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EMT Chapter 17: Cardiovascular Emergencies
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EMT Chapter 17: Cardiovascular Emergencies

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Questions and Answers

A dissecting aortic aneurysm occurs when:

  • The inner layers of the aorta become separated. (correct)
  • All layers of the aorta suddenly contract.
  • A weakened area develops in the aortic wall.
  • The aorta ruptures.

    • Angina pectoris occurs when:

  • Myocardial oxygen supply exceeds the demand.
  • Myocardial oxygen demand exceeds supply. (correct)
  • One or more coronary arteries suddenly spasm.
  • A coronary artery is totally occluded by plaque.

    • Cardiogenic shock following AMI is caused by:

  • A profound increase in the patient's heart rate.
  • Hypovolemia secondary to severe vomiting.
  • Decreased pumping force of the heart muscle. (correct)
  • Widespread dilation of the systemic vasculature.

    • Deoxygenated blood from the body returns to the:

    <p>Right atrium</p> Signup and view all the answers

    In contrast to the sympathetic nervous system, the parasympathetic nervous system:

    <p>Slows the heart and respiratory rates.</p> Signup and view all the answers

    Most patients are instructed by their physician to take up to_____ doses of nitroglycerin before calling EMS.

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

    Narrowing of the coronary arteries caused by a buildup of fatty deposits is called:

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

    Prior to attaching the AED to a cardiac arrest patient, the EMT should:

    <p>Dry the chest if it is wet.</p> Signup and view all the answers

    The AED is most advantageous to the EMT because:

    <p>It delivers prompt defibrillation to patients with ventricular fibrillation.</p> Signup and view all the answers

    The electrical impulse generated by the heart originates in the:

    <p>Sinoatrial node.</p> Signup and view all the answers

    The iliac arteries immediately subdivide into the:

    <p>Femoral arteries.</p> Signup and view all the answers

    The most common reason that many people experiencing AMI do not seek immediate medical attention is because they:

    <p>Are in denial.</p> Signup and view all the answers

    The right coronary artery supplies blood to the:

    <p>Right atrium and posterior wall of the right ventricle.</p> Signup and view all the answers

    Upon arriving at the residence of a patient with a possible cardiac problem, it is most important to:

    <p>Assess the scene for potential hazards.</p> Signup and view all the answers

    When documenting a patient's description of his or her chest pain or discomfort, the EMT should:

    <p>Use the patient's own words.</p> Signup and view all the answers

    When preparing to obtain a 12-lead ECG, the LL and RL electrodes should be placed:

    <p>On the thighs or ankles.</p> Signup and view all the answers

    Which of the following blood vessels transports oxygenated blood?

    <p>Pulmonary veins.</p> Signup and view all the answers

    Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

    <p>Aspirin.</p> Signup and view all the answers

    Which of the following signs is commonly observed in patients with right-sided heart failure?

    <p>Dependent edema.</p> Signup and view all the answers

    Which of the following statements regarding nitroglycerin is correct?

    <p>Nitroglycerin usually relieves anginal chest pain within 5 minutes.</p> Signup and view all the answers

    The AED has delivered a shock to an elderly male in cardiac arrest. Following 2 minutes of CPR, you re-analyze the patient's cardiac rhythm and receive a 'no shock advised' message. After further resuscitation, you restore a palpable carotid pulse. Your next action should be to:

    <p>Reassess airway and breathing and treat accordingly.</p> Signup and view all the answers

    The main legal risk in using the AED is:

    <p>Failing to deliver a shock when one is needed.</p> Signup and view all the answers

    Ischemic heart disease is defined as:

    <p>Decreased blood flow to one or more portions of the myocardium.</p> Signup and view all the answers

    A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her right arm. What do these signs and symptoms most likely indicate?

    <p>Dissecting aortic aneurysm.</p> Signup and view all the answers

    Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a 'no shock advised' message. You should:

    <p>Perform CPR for 2 minutes and reassess.</p> Signup and view all the answers

    The inferior vena cava returns deoxygenated blood to the right side of the heart from all of the following areas, except the:

    <p>Brain.</p> Signup and view all the answers

    It would be most appropriate for a patient to take his or her prescribed nitroglycerin when experiencing:

    <p>Chest pain that does not immediately subside with rest.</p> Signup and view all the answers

    The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

    <p>Automaticity.</p> Signup and view all the answers

    The posterior tibial pulse can be palpated:

    <p>Behind the medial malleolus, on the inside of the ankle.</p> Signup and view all the answers

    When an electrical impulse reaches the AV node, it is slowed for a brief period of time so that:

    <p>Blood can pass from the atria to the ventricles.</p> Signup and view all the answers

    Which of the following cardiac dysrhythmias has the greatest chance of deteriorating into a pulseless rhythm?

