Podcast
Questions and Answers
What is the purpose of a cardiac arrest/emergency alarm button in the ICU?
What is the purpose of a cardiac arrest/emergency alarm button in the ICU?
- To facilitate social interactions among staff
- To replace the need for bedside monitoring equipment
- To notify the nursing staff in a timely manner (correct)
- To provide entertainment for patients
Which of the following is NOT a component of prearrival assessment for ICU patients?
Which of the following is NOT a component of prearrival assessment for ICU patients?
- Surgical history (correct)
- General communication
- Chief complaint
- Status of laboratory tests
What aspect of critical care involves reducing patient stress through communication?
What aspect of critical care involves reducing patient stress through communication?
- Emergency alarm systems
- Expertise supportive care
- Anticipatory nursing care (correct)
- Crisis intervention
Why is early detection emphasized in critical care nursing?
Why is early detection emphasized in critical care nursing?
Which component is involved in the preservation of a patient’s physiological defenses?
Which component is involved in the preservation of a patient’s physiological defenses?
What should be included in the spirituality assessment of ICU patients?
What should be included in the spirituality assessment of ICU patients?
Which system is central for notifying the staff of emergencies in the ICU?
Which system is central for notifying the staff of emergencies in the ICU?
Which of the following items is typically checked regarding equipment status during the prearrival assessment?
Which of the following items is typically checked regarding equipment status during the prearrival assessment?
What does a positive QRS complex indicate regarding the isoelectric line?
What does a positive QRS complex indicate regarding the isoelectric line?
How is the cardiac axis approximated?
How is the cardiac axis approximated?
What is indicated by a left axis deviation?
What is indicated by a left axis deviation?
What is the primary cause of distributive shock due to hyperergic reactions?
What is the primary cause of distributive shock due to hyperergic reactions?
What does a negative QRS complex indicate?
What does a negative QRS complex indicate?
What does one large box on the ECG paper represent?
What does one large box on the ECG paper represent?
Which of the following conditions might require antithrombotic therapy?
Which of the following conditions might require antithrombotic therapy?
How long does one small box on the ECG paper represent?
How long does one small box on the ECG paper represent?
What INR range is targeted for chronic oral anticoagulant therapy with vitamin K antagonists?
What INR range is targeted for chronic oral anticoagulant therapy with vitamin K antagonists?
What is the significance of measuring the vertical height of the ECG waveform?
What is the significance of measuring the vertical height of the ECG waveform?
Which of the following is NOT a condition that generally requires antithrombotic therapy?
Which of the following is NOT a condition that generally requires antithrombotic therapy?
In which situation is anticoagulation with a vitamin K antagonist generally recommended?
In which situation is anticoagulation with a vitamin K antagonist generally recommended?
Which interval does a large box contain on the ECG?
Which interval does a large box contain on the ECG?
What can disturbances in the heart's electrical activity lead to?
What can disturbances in the heart's electrical activity lead to?
What do the small squares on the ECG represent?
What do the small squares on the ECG represent?
What is the height measurement of a large box in millivolts on ECG paper?
What is the height measurement of a large box in millivolts on ECG paper?
What does the S-T segment represent in an ECG reading?
What does the S-T segment represent in an ECG reading?
Which condition is associated with significant S-T elevation?
Which condition is associated with significant S-T elevation?
What appearance does a normal S-T segment typically have?
What appearance does a normal S-T segment typically have?
In which leads is the U wave best seen?
In which leads is the U wave best seen?
What is a common cause of S-T elevation in patients with pulmonary embolism?
What is a common cause of S-T elevation in patients with pulmonary embolism?
What does the U wave represent in ECG readings?
What does the U wave represent in ECG readings?
Which of the following conditions can lead to widespread S-T elevation throughout the ECG?
Which of the following conditions can lead to widespread S-T elevation throughout the ECG?
What is the characteristic of the J point in an ECG?
What is the characteristic of the J point in an ECG?
What condition may be suggested by changes in P wave morphology?
What condition may be suggested by changes in P wave morphology?
Which of the following heart rhythms is characterized by narrow QRS complexes that are not preceded by P waves?
