Transcript Cardiac Monitoring and Cardiopulmonary Resuscitation Techniques

Cardiac Monitoring and
Cardiopulmonary Resuscitation
Techniques
A normal sinus rhythm can be identified
by:
I. A resting rate of 60 to 100 beats/min in
an adult
II.A P wave before every QRS complex
III.A regular rhythm
IV.A QRS complex after every P wave
V. A upright T wave in lead II
A. II and IV
B. II, III, and IV
C. I, II, III, and V
D.I, II, III, IV, and V
A normal sinus rhythm can be identified
by:
I. A resting rate of 60 to 100 beats/min in
an adult
II.A P wave before every QRS complex
III.A regular rhythm
IV.A QRS complex after every P wave
V. A upright T wave in lead II
A. II and IV
B. II, III, and IV
C. I, II, III, and V
D.I, II, III, IV, and V
A patient with an acute myocardial infarction
may have which of the following clinical
findings?
I. jaw pain
II. Diaphoresis
III. nausea and vomiting
IV.digital clubbing
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
A patient with an acute myocardial infarction
may have which of the following clinical
findings?
I. jaw pain
II. Diaphoresis
III. nausea and vomiting
IV.digital clubbing
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
Electrocardiogram monitoring is important
with an intensive care unit patient in all of
the following situations except:
A.If it is used to evaluate peripheral
perfusion
B.The patient has an electrolyte disturbance
C.The patient has a history of arrhythmias
D.The patient is being given a rapid infusion
of potassium
Electrocardiogram monitoring is important
with an intensive care unit patient in all of
the following situations except:
A.If it is used to evaluate peripheral
perfusion
B.The patient has an electrolyte disturbance
C.The patient has a history of arrhythmias
D.The patient is being given a rapid infusion
of potassium
After attaching a cardiac monitor to a patient's
chest, the respiratory therapist notes the
ECG recording contains artifact. Which of
the following could cause artifact in this
situation?
I. inadequate electrode contact
II. improper electrode placement
III. the patient scratching the electrodes
IV.disconnected leads
A. I and III only
B. I and IV only
C. II and III only
D. II and IV only
After attaching a cardiac monitor to a patient's
chest, the respiratory therapist notes the
ECG recording contains artifact. Which of
the following could cause artifact in this
situation?
I. inadequate electrode contact
II. improper electrode placement
III. the patient scratching the electrodes
IV.disconnected leads
A. I and III only
B. I and IV only
C. II and III only
D. II and IV only
While assisting the physician using a
synchronous defibrillator for cardioversion,
the unit does not discharge. The respiratory
therapist should check the
I. charge level of the defibrillator.
II. presence of a P wave.
III. chest lead connections.
IV.contact gel on the paddles.
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
While assisting the physician using a
synchronous defibrillator for cardioversion,
the unit does not discharge. The respiratory
therapist should check the
I. charge level of the defibrillator.
II. presence of a P wave.
III. chest lead connections.
IV.contact gel on the paddles.
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
A 59-year-old patient is brought to the
hospital with a complaint of sudden,
severe substernal chest pain and dyspnea.
What initial thing should the RRT
recommend?
A.Begin ECG monitoring
B.Draw and ABG
C.Get a CXR
D.Get a capnometer sample
A 59-year-old patient is brought to the
hospital with a complaint of sudden,
severe substernal chest pain and dyspnea.
What initial thing should the RRT
recommend?
A.Begin ECG monitoring
B.Draw and ABG
C.Get a CXR
D.Get a capnometer sample
Defibrillation should be done immediately in
which of the following patient situations?
A.Second degree heart block
B.Atrial flutter
C.Pulseless ventricular tachycardia
D.Sinus tachycardia
Defibrillation should be done immediately in
which of the following patient situations?
A.Second degree heart block
B.Atrial flutter
C.Pulseless ventricular tachycardia
D.Sinus tachycardia
While performing CPR on a patient with chronic
CO 2 retention, the resuscitation bag should
be used
A.without a reservoir and oxygen at 5 L/min.
