Cardiology Pharmacology Quiz

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Questions and Answers

In which condition are amiodarone and dronedarone contraindicated?

  • Atrioventricular (AV) block (correct)
  • Atrial fibrillation
  • Sinus tachycardia
  • Premature ventricular contractions

What is a critical nursing action to perform before administering a beta blocker?

  • Monitor urine output and electrolyte levels
  • Assess respiratory rate and depth
  • Evaluate patient's level of consciousness
  • Check apical pulse and blood pressure (correct)

How do calcium channel blockers primarily affect myocardial contractility and the conduction system?

  • Increase myocardial contractility and depress conduction
  • Decrease myocardial contractility and depress conduction (correct)
  • Decrease myocardial contractility and accelerate conduction
  • Increase myocardial contractility and accelerate conduction

Which electrolyte imbalance is known to increase the risk of digoxin toxicity?

<p>Hypokalemia (A)</p> Signup and view all the answers

For which primary cardiac condition would epinephrine be administered?

<p>Asystole (C)</p> Signup and view all the answers

Which of the following is a physiological cause of sinus tachycardia?

<p>Dehydration (D)</p> Signup and view all the answers

What is the primary pharmacological action of atropine sulfate?

<p>Increases heart rate (A)</p> Signup and view all the answers

Dopamine is contraindicated in patients taking which class of medications?

<p>Nonselective beta blockers (A)</p> Signup and view all the answers

What is the typical atrial rate observed in atrial flutter?

<p>250 to 350 bpm (D)</p> Signup and view all the answers

Which ECG finding is characteristic of atrial flutter?

<p>Sawtooth pattern of P waves (D)</p> Signup and view all the answers

What distinguishes sinus bradycardia in athletes from other cases?

<p>Efficient heart function (A)</p> Signup and view all the answers

What is the primary treatment goal for atrial flutter?

<p>Control ventricular rate and convert to NSR (C)</p> Signup and view all the answers

Which medication class is commonly used to control the ventricular rate in atrial flutter?

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

Which of the following is NOT a characteristic of sinus bradycardia?

<p>PRI of 0.25 seconds (A)</p> Signup and view all the answers

If a patient with atrial flutter has a normal ventricular rate, what is the typical clinical presentation?

<p>Usually no symptoms (B)</p> Signup and view all the answers

A patient presents with a heart rate of 55 bpm, regular rhythm, and no other symptoms. What is the appropriate therapeutic measure?

<p>Observe for symptom development (C)</p> Signup and view all the answers

How are premature atrial contractions (PACs) typically managed?

<p>Often no treatment other than correcting the cause (D)</p> Signup and view all the answers

Which symptom is NOT typically associated with symptomatic bradycardia?

<p>Increased peripheral pulses (A)</p> Signup and view all the answers

What can frequent PACs indicate?

<p>Atrial irritability (C)</p> Signup and view all the answers

What is the defining characteristic of sinus tachycardia?

<p>Heart rate greater than 100 bpm (D)</p> Signup and view all the answers

If atropine is ineffective in treating symptomatic bradycardia, what is the next recommended step?

<p>Transcutaneous pacing (B)</p> Signup and view all the answers

What intervention is used for an unstable patient with atrial flutter and a rapid ventricular rate?

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

Which medication is used to reduce the risk of blood clots in nonvalvular atrial fibrillation (AF)?

<p>Apixaban (C)</p> Signup and view all the answers

What is the role of adenosine in treating supraventricular tachycardia?

<p>Slows conduction through the AV node (D)</p> Signup and view all the answers

What is the primary advantage of a transcutaneous pacemaker?

<p>Rapid deployment in emergency situations (A)</p> Signup and view all the answers

Which type of pacemaker offers rate responsiveness based on the patient's activity level?

<p>Activity-responsive pacemaker (A)</p> Signup and view all the answers

How does a leadless pacemaker differ from traditional pacemakers?

<p>It eliminates the need for leads (D)</p> Signup and view all the answers

What medical imaging technique guides the implantation of permanent pacemakers?

<p>Fluoroscopy (B)</p> Signup and view all the answers

What does a spike on an ECG indicate in a paced rhythm?