Which of the following heart rhythms is characterized by narrow QRS complexes that are not preceded by P waves?
What happens if the sinus node fails to initiate the impulse?
What happens if the sinus node fails to initiate the impulse?
What does an inverted P wave after the QRS complex indicate?
What does an inverted P wave after the QRS complex indicate?
Which of the following has the fastest automaticity?
Which of the following has the fastest automaticity?
If both the sinus node and the atrial focus fail, which part of the heart assumes pacemaker control next?
If both the sinus node and the atrial focus fail, which part of the heart assumes pacemaker control next?
Which rhythm is characterized by wide QRS complexes that are also not preceded by P waves?
Which rhythm is characterized by wide QRS complexes that are also not preceded by P waves?
In what scenario does the heart rhythm become non-sinus?
In what scenario does the heart rhythm become non-sinus?
Study Notes
Electrical Spread in the Heart
- The cardiac axis indicates the mean direction of ventricular depolarization in the frontal plane.
- Positive QRS Complex indicates that the area above the isoelectric line is larger than below; Negative QRS Complex indicates the opposite.
- Cardiac axis approximated by evaluating QRS complex polarities in leads I and aVF:
- Positive in both leads indicates normal axis.
- Positive in lead I and negative in aVF suggests left axis deviation.
- Negative in lead I and positive in aVF suggests right axis deviation.
- Negative in both leads indicates extreme right axis deviation.
Antithrombotic Therapy
- Recommended for all patients with Atrial Fibrillation (AF) except those with lone AF or contraindications.
- Chronic oral anticoagulant therapy with vitamin K antagonists targets an INR of 2.0 to 3.0, not advised for patients with mechanical heart valves.
- Anticoagulation recommended for patients with multiple moderate risk factors (e.g., age >75, hypertension).
Principles of Critical Care Nursing
- Emphasizes early detection, prompt action, and supportive care.
- Includes crisis intervention and effective communication.
- Ethical principles include preserving patient physiological defenses and preventing infection.
ICU Admission Process
- Prearrivals and assessments should involve:
- Collecting general information including age, gender, chief complaints, and physiological status.
- Evaluating coping styles, anxiety levels, and family needs.
- Considering spiritual needs and preferences.
Shock Due to Hyperergic Reactions
- Distributive shock develops from allergic reactions in hypersensitive patients.
ECG Reading and Interpretation
- Electrocardiography (ECG) measures the heart's electrical activities using external electrodes.
- Horizontal measures on ECG:
- Large Box: 5 mm wide represents 0.2 seconds.
- Small Box: 1 mm wide represents 0.04 seconds.
- Vertical measures:
- Large Box: Represents 0.5 mV (millivolts), crucial for assessing amplitude of electrical signals.
Major Components of Heart's Electrical Activities
- Baseline reference indicates ST segment elevation or depression.
- Normal ST segment appears as a horizontal isoelectric line; it extends from the J point to the start of the T wave.
- U wave appears after the T wave, polarity same as T wave; cause thought to be delayed repolarization.
Etiologies Related to ECG Findings
- STEMI associated with significant ST elevation.
- LBBB can cause ST elevation; often normal in athletes.
- Pulmonary embolism may result in ST elevation.
- Brugada pattern is a distinct ECG pattern linked to sudden cardiac death.
Cardiac Rhythm Control
- Myocytes exhibit inherent automaticity; SA node is the natural pacemaker.
- The hierarchy of pacemaker control:
- SA Node → AV Node → Ventricles.
- If the SA node fails, an atrial focus may take over, followed by the AV node if needed.
Atrial and Ventricular Rhythms
- Atrial rhythm characterized by narrow QRS complexes; junctional rhythm shows narrow QRS without P waves.
- Ventricular rhythm characterized by wide QRS complexes, indicating that it is not initiated by the sinus node.
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Description
This quiz covers essential concepts in cardiology, focusing on the electrical spread in the heart and the application of antithrombotic therapy. Learn about the cardiac axis, QRS complex interpretations, and guidelines for anticoagulation therapy in atrial fibrillation patients. Test your knowledge on these critical topics!
