncope is

02, Trendelenburg position

210

If a diabetic take their medication as usual the day of the surgery We would worry about

Hypoglycemia

211

The first medication to consider in an anaphylactic crisis is

Epinephrine

212

The causes of syncope is

Slowed heart rate and blood pressure

213

A patient’s mother states the patient is allergic to Vicodin. She says he becomes nauseated with it is this a true allergy

No

214

The most common presentation of an allergic reaction is

Itchy red rash

215

A severe allergic reaction is called

Anaphylaxis

216

The trachea branches into the right and left main stem Bronchus. The patient is undergoing general anesthesia in your office To remove a tooth. The patient aspirates the tooth. Which long would you guess the tooth ended up in

Right

217

A patient with type two (non-insulin-dependent) Diabetes would typically be taking pills To control their blood glucose and their diabetes

True

218

You have a 17-year-old patient that is undergoing General Anastasia to remove four wisdom teeth. During the surgery you hear a high-pitched crowing sound. You look down and her chest and abdomen are not in sync When she is breathing. Her oxygen saturation begins to fall rapidly. Your diagnosis and treatment are

Laryngospasm: Administer positive pressure and succinylcholine if needed

219

The right side of the heart carries deoxygenated blood

True

220

Which of the following general drug categories Are used to treat someone experiencing an asthma attack

Beta agonist

221

A laryngospasm is a disorder of the

Upper airway

222

Your patients presents for surgery at 10am. He states that he has not had anything to eat or drink but out of habit he took his daily dose of insulin. He is pale trembling and no feeling well. You perform a finger stick as you do with all your diabetic patients. His blood glucose is 50. You have not started an IV yet. The best treatment option for this pt is to...

Start an IV and give D5W as your IV fluids

223

The most Common cardiac rhythm on an EKG For an adult patient in cardiac arrest is

Ventricular fibrillation

224

The classification of drugs Used to relieve pain is

Narcotics

225

Your patient is a relatively difficult anesthetic patient. He is morbidly obese With a short neck, recessed jaw, and a mallampatti class of four. You’re struggling to chin him. You already have a nasopharyngeal airway in. What else might you try before you into beat him

Laryngeal mask airway

226

The most frequent anatomical airway obstruction is

The tongue

227

The most concerning signs and symptoms of An acute anaphylactic reaction are

Airway edema and circulatory collapse

228

Two types of diabetes that are characteristically classified as the following

Type one: Insulin-dependent and type two: non-insulin-dependent

229

A patient with type one diabetes would typically be giving themselves shots Of insulin to control their blood glucose And to control their Diabetes

True

230

The correct air flow sequence from the nose to the lungs is

Nose, nasal pharynx, oral pharynx, laryngopharynx, Trachea, lungs

231

The agent used to reverse the effects of versed is

Romazicon (flumazenil)

232

The acronym fast refers to facial droop, Arm weakness, Speech problems, and time to call 911. This refers to what condition

Stroke

233

Which monitor gives the most information About ventilation

Capnograph

234

Dilation or widening of blood vessels And arteries will cause your blood pressure to increase

False

235

You are starting an IV on your patient through the anti-cubital fossa. The artery you want to avoid in the anti-cubital fossa is

Brachial artery

236

The ASA classification is used For assessing patients prior to General Anesthesia As a risk assessment tool. You have a patient with a history of only hypertension, high blood pressure, what classification would they be

ASA 2

237

The QRS complex on the EKG represents

Ventricular depolarization

238

A pediatric airway is different from an adult airway in that

Kids have a large tongue and conical shaped airway

239

Your patient has stopped breathing. What is the main primary physiological Mechanism that will restart this patient’s breathing

Excess of carbon dioxide

240

Drugs given to patients are usually metabolized In the body by what organ

Liver

241

You have a 68-year-old male patient with a history of hypertension. He had a heart attack a while back. When he had a heart attack He states he had it angioplasty with one stent placed. He’s anxious and wants to go to sleep for his extractions. Which anesthetic agent would you want to avoid