<p>Electrical stimulus from the pacemaker (B)</p> Signup and view all the answers

Where is the generator of a permanent pacemaker typically implanted?

<p>Subcutaneously (A)</p> Signup and view all the answers

What is the typical lifespan of a leadless pacemaker battery?

<p>8-12 years (A)</p> Signup and view all the answers

What is the function of leads in a traditional pacemaker?

<p>To transmit impulses to the heart wall (B)</p> Signup and view all the answers

What is the primary function of the heart's electrical conduction system?

<p>To initiate impulses for heart muscle contraction (B)</p> Signup and view all the answers

An ECG primarily provides information about which aspect of the heart's function?

<p>Electrical activity of the heart (C)</p> Signup and view all the answers

What additional assessments are essential to confirm cardiac contraction and perfusion, alongside ECG readings?

<p>Blood pressure and pulses (apical and peripheral) (D)</p> Signup and view all the answers

Which components represent a complete cardiac cycle on an ECG?

<p>P wave, QRS complex, and T wave (A)</p> Signup and view all the answers

What does an ECG recording essentially capture?

<p>A snapshot of the heart's electrical activity at a specific moment (D)</p> Signup and view all the answers

What is the purpose of using different leads in an ECG?

<p>To assess various aspects of the heart's electrical activity from diverse perspectives (A)</p> Signup and view all the answers

On standard ECG graph paper, what is the time duration represented by one small square?

<p>0.04 seconds (C)</p> Signup and view all the answers

How many small squares are contained within one large block on ECG graph paper?

<p>25 (C)</p> Signup and view all the answers

Which of the following is a potential issue with pacemakers related to the heart's electrical activity?

<p>Failure to sense the patient's own heartbeat (B)</p> Signup and view all the answers

What is the recommended patient positioning in cases of pacemaker failure to capture?

<p>Left lateral decubitus position (C)</p> Signup and view all the answers

Which ECG tracing displays a ventricular-only pacemaker?

<p>Green spike before QRS complex (A)</p> Signup and view all the answers

Post-pacemaker implantation, which finding warrants immediate reporting to the healthcare provider?

<p>Irregular heart rhythm slower than the pacemaker's set rate (C)</p> Signup and view all the answers

Which activity restriction is typically advised after pacemaker implantation?

<p>Limiting arm elevation on the pacemaker side (D)</p> Signup and view all the answers

Which device generally requires caution when used by a patient with a pacemaker?

<p>Cell phone held close to the chest (C)</p> Signup and view all the answers

Which device poses a potential risk to pacemaker function and requires careful consideration?

<p>Magnetic resonance imaging (MRI) with an incompatible device (C)</p> Signup and view all the answers

What should a patient with a pacemaker do if they experience lightheadedness near an electromagnetic device?

<p>Increase the distance between themselves and the device (C)</p> Signup and view all the answers

Flashcards

Cardiac Conduction System

The heart's electrical system that initiates impulses for contraction.

ECG

A recording of the electrical activity of the heart over time.

P wave, QRS complex, T wave

Three waveform indicators of heart cycle's electrical activity.

Mechanical cells

Heart cells that contract in response to electrical impulses.

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Blood pressure measurement

Physical assessment to verify heart muscle contraction and perfusion.

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Rhythm changes

Alterations in the heart's normal electrical activity patterns.

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12-lead ECG

An ECG that provides 12 different views of the heart's activity.

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Small square on ECG graph

Represents 0.04 seconds in ECG timing measurement.

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Amiodarone

A medication for treating ventricular and atrial arrhythmias.

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Dronedarone

An antiarrhythmic drug used for atrial fibrillation.

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Atropine Sulfate

Increases heart rate; used for symptomatic bradycardia.

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Beta Blockers

Medications that decrease heart contractility and control rate.

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Calcium Channel Blockers

Decrease myocardial contractility and control heart rate.

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Digoxin

A cardiac glycoside that slows heart rate and maintains rhythm.

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Vasopressors

Medications that stimulate cardiac output and blood pressure.

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Sinus Tachycardia

Increased heart rate due to various factors like exercise or anxiety.