    <p>Ventricular tachycardia.</p> Signup and view all the answers

    You and your EMT partner are the first to arrive at the scene of an unresponsive 70-year-old man. Your assessment reveals that he is apneic and pulseless. A paramedic unit is en route to the scene and will arrive in approximately 5 minutes. You should:

    <p>Begin CPR, apply AED, and deliver shock if it is indicated.</p> Signup and view all the answers

    Which of the following represents the most appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

    <p>Administer the medication sublingually and allow it to dissolve or absorb.</p> Signup and view all the answers

    A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced?

    <p>Acute myocardial infarction.</p> Signup and view all the answers

    Prompt transport of a patient with a suspected AMI is important because:

    <p>The patient may be eligible to receive thrombolytic therapy.</p> Signup and view all the answers

    Which of the following is least important when obtaining a medical history from a patient complaining of chest discomfort?

    <p>Family history of hypertension.</p> Signup and view all the answers

    A percutaneous transluminal coronary angioplasty (PTCA) restores blood flow to the ischemic myocardium by:

    <p>Dilating the affected coronary artery with a small inflatable balloon.</p> Signup and view all the answers

    Prior to assisting a patient with his or her prescribed nitroglycerin, the EMT must:

    <p>Obtain authorization from medical control.</p> Signup and view all the answers

    Common signs and symptoms of AMI include all of the following, except:

    <p>Pain exacerbated by breathing.</p> Signup and view all the answers

    Sudden death following AMI is most often caused by:

    <p>Ventricular fibrillation.</p> Signup and view all the answers

    Rapid, labored breathing in a patient with signs and symptoms of AMI should make you suspicious for:

    <p>Congestive heart failure.</p> Signup and view all the answers

    During your treatment of a woman in cardiac arrest, you apply the AED, analyze her cardiac rhythm, and receive a 'no shock advised' message. This indicates that:

    <p>She is not in ventricular fibrillation.</p> Signup and view all the answers

    Which of the following statements regarding the pain associated with AMI is correct?

    <p>It can occur during exertion or when the patient is at rest.</p> Signup and view all the answers

    Which of the following statements regarding the AED and defibrillation is correct?

    <p>The AED will not analyze the rhythm of a moving patient.</p> Signup and view all the answers

    Nitroglycerin is contraindicated in patients:

    <p>Who have experienced a head injury.</p> Signup and view all the answers

    The electrical stimulus that originates in the heart's primary pacemaker is controlled by impulses from the brain that arrive by way of the:

    <p>Autonomic nervous system.</p> Signup and view all the answers

    A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment?

    <p>Absence of a palpable pulse.</p> Signup and view all the answers

    Acute coronary syndrome (ACS) is a term used to describe:

    <p>A group of symptoms that are caused by myocardial ischemia.</p> Signup and view all the answers

    A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:

    <p>Administer oxygen, give her 324 mg of aspirin, and assess her further.</p> Signup and view all the answers

    The descending aorta divides into the two iliac arteries at the level of the:

    <p>Umbilicus.</p> Signup and view all the answers

    Study Notes

    Cardiovascular Emergencies

    • Dissecting Aortic Aneurysm: Occurs when the inner layers of the aorta separate.
    • Angina Pectoris: Characterized by myocardial oxygen demand exceeding supply.
    • Cardiogenic Shock: Follow-up of acute myocardial infarction (AMI) caused by decreased pumping force of the heart.
    • Deoxygenated Blood Return: Blood from the body returns to the right atrium.
    • Nervous System Functions: The parasympathetic system slows heart and respiratory rates, in contrast to the sympathetic system.
    • Nitroglycerin Administration: Patients are typically instructed to take up to three doses before contacting EMS.
    • Atherosclerosis: Refers to the narrowing of coronary arteries due to fatty deposit buildup.
    • AED Pre-attachment Protocol: EMTs should dry the patient’s chest if wet before attaching the AED.
    • AED Advantage: Delivers prompt defibrillation for ventricular fibrillation patients.
    • Heart’s Electrical Impulse: Originates from the sinoatrial (SA) node.
    • Iliac Arteries: Immediately subdivide into femoral arteries.
    • Delay in Seeking Help: Many AMI patients hesitate to seek help due to denial.
    • Right Coronary Artery Supply: Supplies the right ventricle and inferior wall of the left ventricle.
    • Scene Assessment: Most important action upon arrival at a potential cardiac emergency scene is to assess for hazards.
    • Patient Documentation: EMTs should document in patients’ own words regarding chest pain or discomfort.
    • 12-Lead ECG Placement: Left leg (LL) and right leg (RL) electrodes are placed on thighs or ankles.
    • Oxygenated Blood Transport: Pulmonary veins are responsible for carrying oxygenated blood.
    • Medication for Chest Pain: Aspirin is commonly given to prevent blood clots in patients with chest pain.
    • Right-Sided Heart Failure: Commonly presents with dependent edema.
    • Nitroglycerin Effectiveness: Usually relieves anginal chest pain within five minutes.
    • Post-AED Shock Care: After restoring a palpated carotid pulse, reassess airway and breathing.
    • AED Legal Risks: The primary risk involves failing to deliver a needed shock.
    • Ischemic Heart Disease: Defined as decreased blood flow to myocardial regions.
    • Possible Dissecting Aortic Aneurysm Signs: Stabbing pain radiating to the back, elevated blood pressure in one arm.
    • Return to CPR: Following a "no shock advised" AED alert, EMTs should perform CPR for two minutes before reassessment.
    • Brain Drain via Inferior Vena Cava: Returns deoxygenated blood from all body areas except the brain.
    • Nitroglycerin Usage: Recommended for chest pain not relieved immediately by rest.
    • Cardiac Muscle Autonomy: Cardiac muscle cells demonstrate automaticity, contracting spontaneously.
    • Posterior Tibial Pulse Location: Located behind the medial malleolus, inside the ankle.
    • AV Node Function: Slows the electrical impulse to allow blood passage from atria to ventricles.
    • Dysrhythmia Risks: Ventricular tachycardia has the highest risk of deteriorating to pulseless activity.
    • First Response to Unresponsive Patients: Begin CPR immediately, apply AED, and deliver shocks if indicated.
    • Administering Nitroglycerin: Should be done sublingually and allowed to dissolve for effectiveness.
    • Condition with LVAD: Common condition in patients with an LVAD is a history of acute myocardial infarction.
    • Importance of Rapid Transport: Critical for AMI patients due to potential eligibility for thrombolytic therapy.
    • Medical History Priority: Family history of hypertension is least relevant in chest discomfort cases.
    • PTCA Functionality: Restores ischemic myocardium blood flow by dilating coronary arteries with a balloon.
    • Nitroglycerin Precautions: Requires medical control authorization before administration.
    • Common AMI Signs: Include sudden sweating, irregular heartbeat, and shortness of breath; pain should not be exacerbated by breathing.
    • Sudden Death After AMI: Most often caused by ventricular fibrillation.
    • AMI and Breathing: Rapid, labored breathing in AMI indicates potential for congestive heart failure.
    • AED No Shock Message: Indicates the patient is not in ventricular fibrillation.
    • AMI Pain Characteristics: Can occur during exertion or at rest; fluctuating intensity is common.
    • AED Functionality Limitation: It cannot analyze rhythm in a moving patient.
    • Nitroglycerin Contraindications: Contraindicated in patients with recent head injuries.
    • Electrical Impulse Origin: Controlled by the autonomic nervous system.
    • Continuous Flow with LVAD: Absence of a palpable pulse may be noted in LVAD patients.
    • Acute Coronary Syndrome (ACS): Refers to a group of symptoms caused by myocardial ischemia.
    • Patient with Chest Pressure: Administer oxygen and aspirin while evaluating further if prescribed nitroglycerin is lacking.
    • Descending Aorta Division: Divides into iliac arteries at the level of the umbilicus.

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    Description

    Test your knowledge on cardiovascular emergencies with this quiz based on EMT Chapter 17. You'll encounter questions on various topics including dissecting aortic aneurysms and angina pectoris. Prepare to enhance your understanding of critical cardiovascular conditions.

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