AAA Diagnosis and Management Quiz
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Questions and Answers

What is the primary treatment for tension pneumothorax?

  • Needle decompression followed by chest tube placement (correct)
  • Immediate chest tube insertion
  • Covering the wound with sterile dressing
  • Observation and monitoring of symptoms

    • Which formula is used to calculate fluid resuscitation after burns?

  • Modified Brooke Formula
  • Alder Creek Calculation
  • Harrison's Equation
  • Parkland Baxter Formula (correct)

    • What is a major risk factor for renal failure in patients with compartment syndrome due to femur fracture?

  • Enhanced renal perfusion pressure
  • Decreased blood flow to kidneys (correct)
  • Increased blood volume
  • Improved urinary output

    • In the context of trauma management, what is the meaning of 'D' in the ABCDEFG approach?

    <p>Disability assessment</p> Signup and view all the answers

    Which of the following conditions is characterized by an increase in lactic acid leading to metabolic acidosis?

    <p>Rhabdomyolysis</p> Signup and view all the answers

    What is the appropriate duration for suctioning to avoid potential complications?

    <p>No longer than 10 seconds</p> Signup and view all the answers

    Which of the following treatments is NOT included in the CBIGKD protocol for elevated potassium levels?

    <p>Beta blockers</p> Signup and view all the answers

    Which lead corresponds to the inferior area of the heart and is typically affected by RCA occlusion?

    <p>II, III, aVF</p> Signup and view all the answers

    Which medication is commonly used to relieve chest pain in acute myocardial infarction?

    <p>Morphine sulfate</p> Signup and view all the answers

    When managing a patient in acute myocardial infarction (MI), which symptom might be misinterpreted as indigestion?

    <p>Epigastric pain</p> Signup and view all the answers

    Which of the following best describes the purpose of Cerebral Perfusion Pressure (CPP)?

    <p>To ensure adequate blood flow to the brain</p> Signup and view all the answers

    What is the primary indication for using assist-control ventilation (ACV)?

    <p>To maintain a specific tidal volume regardless of patient effort</p> Signup and view all the answers

    In the arterial blood gas (ABG) interpretation, what condition does a pH of 7.32, PaCO2 of 50 mmHg, and HCO3 of 24 mEq/L indicate?

    <p>Acute respiratory acidosis</p> Signup and view all the answers

    Which of the following is a common effect of benzodiazepines used for sedation?

    <p>Decreased blood pressure</p> Signup and view all the answers

    What is the complication associated with hepatic encephalopathy due to liver failure?

    <p>Rising ammonia levels</p> Signup and view all the answers

    What is the role of succinylcholine as a neuromuscular blocking (NMB) agent?

    <p>To provide rapid onset muscle paralysis</p> Signup and view all the answers

    What distinguishes metabolic acidosis from other acid-base disorders?

    <p>Decreased HCO3 levels and low pH</p> Signup and view all the answers

    Which sedation agent, when used at doses of 5-50 mcg/kg/min, produces deep sedation?

    <p>Propofol</p> Signup and view all the answers

    What is the normal range for cardiac output (CO)?

    <p>4-8 liters</p> Signup and view all the answers

    Which of the following statements about stroke volume (SV) is accurate?

    <p>Normal stroke volume is typically 50-100 ml/beat.</p> Signup and view all the answers

    What does cerebral perfusion pressure (CPP) reflect?

    <p>The pressure needed to ensure blood flow to the brain.</p> Signup and view all the answers

    What is the normal range for systemic vascular resistance (SVR)?

    <p>800-1200</p> Signup and view all the answers

    What is the significance of an intracranial pressure (ICP) reading over 20 mm Hg?

    <p>It is a sign of a possible brain infarction.</p> Signup and view all the answers

    How is cerebral perfusion pressure (CPP) calculated?

    <p>CPP = MAP - ICP</p> Signup and view all the answers

    What should be done if intracranial pressure (ICP) monitoring transducer is moved?

    <p>Re-zero the transducer at the foramen of Monro.</p> Signup and view all the answers

    Which of the following is a potential complication associated with the use of a Swan-Ganz catheter?

    <p>Thromboembolism</p> Signup and view all the answers

    What is the appropriate intervention for a patient experiencing asystole?

    <p>CPR and administration of Epinephrine</p> Signup and view all the answers

    Which treatment is considered the mainstay for stable Atrial Flutter?

    <p>Ablation therapy</p> Signup and view all the answers

    What is the first-line treatment for unstable Ventricular Tachycardia?

    <p>Immediate defibrillation</p> Signup and view all the answers

    In a third-degree heart block, what is the recommended treatment?

    <p>Temporary pacemaker</p> Signup and view all the answers

    Which characteristic of Ventricular Fibrillation indicates the urgency for defibrillation?

    <p>Absence of synchronized rhythm</p> Signup and view all the answers

    For stable patients experiencing a Mobitz II block, what intervention is most appropriate?