B.with a reservoir and an oxygen blender set at
40%.
C.with a reservoir and oxygen at 15 L/min.
D.without oxygen and a reservoir.
While performing CPR on a patient with chronic
CO 2 retention, the resuscitation bag should
be used
A.without a reservoir and oxygen at 5 L/min.
B.with a reservoir and an oxygen blender set at
40%.
C.with a reservoir and oxygen at 15 L/min.
D.without oxygen and a reservoir.
You are the RRT attending the delivery of a
preterm neonate. His vital signs are:
respiratory rate 12; heart rate 70. In
addition, he has peripheral cyanosis and is
responding minimally to stimulation. What
should be done?
A.Direct supplemental oxygen to his face
B.Begin chest compressions
C.Begin manual ventilation with 100%
oxygen
D.Continue to stimulate the newborn to
breathe more deeply
You are the RRT attending the delivery of a
preterm neonate. His vital signs are:
respiratory rate 12; heart rate 70. In
addition, he has peripheral cyanosis and is
responding minimally to stimulation. What
should be done?
A.Direct supplemental oxygen to his face
B.Begin chest compressions
C.Begin manual ventilation with 100%
oxygen
D.Continue to stimulate the newborn to
breathe more deeply
Pulmonary Artery Catheter:
Waveform
A 3-daypostoperative open-heart surgery patient has an
arterial catheter in the right radial artery for
continuous blood pressure measurements. Because of
retained secretions, the respiratory therapist places
him into a head down position for postural drainage
therapy. The nurse notices that the patient’s blood
pressure is less than before being placed into this new
position. After the patient is returned to the original
position, the blood pressure is the same as it was
originally. How can the therapist explain the blood
pressure changes?
A. There was an air bubble in the arterial catheter
B. There was a clot in the arterial catheter
C. The patient’s body was below the level of the pressure
transducer
D. Postural drainage positions always cause the blood
pressure to decrease
A 3-daypostoperative open-heart surgery patient has an
arterial catheter in the right radial artery for
continuous blood pressure measurements. Because of
retained secretions, the respiratory therapist places
him into a head down position for postural drainage
therapy. The nurse notices that the patient’s blood
pressure is less than before being placed into this new
position. After the patient is returned to the original
position, the blood pressure is the same as it was
originally. How can the therapist explain the blood
pressure changes?
A. There was an air bubble in the arterial catheter
B. There was a clot in the arterial catheter
C. The patient’s body was below the level of the pressure
transducer
D. Postural drainage positions always cause the blood
pressure to decrease
A patient with advanced emphysema is admitted to
the respiratory intensive care unit. He is placed
on a 24% Venturi-type mask and has a
pulmonary artery catheter inserted. His initial
pulmonary vascular resistance (PVR) is 300
dynes/sec/cm-5, and the PaO2 is 57 torr. The
physician orders him increased to 28% oxygen.
The resulting PVR is 220 dynes/sec/cm-5, and the
PaO2 is 63 torr. Based on this information, what
would you recommend?
A. Decrease the oxygen to 24%
B. Place the patient on a ventilator
C.Administer a bronchodilator
D.Keep the patient on 28% oxygen
A patient with advanced emphysema is admitted to
the respiratory intensive care unit. He is placed
on a 24% Venturi-type mask and has a
pulmonary artery catheter inserted. His initial
pulmonary vascular resistance (PVR) is 300
dynes/sec/cm-5, and the PaO2 is 57 torr. The
physician orders him increased to 28% oxygen.
The resulting PVR is 220 dynes/sec/cm-5, and the
PaO2 is 63 torr. Based on this information, what
would you recommend?
A. Decrease the oxygen to 24%
B. Place the patient on a ventilator
C.Administer a bronchodilator
D.Keep the patient on 28% oxygen
Capnography will be used to monitor a
patient’s recovery from anesthesia. What
gas should be used for the “zero”
calibration?