Ketamine

242

A patient calls one day after the removal of an infected tooth. She reports an itchy red rash all over her body after taking amoxicillin That your doctor prescribed. She is worried that she is allergic to amoxicillin. Your recommendation to her is

Stop the amoxicillin and take over-the-counter Benadryl

243

The difference between angina and myocardial infarction is

A myocardial infarction implies death or necrosis of the heart muscle

244

Your doctor has started an IV. You are hooking the IV line with the catheter. Which bag of IV fluids is the preferred Fluid for a routine healthy patient

LR

245

There are two main categories of local anesthetics used in dentistry. Most common category of local anesthetic used in oral and maxillofacial surgery’s is

Amide

246

What drug is most commonly associated with respiratory depression when given IV

Fentanyl

247

The P-wave in the EKG represents

Atrial depolarization

248

Constriction of or narrowing Of the coronary arteries can cause angina

True

249

Indications for patients to be on anticoagulants are

Stroke, pulmonary embolism, History of blood clot in the legs

250

The doctor asks you to assess the patient’s ventilation. The things you look at include the rising and falling of the chest and

Oxygen saturation and end title CO2

251

When insulin is given to a patient at lowers the patient’s blood glucose

True

252

Myocardial infarction of the heart muscle is reversible

False

253

A contraindication for the use of propofol is

Allergy to eggs

254

A patient has taking 20 mg of prednisone daily for the last 30 years for the rheumatoid arthritis. Your doctor is planning to remove a difficult deeply impacted wisdom tooth. Our concern preoperatively for this patient is

The patient will not be able to properly handle a flight or fight response From a stressful procedure

255

Anginas potentially reversible

True

256

Asthma is a disease of the long. Specifically Considered a disease of the

Lower airway, bronchiolar constriction

257

Normal pathway of the conducting system in the heart is

SA node, AV node, Bundle of his, Purkinje fibers

258

Stimulation of the sympathetic nervous system will result in

Increased heart rate, increased blood pressure

259

Classic symptoms of congestive heart failure include

Shortness of breath, Swollen ankles

260

Angina is due to

Decreased blood flow to the heart muscle

261

Atrial fib relation is a type of heart rhythm. Patients who have this rhythm will have an irregular pulse

True

262

Ketamine can cause hallucinations. The best medication to give with ketamine To reduce the incidence of the side effects is

Versed

263

In compartment syndrome, one can see an increase pressure in the forearm. This can be caused by venipuncture. This is considered a true medical emergency

True

264

Epinephrine is one of the components of local anesthesia. When epinephrine is added to local anesthesia It helps maintain the local anesthetic Close to the inferior alveolar nerve Potential he making it more effective for profound Local anesthesia. They should theoretically

Decrease the number of cartridges used to obtain a profound local anesthesia

265

Insulin converts

Glucose into glycogen

266

Can you compare the ventricles of the heart to the atria of the heart, The walls of the ventricles are thicker than the atria

True

267

Constrictions of or narrowing of the blood vessels and arteries Will cause your blood pressure to increase

True

268

One way for your doctor to know that they have inadvertently Placed an IV into an artery is

Pulsatile movement and bright red blood in the IV line

269

The left side of the heart carries deoxygenated blood

False

270

You just completed a surgical procedure on a patient. This patient received fentanyl, versed, and propofol Intravenously with LR As the fluids. The patient has been in recovery for 45 minutes And is still drowsy. Which medication is most likely causing them to be drowsy

Versed

271

The following is the correct sequence of blood flow through the heart

Superior/inferior vena cava, Right atrium, tricuspid valve, Right ventricle, Pulmonic valve, Pulmonary artery, pulmonary vein, Left atrium, mitral valve, left ventricle, Aortic valve, aorta