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Sinus Bradycardia

A condition with a heart rate of less than 60 bpm, usually regular rhythm.

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Signs of Symptomatic Bradycardia

May include decreased blood pressure, respiratory distress, fatigue, or syncope.

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Treatment for Symptomatic Bradycardia

Includes IV atropine or infusions of dopamine/epinephrine; pacing may be needed.

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Dysrhythmia

An abnormal or difficult rhythm of the heart.

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Anticoagulants

Drugs that increase clotting time to reduce blood clots, e.g. warfarin.

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Adenosine

An antiarrhythmic that slows conduction through the AV node for SVT.

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Vitamin K (Reversal Agent)

Used to reverse the effects of anticoagulants like warfarin.

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PACs

Premature Atrial Contractions that may occur in healthy or diseased hearts, often without symptoms.

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Symptoms of PACs

Usually absent, but may include palpitations if several PACs occur.

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Beta blockers usage

Medications used for treating frequent PACs to slow heart rate.

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Atrial Flutter

A condition where the atria contract rapidly (250-350 bpm) resulting in flutter waves on ECG.

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Causes of Atrial Flutter

Includes heart failure, hypertension, and certain medications affecting heart rhythm.

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Atrial Flutter Rules

Regular atrial rhythm, varying ventricular rate, sawtooth P waves, and measurable QRS interval.

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Symptoms of Atrial Flutter

Dependent on ventricular rate; can include palpitations, angina, or dyspnea with rapid rates.

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Treatment for Atrial Flutter

Aim to control ventricular rate; may include medications or synchronized cardioversion for unstable patients.

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Temporary Pacemaker

Used during surgery or in emergencies; supports heart rhythm temporarily.

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Transcutaneous Pacemaker

Easily applied external device delivering impulses through skin electrodes in emergencies.

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Permanent Pacemaker

Implanted device used for managing bradycardia and AV block; ongoing heart rhythm support.

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Single-lead Pacemaker

Paces either the right atrium or right ventricle with one lead inserted into the heart.

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Dual-chamber Pacemaker

Has two leads, pacing both right atrium and ventricle simultaneously for better coordination.

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Activity-responsive Pacemaker

Adapts heart rate according to activity levels, offering flexibility for exercise demands.

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Leadless Pacemaker

A compact device implanted via a leg vein, with no leads and a longer battery life.

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Paced Rhythm on ECG

Small spikes seen on ECG indicating electrical stimulations from the pacemaker.

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Failure to sense

When a pacemaker does not detect the patient's own heartbeat.

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Failure to pace

Malfunction of the pulse generator preventing pacing.

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Failure to capture

The heart does not depolarize when paced.

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Post-implant monitoring

Monitoring heart rhythm and incision after pacemaker placement.

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Activity restrictions

Limitations on movements after pacemaker surgery.

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Safe devices with pacemakers

Common devices like microwaves and cell phones are generally safe.

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Caution devices

Devices that require careful use around a pacemaker.

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Pacemaker identification card

A card to show HCPs and security about having a pacemaker.

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Study Notes

Cardiac Conduction System

  • The heart's electrical system initiates impulses, causing heart muscle contraction.
  • Electrical activity is visible on a cardiac monitor or ECG tracing.
  • ECG activity doesn't confirm mechanical contraction, confirming perfusion is crucial.
  • Blood pressure and peripheral pulses verify cardiac contraction and perfusion.

Cardiac Cycle

  • The electrical cycle involves P wave, QRS complex, and T wave which represent atrial and ventricular depolarization/repolarization.

Electrocardiogram (ECG)

  • ECGs visualize heart's electrical activity, offering various views (leads).
  • A 12-lead ECG shows 12 different views of the heart's electrical activity.
  • An 18-lead ECG presents 18 views.
  • Continuous monitoring can use one or two leads; continuous 12-lead monitoring can also be done.
  • Understanding normal heart rhythms and common arrhythmias are needed to identify abnormalities.

ECG Graph Paper

  • ECG graph paper is calibrated in small squares.
  • Each small square represents 0.04 seconds.
  • Half square = 0.02 seconds.
  • Waveform measurement is done horizontally (left to right) for time and vertically (amplitude) for height.

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