ACLS Pretest 2023 Flashcards

Questions and Answers

Which drug do you anticipate giving to the patient with a blood pressure of 180/100 mm Hg?

rtPA

Nicardipine

Aspirin (correct)

Glucose (D50)

If no pathway for medication administration is in place, which method is preferred for a patient in cardiac arrest?

IV or IO (correct)

External Jugular Vein

Endotracheal Tube

Central Line

What is a contraindication to nitrate administration for a patient with ongoing chest discomfort?

Heart rate less than 90/min

Systolic blood pressure greater than 180 mm Hg

Anterior wall myocardial infarction

Use of a phosphodiesterase inhibitor within the previous 24 hours (correct)

What is the indication for the use of magnesium in cardiac arrest?

Pulseless ventricular tachycardia-associated torsades de pointes Signup and view all the answers

What is your next action for a monitored patient in the ICU with narrow-complex tachycardia?

Administer adenosine 6 mg IV push Signup and view all the answers

What is the maximum interval for pausing chest compressions?

10 seconds Signup and view all the answers

What is the recommended depth of chest compressions for an adult victim?

At least 2 inches Signup and view all the answers

What do you administer for a patient who collapsed after recovering from a pulmonary embolism?

Epinephrine 1 mg IV Signup and view all the answers

What is the recommended compression rate for high-quality CPR?

100-120 compressions per min Signup and view all the answers

How often should you switch chest compressors to avoid fatigue?

About every 2 min Signup and view all the answers

What do you administer next for a patient presenting with dizziness and a blood pressure of 80/60 mm Hg?

Atropine 1 mg IV Signup and view all the answers

How does complete chest recoil contribute to effective CPR?

Allows maximum blood return to the heart Signup and view all the answers

Which action is likely to cause air to enter the victim's stomach during bag-mask ventilation?

Ventilating too quickly Signup and view all the answers

What action minimizes the risk of air entering the victim's stomach during bag-mask ventilation?

Ventilating until you see the chest rise Signup and view all the answers

Which action should you take immediately after providing an AED shock?

Resume chest compressions Signup and view all the answers

How often should you provide ventilations for a patient in respiratory arrest?

Every 6 seconds Signup and view all the answers

Which intervention would be your next action for a patient with no pulse or respiration?

Epinephrine 1 mg Signup and view all the answers

What rhythm is identified by the term Sinus Bradycardia?

Heart rate less than 60 bpm Signup and view all the answers

What rhythm is identified by the term Reentry Supraventricular Tachycardia?

Rapid heart rate due to reentry Signup and view all the answers

What rhythm corresponds to the term Second-degree AV block (Mobitz II block)?

Dropped beats with consistent PR interval Signup and view all the answers

What rhythm is identified by the term Agonal Rhythm/Asystole?

Final heartbeats or no electrical activity Signup and view all the answers

What rhythm should be identified as Third-Degree AV Block?

Complete dissociation of atrial and ventricular activity Signup and view all the answers

Identify the rhythm associated with Monomorphic Ventricular Tachycardia.

Wide regular QRS complexes Signup and view all the answers

What rhythm is referred by the term Sinus Tachycardia?

Elevated heart rate above 100 bpm Signup and view all the answers

What rhythm corresponds to Atrial Fibrillation?

Irregularly irregular rhythm Signup and view all the answers

What is identified by Course Ventricular Fibrillation?

Chaotic electrical activity without a clear pattern Signup and view all the answers

Which treatment is appropriate for a patient with a regular wide-complex QRS at a rate of 180/min?

Perform electrical cardioversion Signup and view all the answers

What is the appropriate action for a patient with ongoing chest discomfort unresponsive to nitroglycerin?

Give normal saline 250 mL to 500 mL fluid bolus Signup and view all the answers

What drug should be administered after two shocks in pulseless ventricular tachycardia?

Amiodarone 300 mg Signup and view all the answers

What describes the recommended second dose of Amiodarone for refractory ventricular fibrillation?

150 mg IV push Signup and view all the answers

What medication should be administered for a patient with stable tachycardia after ineffective vagal maneuvers?

Adenosine 6 mg Signup and view all the answers

What action is recommended for a patient with rapid irregular wide-complex tachycardia?

Seek expert consultation Signup and view all the answers

What is the indicated therapy for a patient with sinus bradycardia, confusion, and low blood pressure?