A.Room air for 0% carbon dioxide
B.Room air for 21% oxygen
C.5% carbon dioxide
D.The same concentration of anesthetic gas
as used with the patient
Capnography will be used to monitor a
patient’s recovery from anesthesia. What
gas should be used for the “zero”
calibration?
A.Room air for 0% carbon dioxide
B.Room air for 21% oxygen
C.5% carbon dioxide
D.The same concentration of anesthetic gas
as used with the patient
Your patient is in the intensive care unit and
is being monitored with a pulmonary
artery catheter. She has the following
parameters: PAP 35/20 mmHg; PCWP 9
mmHg; CVP 10 mmHg. You would
interpret the data to indicate that she:
A.Has right ventricular failure/ cor pulmonale
B.Has left ventricular failure
C.Has increased pulmonary vascular
resistance
D.Is hypovolemic
Your patient is in the intensive care unit and
is being monitored with a pulmonary
artery catheter. She has the following
parameters: PAP 35/20 mmHg; PCWP 9
mmHg; CVP 10 mmHg. You would
interpret the data to indicate that she:
A.Has right ventricular failure/ cor pulmonale
B.Has left ventricular failure
C.Has increased pulmonary vascular
resistance
D.Is hypovolemic
A 40-year old patient receiving mechanical
ventilation has an arterial line in place. It is
noticed that a significant difference exists
between the blood pressure taken by cuff on the
left arm and the blood pressure taken by arterial
line on the right arm. What could explain this
difference?
I. A clot is at the tip of the catheter
II. There is an air bubble in the arterial line
III.The ventilator’s peak pressure is too high
IV.The patient has a ventricular septal defect
A. I and II
B. II and III
C. I, III, and IV
D. I, II, III, and IV
A 40-year old patient receiving mechanical
ventilation has an arterial line in place. It is
noticed that a significant difference exists
between the blood pressure taken by cuff on the
left arm and the blood pressure taken by arterial
line on the right arm. What could explain this
difference?
I. A clot is at the tip of the catheter
II. There is an air bubble in the arterial line
III.The ventilator’s peak pressure is too high
IV.The patient has a ventricular septal defect
A. I and II
B. II and III
C. I, III, and IV
D. I, II, III, and IV
An adult patient is receiving mechanical
ventilation when the following data are
gathered:
9:00 am 11:00 am
PaO2
75
53 mmHg
PVR
120
340 dynes/sec/cm-5
PCWP
8
10 mmHg
PAP
25/10
42/21 mmHg
How should the results be interpreted
A.Pulmonary edema
B.Pulmonary embolism
C.Pneumonia
D.Cardiac tamponade
An adult patient is receiving mechanical
ventilation when the following data are
gathered:
9:00 am 11:00 am
PaO2
75
53 mmHg
PVR
120
340 dynes/sec/cm-5
PCWP
8
10 mmHg
PAP
25/10
42/21 mmHg
How should the results be interpreted
A.Pulmonary edema
B.Pulmonary embolism
C.Pneumonia
D.Cardiac tamponade
A 35-year-old patient in the intensive care
unit has the following hemodynamic data.
Which of them indicates a problem with
the patient?
A. SVR of 600 dynes/sec/cm-5
B. CI of 3 L/min/m2
C. PvO2 of 38 torr
D. Shunt of 4%
A 35-year-old patient in the intensive care
unit has the following hemodynamic data.
Which of them indicates a problem with
the patient?
A. SVR of 600 dynes/sec/cm-5
B. CI of 3 L/min/m2
C. PvO2 of 38 torr
D. Shunt of 4%
An unconscious 25-year-old patient is admitted with
viral pneumonia, vomiting, and diarrhea.
Mechanical ventilation is initiated, and flowdirected pulmonary artery (Swan-Ganz) catheter
is inserted. The following data are gathered:
Pulmonary artery pressure, 22/8 mm Hg;
Pulmonary capillary wedge pressure, 3 mm Hg;
Central venous pressure, 0 mm Hg; blood
pressure, 90/60 mm Hg; Pulse, 142/min.