    <p>Observation with a standby pacemaker</p> Signup and view all the answers

    How would you describe the ventricular response in Atrial Flutter?

    <p>Regular rhythm at a rapid rate between 200-350 bpm</p> Signup and view all the answers

    Which of the following conditions best exemplifies the significance of epinephrine in managing asystole?

    <p>To initiate electrical activity in non-functional myocardium</p> Signup and view all the answers

    What distinguishes Wenckebach arrhythmia from other heart blocks?

    <p>Progressive elongation of the PR interval until a QRS is dropped</p> Signup and view all the answers

    In the treatment of symptomatic unifocal PVCs, which medication is likely to be administered?

    <p>Amiodarone</p> Signup and view all the answers

    What is the primary management strategy for a patient experiencing ventricular fibrillation?

    <p>Immediate defibrillation and CPR</p> Signup and view all the answers

    In the management of atrial flutter, which of the following is considered a pharmacological intervention?

    <p>Calcium channel blockers</p> Signup and view all the answers

    Which classification of heart block is characterized by a progressive prolongation of the PR interval until a QRS complex is dropped?

    <p>Second-degree heart block, Type I</p> Signup and view all the answers

    What is the recommended response to asystole in a cardiac arrest scenario?

    <p>Administer epinephrine and continue CPR</p> Signup and view all the answers

    Which intervention is typically used for patients with stable ventricular tachycardia?

    <p>Intravenous procainamide therapy</p> Signup and view all the answers

    Which factor differentiates stable from unstable angina?

    <p>Severity of associated symptoms</p> Signup and view all the answers

    What is the appropriate treatment protocol for atrial fibrillation in an unstable patient?

    <p>Synchronized cardioversion</p> Signup and view all the answers

    Which of the following symptoms could indicate a complication when managing a patient with heart block?

    <p>Dizziness and confusion indicating potential syncope</p> Signup and view all the answers

    What is the main mechanism of action for beta-adrenergic blockers in managing myocardial infarction?

    <p>Decrease heart rate and myocardial oxygen demand</p> Signup and view all the answers

    For a patient showing signs of ventricular tachycardia with a pulse, what initial treatment is typically recommended?

    <p>Amiodarone infusion</p> Signup and view all the answers

    Which of the following is a critical component when treating a patient with acute chest pain indicative of possible MI?

    <p>Provide immediate administration of aspirin</p> Signup and view all the answers

    In patients with severe hypoxia during suctioning, what is an essential step before proceeding?

    <p>Pre-oxygenate the patient</p> Signup and view all the answers

    What differentiates third-degree heart block from other types?

    <p>No relationship between P waves and QRS complexes</p> Signup and view all the answers

    Study Notes

    AAA (Aortic Aneurysm)

    • AAA is a bulge in the aorta.
    • Symptoms include:
      • Dull, vague pain in the abdomen, back, or flank.
      • Pain can be acute and intense in ruptured AAAs.
      • Sensation of a pulsatile mass in the abdomen.
      • Hypotension, often manifesting as syncope (fainting).
    • Associated complications include:
      • Diminished femoral pulses.
      • "Blue Toe" Syndrome, caused by microemboli from aortic thrombus.
      • Duodenal obstruction, leading to vomiting and weight loss.
      • Vertebral body erosion, leading to severe back pain.

    AAA Diagnosis and Management

    • AAA diagnosis involves assessing small/stable, large/unstable, and ruptured AAAs.
    • Goal: Slow the rate of AAA growth so it does not rupture within the patient's lifetime.
    • Treatment options include:
      • Surveillance for small/stable AAAs.
      • Surgery for large/unstable or ruptured AAAs.

    Hemodynamic Monitoring

    • Includes various waveforms:
      • RA waveform: Normal value 0-8 mmHg; RAP=CVP; wave fluctuations due to contractions.
      • RV waveform: Normal value 15-25/0-8 mmHg; catheter in RV may cause ventricular ectopy; Swan-Ganz tip may drift from PA to RV.
      • PA waveform: Normal value 15-25/8-15 mmHg; dicrotic notch represents PV closure; PAD approximates PAWP (LVEDP), in absence of lung or MV disease.
      • PAWP waveform: Normal value 8-12 mmHg; balloon floats and wedges in pulmonary artery; PAWP=LAP=LVEDP; wedging can cause capillary rupture.
    • Post-insertion procedures:
      • Assess ECG for dysrhythmias.
      • Check for respiratory distress.
      • Ensure sterile dressing is in place.
      • Check PCXR for placement.
      • Zero and level the transducer(s) at the phlebostatic axis.
      • Evaluate quality of waveforms (configuration, dampening, catheter whip).
      • Obtain opening pressures and waveform tracings.
      • Assess insertion site length.
      • Ensure stopcock openings are covered with sterile caps.
      • Inform the physician of any abnormalities.