Epinephrine 2 to 10 mcg/min Signup and view all the answers

What is the first medication to administer in cardiac arrest after ventricular fibrillation is refractory to shock?

Epinephrine 1 mg IV / IO Signup and view all the answers

What is the immediate action following administration of CPR and rhythm check finds asystole?

Establish IV/IO access Signup and view all the answers

What is the next action for a patient with STEMI, ongoing chest discomfort, and aspirin history of gastritis?

Give aspirin 162 to 325 mg to chew Signup and view all the answers

Bradycardia requires treatment when: ____________.

chest pain or shortness of breath is present Signup and view all the answers

What is the first drug/dose to administer for a patient in cardiac arrest with asystole?

Epinephrine 1 mg IV / IO Signup and view all the answers

What is the initial dose of atropine for a patient with sinus bradycardia, diaphoresis, and low blood pressure?

1 mg Signup and view all the answers

What medication should be given next after a dose of epinephrine in refractory ventricular fibrillation?

Epinephrine 1 mg Signup and view all the answers

What is the guideline for antiplatelet and fibrinolytic therapy in the case of rtPA?

Hold aspirin for at least 24 hours if rtPA is administered Signup and view all the answers

What is the correct statement regarding the administration of vasopressin during cardiac arrest?

The correct dose is 40 units administered IV or IO Signup and view all the answers

What combination of drugs can be administered by the endotracheal route?

Lidocaine, epinephrine, vasopressin Signup and view all the answers

What would you do next with a patient who becomes unconscious, has a weak carotid pulse, and has initiated cardiac monitoring?

Give atropine 0.5 mg IV Signup and view all the answers

What is the next action when you find a patient with CPR ongoing, a pulse, and a rhythm indicative of ventricular fibrillation?

Perform defibrillation Signup and view all the answers

What is indicated next for a patient with chest discomfort lasting 15 minutes in transportation with anxiety?

Continue monitoring the patient and seek expert consultation Signup and view all the answers

What is the appropriate initial action after observing a patient become unresponsive with a rhythm signifying potential arrest?

Perform CPR immediately Signup and view all the answers

What should you order for a resuscitated patient from cardiac arrest with low blood pressure and increasing rhythm abnormalities?

1 to 2 L of normal saline Signup and view all the answers

What medication should you order for a patient with a baseline QT interval that is high normal to slightly prolonged?

Give magnesium sulfate 1 to 2 g IV diluted in 10 mL D5W given over 5 to 20 minutes Signup and view all the answers

What action should be taken for a patient with dizziness and low blood pressure when a specific rhythm is noted?

Administer atropine 0.5 mg IV Signup and view all the answers

What should be performed for a patient not breathing with carotid pulse present?

Start rescue breathing Signup and view all the answers

Which intervention is most appropriate for the treatment of a patient in asystole?

Epinephrine Signup and view all the answers

In which situation does bradycardia require treatment?

Hypotension Signup and view all the answers

Study Notes

Cardiac Rhythms and Treatments

Sinus Bradycardia: Characterized by a slow heart rate (typically less than 60 bpm), may require intervention if symptomatic.
Reentry Supraventricular Tachycardia (SVT): Rapid heart rate originating above the ventricles, can cause palpitations and may require medications or cardioversion.
Second-Degree AV Block (Mobitz II): Intermittent failure of conduction from atria to ventricles, higher risk of complete heart block.
Agonal Rhythm/Asystole: Indicates no effective heart contractions; often associated with cardiac arrest requiring immediate CPR.
Third-Degree AV Block: Complete heart block; atria and ventricles beat independently, potentially requiring pacemaker intervention.
Monomorphic Ventricular Tachycardia: Stable form of tachycardia with a consistent QRS complex; can degenerate to ventricular fibrillation.
Sinus Tachycardia: Elevated heart rate (over 100 bpm) with normal sinus rhythm; often transient in response to exercise or anxiety.
Atrial Fibrillation: Irregular and often rapid heart rate that can increase risk of stroke; may require anticoagulation.
Course Ventricular Fibrillation: Life-threatening arrhythmia requiring immediate defibrillation.
Polymorphic Ventricular Tachycardia (Torsades de Pointes): Variable QRS complexes; associated with QT interval prolongation.
Second-Degree AV Block (Mobitz I/Wenckebach): Progressive lengthening of PR interval until a beat is dropped; typically less serious.
Normal Sinus Rhythm: Indicates heart functioning properly with a rate of 60-100 bpm.
Pulseless Electrical Activity (PEA): Electrical activity observed but no pulse detected; requires immediate CPR and advanced life support.
Fine Ventricular Fibrillation: A variation of VF characterized by low amplitude waves; still requires defibrillation.
Atrial Flutter: Rapid atrial rate with a characteristic "sawtooth" pattern; can often be controlled with medication or cardioversion.

