Podcast
Questions and Answers
Which condition is an indication for the use of an Implantable Cardioverter-Defibrillator (ICD)?
Which condition is an indication for the use of an Implantable Cardioverter-Defibrillator (ICD)?
- Mitral valve prolapse
- Atrial fibrillation
- Cardiomyopathy (correct)
- Ventricular septal defect
Which of the following is a therapy that could be delivered by an ICD?
Which of the following is a therapy that could be delivered by an ICD?
- Coronary artery bypass grafting
- Temporary pacing for bradycardia
- Defibrillation shocks for ventricular fibrillation (correct)
- Administration of thrombolytic medications
Why is therapeutic hypothermia initiated after cardiac arrest?
Why is therapeutic hypothermia initiated after cardiac arrest?
- To protect the brain (correct)
- To increase body metabolism
- To induce shivering
- To accelerate the heart rate
What is the target temperature range (in degrees Fahrenheit) for cooling a patient after cardiac arrest?
What is the target temperature range (in degrees Fahrenheit) for cooling a patient after cardiac arrest?
A patient undergoing therapeutic hypothermia develops hypokalemia. What is the MOST appropriate intervention?
A patient undergoing therapeutic hypothermia develops hypokalemia. What is the MOST appropriate intervention?
A patient is being rewarmed after therapeutic hypothermia. Which electrolyte imbalance is MOST likely to occur during the rewarming phase?
A patient is being rewarmed after therapeutic hypothermia. Which electrolyte imbalance is MOST likely to occur during the rewarming phase?
What is a potential risk of rewarming a patient too rapidly after therapeutic hypothermia?
What is a potential risk of rewarming a patient too rapidly after therapeutic hypothermia?
During the initiation of therapeutic hypothermia, which change in heart rhythm is MOST likely to be observed?
During the initiation of therapeutic hypothermia, which change in heart rhythm is MOST likely to be observed?
Which hemodynamic parameter requires close monitoring during rewarming to prevent complications following induced hypothermia?
Which hemodynamic parameter requires close monitoring during rewarming to prevent complications following induced hypothermia?
A patient with an ICD experiences recurrent episodes of ventricular tachycardia. After confirming appropriate ICD function, what should be the FIRST nursing action?
A patient with an ICD experiences recurrent episodes of ventricular tachycardia. After confirming appropriate ICD function, what should be the FIRST nursing action?
Flashcards
ICD Indication
ICD Indication
Device to prevent sudden cardiac death, especially from ventricular fibrillation.
ICD Therapy: Defibrillation
ICD Therapy: Defibrillation
Delivery of shocks to stop ventricular fibrillation.
Hypothermia Therapy
Hypothermia Therapy
Therapeutic cooling to 90-93 degrees F after cardiac arrest.
Hypothermia Mechanism
Hypothermia Mechanism
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Hypothermia Dysrhythmias
Hypothermia Dysrhythmias
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Rewarming Electrolytes
Rewarming Electrolytes
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Risks of Rapid Rewarming
Risks of Rapid Rewarming
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Study Notes
- ICD stands for Implantable Cardioverter Defibrillator
Indication for ICD Implantation
- Prevent sudden cardiac death with conditions like VF arrest
- Prevent sustained VT
- Cardiomyopathy
Therapies Delivered by ICD
- Defibrillation shocks for ventricular fibrillation
- Cardioversion if necessary
- Pacing occurs in two ways:
- Anti-tachycardia pacing if possible to avoid cardioversion
- Bradycardia pacing
Hypothermia Therapy
- Therapeutic hypothermia involves cooling a post-cardiac arrest victim to 90-93 degrees Fahrenheit
- Lowering the body temperature reduces body metabolism
- Brain is protected
Hypothermia Outcomes
- Normothermia Group: 23% experienced Favorable Neurological Outcome
- Hypothermia Group: 62% experienced Favorable Neurological Outcome
Method 1: Cooling Blanket Device
- Use of a cooling blanket device
Method 2: Cold Saline Infusion
- Infusion of cold saline
Hypothermia Therapy: Cool Down
- Atrial and ventricular dysrhythmias are common due to PR, QRS, and QT prolongation
- Sinus tachycardia may occur at the start of therapy, which slows to sinus bradycardia as the therapy progresses
- Hypokalemia is common, and IV supplementation may be necessary
Hypothermia: Rewarming
- Rewarming occurs approximately 12-24 hours after the therapy
- Hyperkalemia may result as electrolytes shift, causing tall, pointy T waves and widened QRS complexes
- Rapid re-warming can cause vasodilation, hypotension, and rapid electrolyte shifts
- It is important to closely monitor CVP, ScVO2, and UO
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