    Hemodynamic Parameters

    • CO: Cardiac Output
    • CI: Cardiac Index
    • SV: Stroke Volume
    • SVR: Systemic Vascular Resistance
    • PVR: Pulmonary Vascular Resistance
    • SvO2/ScvO2: Mixed venous oxygen saturation

    Cerebral Perfusion Pressure (CPP)

    • CPP is the pressure needed to ensure blood flow to the brain.
    • Calculation: CPP = MAP – (CVP or ICP), whichever is higher.

    Intracranial Pressure (ICP)

    • ICP involves measuring intracranial pressure.

    Cerebral Vasospasm

    • Cerebral vasospasm is a condition involving spasms of the brain blood vessels.

    Brain Death

    • Diagnosed using different tests:
      • Oculocephalic (doll's eye) reflex.
      • Oculovestibular (cold caloric) reflex.
      • Apnea test.

    Ischemic Stroke vs. Hemorrhagic Stroke

    • Ischemic strokes result from a blood clot blocking blood flow to the brain.
    • Hemorrhagic strokes result from bleeding in the brain.

    Traumatic Brain Injuries

    • Initial care focuses on preventing further damage.

    Ventilator Settings

    • PEEP: Positive end-expiratory pressure.
    • ACV: Assist-control ventilation.
    • SIMV: Synchronized intermittent mandatory ventilation.
    • PS: Pressure support.
    • PC: Pressure control.
    • CPAP: Continuous positive airway pressure.

    Non-invasive Positive Pressure Ventilation (NIPPV)

    • Used for patients who do not require intubation.

    Intubation Drugs

    • Sedatives: Benzodiazepines (Ativan, Versed), Propofol (Diprivan).
    • Neuromuscular blockers: Zemuron (rocuronium), Norcuron (vecuronium), Tracrium (atracurium), Pavulon (pancuronium), Succinylcholine.

    Arterial Blood Gases (ABGs)

    • pH: 7.34-7.45
    • PaCO2: 35-45
    • HCO3: 22-26

    ABG Interpretations

    • Respiratory acidosis: pH low, PaCO2 high, HCO3 may stay normal or slightly elevated in acute cases.
    • Metabolic acidosis: pH low, PaCO2 normal, HCO3 low.
    • Respiratory alkalosis: pH high, PaCO2 low, HCO3 may stay normal or slight decrease in acute cases.
    • Metabolic alkalosis: pH high, PaCO2 normal, HCO3 high.

    Various Conditions

    • End Stage COPD: The final stage of Chronic Obstructive Pulmonary Disease.
    • Esophageal Varices: Enlarged, swollen veins in the esophagus due to portal hypertension.
    • Acute Pancreatitis: Inflammation of the pancreas.
    • Cirrhosis: Chronic liver disease leading to scarring and reduced liver function, resulting in complications like hepatic encephalopathy, ascites, and esophageal varices.
    • Hepatic Encephalopathy: A terminal complication of liver disease, associated with rising ammonia levels (normal 15-45 mcg N/dL).
    • Hyperthyroidism: Overactive thyroid gland.
    • Retroperitoneal Aortic Rupture: Rupture of the aorta behind the peritoneum, often requiring urgent diagnostics.
    • Femur Fracture: A fracture of the femur bone, often high in blood loss, and risk for compartment syndrome, rhabdomyolysis, and metabolic acidosis.
    • Suctioning Protocols: Including pre-oxygenating, preventing longer than 10-second suctioning, ensuring normal saline is not used in the endotracheal tubes, and monitoring for dysrhythmias.
    • Elevated Potassium Treatment: Procedures like calcium gluconate, bicarbonate, insulin, glucose, kayexalate, and dialysis are used.
    • Chronic & Acute Renal Failure

    Cardiac Conditions

    • Myocardial Infarction (MI): Including:
      • Symptoms (chest pain, radiating pain) and diagnosis approach.
      • Drugs (aspirin, nitrates, morphine sulfate).
      • ECG changes (ST-segment elevation/depression).
      • Anatomy of Coronary arteries and area of the heart affected.
    • Types of MI (STEMI/NSTMEI), associated causes, and different ECG patterns. Stable vs. Unstable Angina (includes causes that lead from stable to unstable).
    • Cardiac Cycle: The sequence of events in one complete heartbeat.
    • Intra-Aortic Balloon Pump (IABP): A device that helps support the heart.

    Other Conditions

    • Pneumothorax: A collection of air in the pleural space.
    • Electrolytes: Including hyperkalemia, hypokalemia, and hypercalcemia.

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    Related Documents

    N486 Final Review Student PDF
    Medical Notes on AAA and Related Conditions PDF

    Description

    Test your knowledge on Aortic Aneurysms (AAA) with this quiz covering symptoms, diagnosis, management, and complications associated with AAAs. Understand the important aspects of hemodynamic monitoring and the approaches to treatment for various stages of AAAs.

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