H476 Dysrhythmia-Hemodynamics Activity 1 with Answers.

Dysrhythmia-Hemodynamic Activity 1 H476 Dysrhythmia-Hemodynamics

1. Name the rhythm above. a. First Degree Heart Block (PR interval >.20) b. Second degree heart block Mobitz Type II c. Third Degree Heart Block d. Normal Sinus Rhythm

2. Name the rhythm above. a. Supraventricular Tachycardia b. Torsades de Pointes (Big, Small, Big, Small pattern, check electrolytes) c. Ventricular Fibrillation d. Ventricular Tachycardia

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Dysrhythmia-Hemodynamic Activity 2

3. Name the rhythm above. a. Atrial Pacing b. Idioventricular rhythm c. Ventricular Pacing (pacer spike followed by wide QRS complex) d. Ventricular Tachycardia

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Dysrhythmia-Hemodynamic Activity 3

4. Name the rhythm above. a. First Degree Heart Block with Unifocal PVC’s b. Normal Sinus Rhythm with PJC’s c. Normal Sinus Rhythm with Multifocal PVC’s d. Sinus Bradycardia with PAC’s

5. Name the rhythm above. a. Junctional Rhythm (junctional rhythms have inverted P waves or absent P waves, Sole pg 113) b. Normal Sinus Rhythm c. Sinus Bradycardia d. Third Degree Heart Block

6. Name the rhythm above. a. First Degree Heart Block b. Second Degree Heart Block Mobitz Type I (Wenckebach) c. Second Degree Heart Block Mobitz Type II (More P waves then QRS & PR interval is normal when followed by a QRS complex)

d. Third Degree Heart Block 7. What treatment should the nurse prepare for the above dysrhythmia in question 6? a. Cardioversion b. Lidocaine c. Metoprolol (Lopressor) d. Transcutaneous Pacing

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Dysrhythmia-Hemodynamic Activity 4

8. Name the rhythm above. a. First Degree Heart Block b. Second Degree Heart Block Mobitz Type I ( Wenckebach) c. Second Degree Heart Block Mobitz Type II d. Third Degree Heart Block (P & QRS complexes march out independently, no communication)

9. Name the rhythm above. a. Atrial Fibrillation b. Atrial Flutter c. Supraventricular Tachycardia (QRS complex narrow, fast, no P wave, regular) d. Ventricular Tachycardia 10. What is a treatment for the above dysrhythmia in question 9? a. Adenosine b. Atropine c. Defibrillation d. Dopamine

11. Name the rhythm above. a. First Degree Heart Block b. Second Degree Heart Block Mobitz Type I ( Wenckebach) (PR interval progressively gets longer) c. Second Degree Heart Block Mobitz Type II d. Third Degree Heart Block

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Dysrhythmia-Hemodynamic Activity 5 Normal Hemodynamic Values Cardiac Output (CO) Cardiac Index (CI) Central Venous Pressure (CVP) Pulmonary Artery Pressure (PAP) PAS PAD

List Normal Values Here 4-8 2.5-4.2 2-6 15-25/8-15

Pulmonary Artery Wedge Pressure (PAWP)

8-12 800-1500 100-250

Systemic Vascular Resistance (SVR) Pulmonary Vascular Resistance (PVR)

Dave Brown is a 66 year-old man admitted to the ICU with acute exacerbation of heart failure.

HR 122; RR 34; B/P is 116/64 (MAP 81) SpO2 is 88% on 2L nasal cannula; Fine crackles auscultated 1/3 up bilaterally Urine output <30 mL/hr; dark, amber urine.

Pulmonary artery pressures and hemodynamic calculations are: PAP 43/21 PAWP 20 CVP 11 CO 2.8 L/min SVR 2000 PVR 238 12. What hemodynamic parameter measures Right Preload? a. Central Venous Pressure b. Pulmonary Artery Wedge Pressure c. Pulmonary Artery Diastolic Pressure d. Pulmonary Vascular Resistance e. Systemic Vascular Resistance 13. Based on Mr. Brown’s hemodynamic profile above, Right Preload is: a. Decreased b. Increased c. Normal 14. What hemodynamic parameter measures Left Preload? a. Central Venous Pressure b. Pulmonary Artery Wedge Pressure c. Pulmonary Artery Systolic Pressure d. Right Atrial Pressure e. Systemic Vascular Resistance 15. Based on Mr. Brown’s hemodynamic profile above, Left Preload is: a. Decreased b. Increased c. Normal

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Dysrhythmia-Hemodynamic Activity 6 16. What hemodynamic parameter measures Left Afterload? a. Central Venous Pressure b. Pulmonary Artery Wedge Pressure c. Pulmonary Artery Diastolic Pressure d. Pulmonary Vascular Resistance e. Systemic Vascular Resistance 17. Based on Mr. Brown’s hemodynamic profile, the Left Afterload parameter indicates: a. Normal b. Vasoconstriction c. Vasodilation 18. You would describe Mr. Brown’s fluid volume status as: a. Hypervolemia b. Hypovolemia c. Normovolemia 19. Which hemodynamic parameters identify the fluid volume status (circle all that apply) a. Central Venous Pressure b. Pulmonary Artery Wedge Pressure c. Pulmonary Artery Diastolic Pressure d. Pulmonary Vascular Resistance e. Systemic Vascular Resistance 20. What hemodynamic parameter takes body size into account and is therefore more accurate than the cardiac output when determining the volume ejected from the heart per minute? a. Cardiac Index b. Cardiac Workload c. Pulmonary Vascular Resistance d. Stroke Volume e. Systemic Vascular Resistance 21. Which two drugs can be used as an IV infusion to quickly improve cardiac output by increasing contractility? (Circle or highlight 2) a. Digoxin (Lanoxin) b. Dobutamine (Dobutrex) Continuous IV infusion c. Losartan (Cozaar) d. Milrinone (Primacor) e. Phenylephrine (Neosynephrine) 22. Which two drugs are used as an IV infusion to quickly decrease afterload?

(Circle or highlight 2) a. Dopamine (Intropin) b. Fenoldopam (Corlopam) Continuous IV infusion c. Nitroprusside (Nipride) d. Norepinephrine (Levophed) e. Ramipril (Altace)

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Dysrhythmia-Hemodynamic Activity 7 23. Which two drugs are used to decrease preload? (Circle or highlight 2) a. Furosemide (Lasix) b. Diltiazem (Cardizem) c. Epinephrine (Adrenalin) d. Nitroglycerin (Tridil) e. Norepinephrine (Levophed) 24. When auscultating the heart, the first heart sound S1 is created by the closure of which two valves? (circle or highlight 2) a. Aortic Valve b. Mitral Valve c. Pulmonic valve d. Tricuspid valve 25. When auscultating the heart, the second heart sound S2 is created by the closure of which two valves? (circle or highlight 2) a. Aortic Valve b. Mitral Valve c. Pulmonic valve d. Tricuspid valve

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