ACLS review

126.  What are the therapeutic effects of Nitroglycerine?

Decreases pain of ischemia

Increases venous dilation

Decreases venous blood return to heart

Decreases preload and cardiac oxygen consumption

Dilates coronary arteries

127.  What are some precautions to observe during the administration of Nitroglycerine?

Use extreme caution if systolic BP <90 mm Hg

Use extreme caution in RV infarction

Suspect RV infarction with inferior ST changes

Limit BP drop to 10% if patient is normotensive

Limit BP drop to 30% if patient is hypertensive

Watch for headache, a drop in BP, syncope, and tachycardia

128.  What are the ECG characteristics of atrial fibrillation?

Rate:  Atrial rate may be 200-400, ventricular rate will vary

Rhythm:  ventricular rhythm is irregular

P waves:  No identifiable P waves, fibrillatory waves are present

PR interval is not measurable

QRS complex will usually be less than .10 seconds

130.  What are some factors that affect transthoracic resistance or impedance during defibrillation and cardioversion?

Paddle size

Chest size

Distance between the paddles

Paddle pressure

Presence of conductive gel

Lower joule settings

Reviewed 2/28/16