ACLS review: Asystole/PEA Review Questions Part 3

21.     A 45 year old woman has been admitted to PCU for nausea and vomiting x 4 days.  Her initial STAT serum chemistries show her BUN to be 55 and her creatinine to be 2.5.   Her heart rate is 148 and her BP is 84/40. She complains of weakness and dizziness.  A saline lock was inserted in her left antecubital and she has been placed on telemetry.  As you begin to assess her she suddenly loses consciousness.  What would be the next appropriate step for this patient?

1. Administer a precordial thump
2. Shock the patient at 200J
3. Call respiratory therapy
4. Assess her responsiveness and breathing

22.  The following rhythm is noted on the monitor:

Name the above rhythm.

1. Ventricular tachycardia
2. Supraventricular tachycardia
3. Wide complex tachycardia
4. Accelerated Idioventricular rhythm

23.  After determining that the patient is unrepsonsive and apneic, the next appropriate intervention would be:

1. Obtain a stat echocardiogram
2. Cardiovert the patient
3. Check for a pulse, if no pulse then begin CPR
4. Defibrillate the patient

24. In order to confirm pulslessness in a patient with PEA, you should

1. Confirm pulselessness with a doppler
2. Check capillary refill time
3. Order a stat echocardiogram
4. Initiate continuous waveform capnography

25.  In the above patient, a fluid bolus is in progress with 0.9% Saline.  What  vasoconstrictor is now indicated in the treatment of PEA

1. Adenosine
2. Isoproterenol
3. Vasopressin 
4. Epinephrine 

26.  For the above patient, CPR is in progress.   IV access had been obtained and the patient has just been successfully intubated with a 7.0 oral ET tube.  What would be the next appropriate step.

1. Suction the patient
2. Administer a second round of Epinephrine and Vasopressin
3. Confirm ET tube placement
4. Reassess the rhythm on the monitor

27. In order to successfully treat a patient in PEA, it is important to recognize and promptly treat reversible causes.  In the above patient what are some possible causes that should be considered.

1. Tension pneumothorax, Tablets, Thrombosis pulmonary
2. Hypovolemia, Hypokalemia, Hydrogen ions
3. Hypothermia, Thrombosis coronary, Hyperkalemia

28. Name 5 ways of confirming correct ET tube placement.

1. _________
2. _________
3. _________
4. _________
5. _________

29. Patients who have either asystole or PEA with a narrow complex tachycardia will benefit from cardioversion attempts?

1. True
2. False

30.  Match the following clinical conditions with the related signs and symptoms

Tamponade, Pericardial                                      ST segment elevation, large Q waves

Hypoxia                                                            Deviated trachea

Tension pneumothorax                                       Bradycardia with wide QRS

                                                                       complex, prolonged QT           

Hyperkalemia                                                     U waves on EKG

Tablets: Tricyclic antidepressant overdose             Hypopnea    

Hypovolemia                                                      Sudden onset of shortness of breath

Hypothermia                                                      Tall T waves, widened QRS complex

Thrombosis pulmonary                                        Poor skin turgor, hypotension,

                                                                        dry mucus membranes

Hydrogen ions, respiratory                                   Stridor

Thrombosis coronary                                          Muffled heart sounds, hypotension,

                                                                                           and JVD

Hypokalemia                                                      Osborne waves

Answers

21. A 45 year old woman has been admitted to PCU for nausea and vomiting x 4 days. Her initial STAT serum chemistries show her BUN to be 55 and her creatinine to be 2.5. Her heart rate is 148 and her BP is 84/40. She complains of weakness and dizziness. A saline lock was inserted in her left antecubital and she has been placed on telemetry. As you begin to assess her she suddenly loses consciousness. What would be the next appropriate step for this patient?

d.  Assess her responsiveness and breathing

22. The following rhythm is noted on the monitor:

Name the above rhythm.

b.  Supraventricular tachycardia

23. After determining that the patient is unrepsonsive and apneic, the next appropriate intervention would be:

c.  Check for a pulse, if no pulse then begin CPR

24. In order to confirm pulslessness in a patient with PEA, you should

a.  Confirm pulselessness with a doppler

25. In the above patient, a fluid bolus is in progress with 0.9% Saline. What vasoconstrictor is now indicated in the treatment of PEA

d. Epinephrine

26. For the above patient, CPR is in progress. IV access had been obtained and the patient has just been successfully intubated with a 7.0 oral ET tube.   What would be the next appropriate step.

c. Confirm ET tube placement

27. In order to successfully treat a patient in PEA, it is important to recognize and promptly treat reversible causes. In the above patient what are some possible causes that should be considered.

b. Hypovolemia, Hypokalemia, Hydrogen ions

28. Name 5 ways of confirming correct ET tube placement.

1. Direct visualization of the cords
2. End tidal CO2
3. Bilateral breath sounds
4. Chest X Ray
5. Continuous waveform capnography
6. Symmetrical chest rise

29. Patients who have either asystole or PEA with a narrow complex tachycardia will benefit from cardioversion attempts?

b.  False

30.  Match the following clinical conditions with the related signs and symptoms

 

Tamponade, Pericardial                                       Muffled heart sounds, hypotension, JVD

Hypoxia                                                             Stridor

Tension pneumothorax                                        Deviated trachea              

Hyperkalemia                                                     Tall T waves, widened QRS complex

Tablets: Tricyclic antidepressant overdose             Slow heart rhythm with wide QRS
                                                                        complex, prolonged QT 

Hypovolemia                                                      Poor skin turgor, hypotension, dry

                                                                        mucus membranes

Hypothermia                                                      Osborne waves

Thrombosis pulmonary                                        Sudden onset of shortness of breath

Hydrogen ions, respiratory                                  Hypopnea    

Thrombosis coronary                                          ST segment elevation, large Q waves

Hypokalemia                                                      U waves on EKG


Reviewed on 3/1/16