Tuesday, June 30, 2015

Nursing Stuff: Isolation Precautions

The answers are:
1. c. Droplet
2. e. Standard
3. d. Neutropenic
4. b. Contact
5. a. Airborne

Monday, June 29, 2015

EKG Rhythm Strip

Identify the following rhythm (Click on the image to enlarge it).

Biventricular paced beats with an 11 beat run of ventricular tachycardia. The rate of the VT is about 150 bpm.  Complex 4 is a fusion beat and you can see that the pacemaker fired at the same time the ventricular ectopic beat occur. The 5th beat falls on the later half of the T wave so this may have triggered the run of VT.  A fusion beat concludes the run of VT and biventricular pacing resumes.  

Friday, June 26, 2015

EKG Rhythm Strip

Identify the following rhythm. (Click on the image to enlarge)

Atrial fibrillation with ventricular escape beats.  The underlying rhythm is atrial fibrillation.  Beats  4, 5, and 6 occur late in the cardiac cycle. The morphology of the QRS complex is much wider than the QRS complexes of beats 1, 2, 3, and 7. The R - R interval between beats 3 and 4 is about 37 small boxes, this corresponds to a rate of about 40 beats/min.  Since the inherent rate of the ventricles is 20 - 40 bpm, complex 4 falls within the upper limits of an escape beat of ventricular origin. Complexes 5 and 6 occur at the same rate.  

Thursday, June 25, 2015

Nursing Stuff: Various Eye Disorders

1. b. Cataract
2. c. Conjunctivitis
3. c. Hyperthyroidism
4. c. Ecchymosis
5. c. Subconjunctival hemorrhage
6. a. Isopto-atropine

Wednesday, June 24, 2015

Practice EKG Strips

1. Identify the following rhythm.

a. Atrial paced
b. AV paced
c. Biventricular paced
d. Ventricular paced

2. Identify the following rhythm.

a. First degree heart block
b. Second degree heart block type I
c. Second degree heart block type II
d. Third degree heart block

3. Identify the following rhythm.

a. Complete heart block
b. Idioventricular rhythm
c. Agonal rhythm
d. Junctional rhythm

4. Identify the following rhythm.

a. Sinus rhythm with ST depression
b. First degree block with ST depression
c. Sinus bradycardia with ST depression
d. Sinus arrhythmia with ST depression

5. Identify the following rhythm.

a. Supraventricular tachycardia
b. Accelerated junctional rhythm
c. Ventricular tachycardia
d. Sinus tachycardia

1. c. Biventricular paced
2. d. Third degree heart block
3. b. Idioventricular rhythm
4. a. Sinus rhythm with ST depression
5. a. Supraventricular tachycardia

Tuesday, June 23, 2015

Nursing Stuff: Blood Transfusions


1. a. It helps restore blood volume while preventing fluid overload
2. c. Testing for atypical antibodies that might cause transfusion problems
3. b. It restores clotting factors, except platelets, and adds fluid volume
4. a. It removes white blood cells (WBCs) that may increase the risk of minor transfusion reactions
5. b. It decreases the risk of alloimunization and transfusion transmitted disease

Monday, June 22, 2015

EKG Rhythm Strip

Identify the following rhythm.

The answer is sinus bradycardia with sinus arrest. 

Friday, June 19, 2015

EKG rhythm Strips

Identify the following rhythm.

The answer is: Atrial fibrillation with aberrantly conducted beats.  The rsR' pattern in lead V1 favors aberrancy.  In his book ACLS 2013 Arrhythmias, Dr Ken Grauer states that when there is a RBBB morphology in the V1 lead with a tall R' wave and an S wave that descends below the baseline then the complex favors abberrancy. 

Thursday, June 18, 2015

EKG Strip

Identify the following rhythm.

The answer is: Ventricular tachycardia converting to normal sinus rhythm.  

Wednesday, June 17, 2015

Nursing Stuff: Pacing


1. b Transcutaneous pacing
2. b. Restoring cardiac output and accelerating the ventricular rate
3. b. Atropine
4. b. AV node
5. a. Deliver pacing impulses at a fixed rate

Tuesday, June 16, 2015

Nursing Stuff: Ventilators

Ventilator Questions

1. b. Remove the ventilator circuit and apply positive pressure ventilations with the ambu bag with 100% oxygen.  Answer A, lavaging is no longer recommended as it introduces bacteria into the airways. Answer C, increasing the versed will not improve his oxygenation.  Answer D.  This may be an appropriate intervention, but generally vent adjustment are made by the respiratory therapist.
2. a. Continuous mandatory ventilation.
3. c. 20 - 30 cm Hg
4. b. PEEP
5. d. Loss of the ET tube cuff pressure will cause a low pressure alarm.

Monday, June 15, 2015