Float Nurse

01. You respond to a Code Blue on the Telemetry floor.  When you arrive to the room CPR is in progress.  The patient already had a # 20 saline lock to the left AC.  When the patient is placed on the defibrillator monitor, the following rhythm is noted.  What is the next appropriate intervention? a. Administer a 1 mg epinephrine followed by a 10 cc saline flush b. Administer 300 mg of amiodarone c. Defibrillate at 200 joules d. Give Vasopressin 40 units IV 02. An 83 year old male who was admitted last night with a hip fracture is noted to be unresponsive.  No spontaneous respirations are noted.  A code is called and CPR is initiated with positive pressure ventilations. The ventilations are noted to adequate with good chest rise.  When you place the patient on the defibrillator monitor, the following rhythm is noted.  What is the next appropriate intervention? a. Give atropine 0.5 mg IV push b. Attempt transcutaneous paci...

01. You respond to a Code Blue on the medical floor. The 56 year old patient with pancreatitis was found to be pulseless and apneic. When you arrive to the room CPR is in progress and the patient is receiving positive pressure ventilations.  The ventilations are adequate with good chest rise. The patient already had a # 18 saline lock to the right AC.  When the patient is placed on the defibrillator monitor, the following rhythm is noted.  What is the next appropriate intervention. a. Administer a 1 mg epinephrine followed by a 10 cc saline flush b. Administer 300 mg of amiodarone followed by a 10 cc saline flush c. Begin transcutaneous pacing at 60 bpm d. Give atropine 0.5 mg IV followed by a 10 cc saline flush 02. A 75 year old is brought to the ER by his family with complaints of shortness of breath, chest pain, and nausea and vomiting.  The chest pain started two hours ago but seemed to go away when he rested.  But it has since returned. A ...

Answers 01.  100/min 02.  Asystole, PEA, pulseless VT, and pulseless VF 03. C- Check responsiveness and breathing.  Check for a carotid pulse.  Compressions A-Open airway and using head-tilt chin lift or jaw thrust maneuver. B-Give two rescue breaths observing for chest rise and fall then resume compressions 04. 120 – 200 J depending upon the manufactures suggested setting.  If unknown, then begin at 200 J. 05.  Anterior/posterior or Apex/right chest wall 06.    The provider delivering ventilations should give 1 breath every 6 to 8 seconds (8 to 10 breaths per minute) and should be careful to avoid hyperventilating the patient. 07. Vasopressin 40 u IV may be given as a onetime dose before epinephrine or as a second dose after the initial dose of epinephrine. 08.    Amiodarone 300 mg may be given IV/IO.   If Aminodarone is unavailable then Lidocaine 1 – 1.5 ...

Identify the following rhythms. 1.Which of the following medications can be used to treat this rhythm: a. Magnesium 1 -2 g IV/IO b. Cardizem 0.25 mg/kg IV/IO c. Epinephrine 1 mg IV/IO d. Amiodarone 300 mg IV/IO 2. During a cardiac arrest a patient receives a third shock at 300 J. A brief review of the post shock rhythm shows the patient to be in refractory VF. What antiarrhythmic can be given.  a. Vasopressin 40 units IV/IO  b. Amiodarone 300 mg IV/IO  c. Epinephrine 1 mg IV/IO  d. Sodium bicarbonate 1 mEq/kg IV/IO 3. What is wrong with this picture? a. It shows failure to capture of polymorphic VT b. It shows inappropriate pacing of VF c, It shows inappropriate synchronization of TDP d. It shows failure to sense during pacing of CHB 4. What is wrong with this picture? a. It shows appropriate cardioversion of supraventricular tachycardia b. It shows inappropriate defibrillation of atrial fibrillat...

Answer the following questions. 1. All of the following medications are indicated in the treatment of this rhythm EXCEPT: a. Epinephrine 1mg (1:10,000) IV q3 - 5 minutes b. Magnesium 1 - 2 gms IV c. Lidocaine 1 - 1.5 mg/kg IV bolus d. Amiodarone 300 mg IV push 2. What antiarrhythmic medication can be given to a patient who has symptomatic VT? a. Lidocaine 3.0 mg/kg IV push b. Procainamide 20 mcg/kg/min until arrhythmia suppressed c. Amiodarone 150 mg IV over 30 minutes d. Cardizem 5 - 10 mg/hr, watch for hypotension 3. In the absence of vascular access, what antiarrhythmic can be given via the ET tube? a. Amiodarone b. Lidocaine c. Magnesium d. Epinephrine 4. Atrial fibrillation with a slow rate may also lead to a drop in cardiac output leading to signs and symptoms of shock. While immediate transcutaneous pacing is recommended, beta adrenergic medication may serve as a “bridge: to transcutaneous pacing. Of the followi...