What is the most likely cause of these findings?
• Hypovolemia
• High ventilating pressures
• Bronchospasm
• Rupture of the balloon on the catheter
An unconscious 25-year-old patient is admitted with
viral pneumonia, vomiting, and diarrhea.
Mechanical ventilation is initiated, and flowdirected pulmonary artery (Swan-Ganz) catheter
is inserted. The following data are gathered:
Pulmonary artery pressure, 22/8 mm Hg;
Pulmonary capillary wedge pressure, 3 mm Hg;
Central venous pressure, 0 mm Hg; blood
pressure, 90/60 mm Hg; Pulse, 142/min.
What is the most likely cause of these findings?
• Hypovolemia
• High ventilating pressures
• Bronchospasm
• Rupture of the balloon on the catheter
Which of the following clinical observations
is most commonly associated with right
heart failure?
A. peripheral edema
B. muscle wasting
C. tracheal deviation
D. skin flushing
Which of the following clinical observations
is most commonly associated with right
heart failure?
A. peripheral edema
B. muscle wasting
C. tracheal deviation
D. skin flushing
While assisting the physician using a synchronous
defibrillator for cardioversion, the unit does not
discharge. The respiratory therapist should
check the
I. charge level of the defibrillator.
II. presence of a P wave.
III. chest lead connections.
IV. contact gel on the paddles.
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
While assisting the physician using a synchronous
defibrillator for cardioversion, the unit does not
discharge. The respiratory therapist should
check the
I. charge level of the defibrillator.
II. presence of a P wave.
III. chest lead connections.
IV. contact gel on the paddles.
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
A patient's chest radiograph shows diffuse alveolar infiltrates.
The following data are available:
Which of the following should be used to differentiate between
cardiac and noncardiac etiology for these results?
A. right atrial pressure
B. central venous pressure
C. mean pulmonary artery pressure
D. pulmonary capillary wedge pressure
A patient's chest radiograph shows diffuse alveolar infiltrates.
The following data are available:
Which of the following should be used to differentiate between
cardiac and noncardiac etiology for these results?
A. right atrial pressure
B. central venous pressure
C. mean pulmonary artery pressure
D. pulmonary capillary wedge pressure
A patient with an acute myocardial infarction may have which
of the following clinical findings?
I. jaw pain
II. diaphoresis
III. nausea and vomiting
IV. digital clubbing
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
A patient with an acute myocardial infarction may have which
of the following clinical findings?
I. jaw pain
II. diaphoresis
III. nausea and vomiting
IV. digital clubbing
A. I, II, and III only
B. I, II, and IV only
C. I, III, and IV only
D. II, III, and IV only
After attaching a cardiac monitor to a patient's
chest, the respiratory therapist notes the ECG
recording contains artifact. Which of the
following could cause artifact in this
situation?
I. inadequate electrode contact
II. improper electrode placement
III. the patient scratching the electrodes
IV. disconnected leads
A. I and III only
B. I and IV only
C. II and III only
D. II and IV only
After attaching a cardiac monitor to a patient's
chest, the respiratory therapist notes the ECG
recording contains artifact. Which of the
following could cause artifact in this
situation?
I. inadequate electrode contact
II. improper electrode placement
III. the patient scratching the electrodes
IV. disconnected leads
A. I and III only
B. I and IV only
C. II and III only
D. II and IV only
A patient hospitalized with a deep-vein
thrombosis in the leg experiences sudden
shortness of breath. Which of the
following should be recommended to
evaluate the patient’s situation?
• Lung compliance
• Electrocardiogram
• Chest radiograph
• VD/VT
A patient hospitalized with a deep-vein
thrombosis in the leg experiences sudden
shortness of breath. Which of the
following should be recommended to
evaluate the patient’s situation?
• Lung compliance
• Electrocardiogram
• Chest radiograph
• VD/VT
The End