272

A patient with type one diabetes calls the morning of the surgery. She states that she knows she’s not supposed to have anything to eat or drink and is not sure what to do about her insulin. She Asks for instructions On her insulin that she normally injects her self with every morning. You instruct her to

You tell her to inject yourself with half the normal dose

273

Drugs given to the patient are usually excreted from the body after passing through what organ

Kidney

274

Signs and symptoms of a myocardial infarction

Chest pain not relieved by nitroglycerin, pain may radiate down the left arm or up to the left jaw, Blood pressure will drop with weak pulse, may experience nausea or vomiting

275

Signs and symptoms of congestive heart failure

Right sided failure: swelling of ankles and belly and distended neck veins. Left sided failure coughs pink frothy sputum, shortness of breath when they lay down, often wakes upIn the middle of the night gasping for air

276

Cerebral vascular accident is another name for

Stroke

277

What are the two types of strokes

Embolic stroke: a blood clot causes the blood vessel to become occluded Hemorrhagic stroke: a blood vessel ruptures and bleeds

278

Signs and symptoms of stroke

Weakness in extremities usually right side, facial palsy/slurred speech, headache

279

What What does not show up on an EKG

Atrial repolarization

280

What is considered bradycardia

A heart rate less than 60

281

What is tachycardia mean

Heart rate over 100

282

What are corticosteroids used for

Suppress inflammation

283

Where is cortisol produced

In the adrenal gland

284

Symptoms of adrenal insufficiency

Hypoglycemia, dehydration, weight loss, disorientation

285

What does your thyroid gland do

Produces hormones that regulate metabolism and growth

286

What does PVC stand for

Premature ventricular contraction (wide bizarre QRS complex) wave not traveling along right/left perkinjie fibers simultaneously

287

What is multifocal PVC caused by

Hypoxia

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What is ventricular tachycardia

Looks like string of PVC run together. Potentially fatal. Low blood output.

289

What is SVT

Supraventricular Tachycardia

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What is bigeminy

A PVC every other beat

291

On an ekg graph how much time is measured from dark line to dark line

.2 seconds

292

On an elf graph how much time does one square represent

.04

293

What is the intrinsic rate of that atria

60-80 bpm

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What is the inherit rate of the ventricles

20-40 bpm

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What is an ectopic foci

Excitable cell area of heart fired out of normal rhythm

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What are PJC’s

Premature junctional contraction

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What is congestive heart failure

Pump failure causing blood to back up.

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What is the treatment for CHF

Diuretic

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What are Korotkoff sounds

The force of ventricular contraction (systolic number)

300

What is the rule of 2’s

If pt has taken more than 20mg of hydrocortisone more than 2 weeks in the last 2 yrs then double their dose before surgery

301

Pts that have had chemotherapy need to have what checked before surgery

CBC (complete blood count)

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What does LR stand for

Lactated ringers (like saline but with more electrolytes

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What is normal physiologic tonicity of human fluid

.9%

304

What does 1:100,000 mean

1 gram in 100,000 cc or solution

305

What is a millimeter

One thousandth of a liter

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What is a milligram

One thousandth of a gram

307

Anatomy from top to bottom of arm

Biceps brachii, brachialis muscle, median nerve, brachial artery, tendon of biceps brachii, pronator teres, brachioradialis, flexor carpi radialis

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What are some drugs that are considered narcotics

Morphine, fent, Demerol, codeine

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What does ketamine do

Dissociative anesthetic. Causes blockade of an excitatory neurotransmitter. Potent analgesia and amnesia

310

What is cyanosis

Blue skin color

311

What are normal values of CO2 expiration

5-6% or 35-45 mm Hg

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What can happen with pts with compromised liver function

May not be able to clot and cannot process drugs as fast and therefore will need less

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What does propofol affect

Wakefulness, euphoria, and is an anti-nausea

314

Another word for zofran

Ondansetron (for nausea)

315

What is dyspnea

Difficultly breathing

316

What is bronchitis

Acute inflammation of mucus membranes of bronchial tube