Answer the following questions. 1. After defibrillating your patient, you observe the monitor and note that there is no change in the rhythm. CPR is in progress. What medication is recommended to treat this rhythm? a. Amiodarone 150 mg IV/IO push b. Epinephrine 40 units IV/IO q3 - 5 minutes c. Magnesium 1 - 2 grams IV/IO d. Lidocaine 1 - 1.5 mg IV/IO 2. You have responded to a rapid response call on the surgical unit. The patient was complaining of nausea, vomiting, weakness, and shortness of breath. BP 88/42. Sats 90 on 2 L/min. He is placed on the monitor and a complete heart block is noted. Transcutaneous pacing is initiated. As you observe the monitor the following rhythm is noted. What should you do? a. Stop pacing attempts and administer Atropine 0.5 mg IV b. Continue to increase the miliamps until electrical capture is obtained c. Put the pacing on hold and begin Dopamine at 5 mcg/kg/min d. Increased to pacing rate to 100 bpm. 3. During a co...

Answer the following questions. 1.  A 35 year old arrives to the ER with complaints of dizziness, weakness, and palpitations for 4 hours. VS: 98.2, 162-20 BP: 123/76. Sats: 97% on room air. An IV is placed and oxygen at 2L/min. He is placed on the monitor and the following rhythm is noted. What is the recommended initial treatment? a. Adenosine 6mg IV given rapidly b. Vagal maneuvers c. Cardioversion at 50 - 100 J d. Cardizem (Diltiazem) 10 mg IV 2.   What is the recommended adult dose of atropine for this rhythm? a. 0.5 mg b. 1.0 mg c. 0.5 mg/kg d. 1.0 mg/kg 3.  You are responding to an announced Code Blue on the telemetry unit.  When you arrive in the room you find that CPR is in progress.  The patient is pulseless and apneic.  The defibrillator monitor has just been placed on the patient and the following rhythm is noted.  What is the most appropriate intervention? a. Attempt transcutaneous p...

Answer the following questions. 1. What is the recommended dose of vasopressin that can be used to treat this rhythm? a. 1 mg IV push.  May repeat every 3 - 5 minutes b. 40 mg IV push as a one time dose c. 300 mg IV push, may repeat at 150 mg for refractory rhythm d. 40 units IV once before epinephrine or as a second dose to epinephrine 2. A 21 year old college student is brought in to the ER with a palpations, dizziness, restlessness, and weakness. She reports taking some "pills" that her friend gave her to help her study for her final examine. Her initial Heart rhythm: NSR at 180 bpm, BP 188/ 101. Temp 100.2. Skin is hot and dry. What is the recommended treatment? a. Adenosine 6 mg IV push, may repeat at 12 mg if needed b. Benzodiazepines and external temperature cooling c. Beta blockers and Tylenol for the fever d. Cardioversion at 50 joules. Increase joules if needed 3. What is the recommended joule setting for elective ...

Answer the following questions 1. What two vasoconstrictors may be used to treat this pulseless rhythm? a. Cardizem and Norepinephrine b. Vasopressin and epinephrine c. Dopamine and vasopressin d. Levophed and epinephrine 2. Magnesium is the recommended drug for this rhythm. What is the correct pediatric dosage? a. 25 - 50 mg/kg IV/IO b. 0.01 mg/kg IV/IO c. 5 mg/kg IV/IO d. 0.02 mg/kg IV/IO 3. After placing your unresponsive and apneic patient on the monitor, you observe this rhythm. CPR is in progress. What is the recommended joule setting for your first biphasic shock? a. 120 joule synchronized b. 360 joules unsynchronized c. 200 joules unsynchronized d. 100 joules synchronized 4. An infusion of Amiodarone may be given to a symptomatic patient with this rhythm. What is the correct dosage? a. 1.0 - 1.5 mg/kg IV/IO push b. 25 - 50 mcg/min c. 150 mg IV over 10 minutes d. 2.5 - 5 mg/hr 5.  What chronotrophic agent i...