Megacode: Unstable Ventricular Tachycardia Part 6

The patient was successful cardioverted to a sinus rhythm.  BP 102/62.  Heart rate: 80  Respirations: 14  Oxygen saturation 98%  The patient is beginning to wake up from the conscious sedation.   He complains of some soreness in his chest.    A 12 lead EKG is obtained

A 12 lead shows the following rhythm.

26.  After successfully cardioverting a patient to a stable rhythm, what else must be done to the patient?

a.            

b.          

c.            

d.            

e.           

f.            

g.  

27. What are 4 reasons that the American Heart Association recommends that a physician seek “expert consultation” on a patient with an unstable tachycardia

a.            

b.          

c.             

d.            

28. The above EKG show ST segment elevation in what anatomical area of the heart?
a. Posterior wall

b. Anterior wall

c. Lateral wall 

d. Inferior wall

29. According to the AHA, what is recommended door to drug time for administering fibrinolytic therapy

a.  The goal is within 30 minutes or less
b. Usually with 24 hours of the onset of chest pain

c.  Within 2 hours of the onset of symptoms
d.  Within 1 hours of being evaluated by the cardiologist

30. What are some therapeutic effects of aspirin in the treatment of a patient with a STEMI?
a.

b.

Answers

26.  After successfully cardioverting a patient to a stable rhythm, what else must be done to the patient?

a.  Continue to monitor the airway and provide supplemental oxygen

b.  Assess their breathing pattern, particularly if they have were pre-treated with analgesics and sedation.  Give reversal agents if needed

c. Monitor circulation, skin temperature, color, and pulse rate

d. Monitor vital signs.   Refractory hypotension may be due to medication or a primary cardiac event.

e.  Assess and treat underlying causes:  evaluate the Hs and Ts

f.  Perform a follow up 12 lead EKG

Monitor IV fluids and IV drip medications

27. What are 4 reasons that the American Heart Association recommends that a physician seek “expert consultation” on a patient with an unstable tachycardia

a.  Stable patients may await expert consultation because treatment has the potential for harm.

b.  Sequential use of 2 or more drugs may have adverse effects: bradycardia, hypotension, and torsades de pointes

c.  Seek expert consultation for tachycardias not responsive to medications

d.  Seek consultation for long term management

28. The above EKG show ST segment elevation in what anatomical area of the heart?
b. Anterior wall

29. According to the AHA, what is recommended door to drug time for administering fibrinolytic therapy

a.  The goal is within 30 minutes or less
b. Usually with 24 hours of the onset of chest pain

c.  Within 2 hours of the onset of symptoms
d.  Within 2 hours of being evaluated by the cardiologist

30. What are some therapeutic effects of aspirin in the treatment of a patient with a STEMI?
a. produces a rapid clinical antiplatelet effect with near-total inhibition of thromboxane A2 production. 

b. It reduces coronary reocclusion and recurrent ischemic events after fibrinolytic therapy