Emergency Interventions

Electrical Cardioversion: Recommended for hemodynamically unstable patients with wide-complex tachycardia (e.g., regular wide QRS at 180/min).
Fluid Bolus: Administer normal saline (250-500 ml) for hypotension, especially post-nitroglycerin.
Amiodarone Administration: Administer 300 mg for pulseless ventricular tachycardia after defibrillation attempts.
Second Dose of Amiodarone: 150 mg IV push for refractory ventricular fibrillation after initial doses.
Adenosine: 6 mg IV for stable narrow-complex tachycardia after vagal maneuvers fail; may repeat with 12 mg if ineffective.
Synchronized Cardioversion: Indicated for unstable tachycardia, adjusting shock timing to coincide with QRS complex.
Epinephrine: First drug in cardiac arrest scenarios, typically administered at 1 mg IV/IO for asystole or VF.
Atropine: 0.5 mg IV indicated for symptomatic bradycardia, relaxing vagal tone to increase heart rate.
Hypovolemia Management: Administering 1-2 L normal saline post-cardio-resuscitation to maintain blood pressure.
Antiplatelet Therapy: Aspirin (162-325 mg) to chew for STEMI patients, monitoring for contraindications like recent intracerebral hemorrhage.

Special Considerations

Contradictions for Nitrates: Avoid in patients who have taken phosphodiesterase inhibitors within the prior 24 hours.
Magnesium Usage: Indicated in cases like pulseless ventricular tachycardia associated with torsades de pointes.
Vagal Maneuvers: First-line intervention in stable SVT to attempt a rhythm change without medication.
Clinical Assessment: Regular evaluation and consideration of patient presentation, including blood pressure and symptoms, guide treatment decisions.

Resuscitation Protocols

Start High-Quality CPR: Immediate action for unresponsive patients at risk for cardiac arrest; ensure continuous chest compressions.
Defibrillation Protocol: Use high-energy shocks for unstable rhythms observed post-cardiac arrest; essential for patient survival.
Monitoring and Consultation: Constant assessment of patient responses during rhythm checks and stabilization efforts; seeking expert consultation as necessary.

This structured approach emphasizes rhythm identification, appropriate intervention protocols, and continuous evaluation during acute cardiac events.### Supraventricular Tachycardia Management

Confirmed diagnosis of supraventricular tachycardia (SVT) with no ischemia or infarction.
If the heart rate does not respond to vagal maneuvers, the next step is to administer adenosine 6 mg IV push.

CPR Guidelines

Maximum interval for pausing chest compressions is 10 seconds.
Recommended depth for chest compressions in adults is at least 2 inches.

Emergency Response During Collapse

Administer epinephrine 1 mg IV after two shocks in a patient who collapsed while recovering from a pulmonary embolism.
High-quality CPR should be performed at a rate of 100-120 compressions per minute.
Switch chest compressors to avoid fatigue approximately every 2 minutes.

Pharmacological Interventions

In hypotensive patients with dizziness and signs of shock, administer atropine 1 mg IV.

Importance of Chest Recoil

Complete chest recoil during CPR is crucial as it allows maximum blood return to the heart.

Bag-Mask Ventilation Techniques

Ventilating too quickly can lead to gastric inflation.
Minimize air entering the stomach by ventilating until you see the chest rise.

Post-AED Shock Protocol

Immediately after providing an AED shock, resume chest compressions without delay.

Ventilation Rhythm During Respiratory Arrest

Provide bag-mask ventilations every 6 seconds for a patient in respiratory arrest.

Code Team Protocol

As the code team leader, after confirming no pulse or respiration, the next action is to administer epinephrine 1 mg.

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Description

Test your knowledge of ACLS rhythms with these flashcards. Each card challenges you to identify crucial cardiac rhythms, ensuring you are prepared for emergencies. Perfect for both beginners and seasoned healthcare professionals.