List the sites for IM injections.
- dorsogluteal
- deltoid
- vastus lateralis
- ventrogluteal
Pulmonary circulation is pumped through which side of the heart?
It is pumped through the right side of the heart
The systemic circulation is pumped through which side of the heart?
It is pumped through the left side of the heart.
What is stroke volume?
Amount of blood ejected from each ventricle with each heartbeat.
What is preload?
The end of diastole; it is the pressure on walls of the ventricles by volume of blood filling the ventricles at the end of diastole
It is vital, to get the position of the ECG chest electrodes correct. Where should they be placed?
Limbs = L & R wrists
-L & R legs (just above the ankle)
V1= 4th intercostal space counting down the pt’s R sternal notch on the R sternal edge
V2= 4th intercostal space counting down rom the pt’s L sternal notch on the L sternal edge
V3= should be positioned midway between V2 and V4
V4= should be positioned in the 5th intercostal space, counting down the middle of the pt’s clavicle
V5= should be positioned in line with V4 but on the axillary line
V6= should be positioned in line with V4 but in the axillary line.
To obtain a good-quality ECG tracing you need to make sure that there is no outside interference, as this can create artefact. What are the 3 most common causes of artefact?
- main interference
- pt movement
- wandering baseline
what does the P wave represent?
the spread of the impulse from the SA node across the atria (atrial depolarisation)
What does the PR interval represent?
the time taken for the impulse to spread over the atrium and through the AV node, where the impulse pauses for a short time
What does the QRS complex represent?
the spread of the impulse through the ventricles (ventricular depolarisation)
What does the T wave represent?
represents ventricular recovery (repolarisation)
What are we assessing for in a ECG rhythm strip analysis?
- rate
- rhythm= regular or irregular
- atrial activity
- ventricular activity = broad, narrow or normal
- relationship
- intervals
- name/description
An ECG represents... A) the structure of the heart B) movement of electrical impulses through the heart C) movement of blood through the heart D) the state of the coronary arteries
An ECG represents... A) the structure of the heart B) movement of electrical impulses through the heart* C) movement of blood through the heart D) the state of the coronary arteries
Electrical conduction of the heart's cells is also known as.. A) polarisation B) repolarisation C) depolarisation D) defibrillation
Electrical conduction of the heart's cells is also known as.. A) polarisation B) repolarisation C) depolarisation* D) defibrillation
The conduction pathway is composed of?
starts at the:
- sinoatrial node(SA) then moves to the
- atrioventricular node (AV)
- the bundle of HIS through the
- R + L branches and then to the
- purkinje fibres
What assessment would we performing for a cardiovascular assessment?
-pt hx: describe present illness and cheif complaint
-observe pt: colour, oedema, LOC,
-pain assessment
-vital signs
12 lead ECG: looking for signs of ischemia or cardiac pathology
-respiratory assessment
-urine output and sample
-assess R side of neck for venous congestion (vein distension)
How do we perform a 6 second HR measurement calculation on an ECG?
- count the R waves on a 6-s strip and multiply by 10 to calculate the rate for one minute
Define shock.
Shock is an altered physiological state that effects the functioning of every cell and organ system in the body.
define oligoanuria
fluid retension
define Hypovolaemic shock
a reduction in circulating blood volume through haemorrhage or dehydration or plasma fluid loss.
What are the management principles of shock?
treatment of shock focuses on treating the underlying cause, restoration and optimisation of perfusion and oxygen delivery
What does the mnemonic VIP stand for?
V- ventilation, including airway, added oxygen and ventilation
I- infusion of appropriate volume expanders
improved heart P-pumping with drug therapy such as antiarrhythmics, inotropes, diuretics and vasodilators
What does the mnemonic FASTHUG stand for?
F-feeding (preventmalnutrition, promote adequate calorie intake)
A-analgesia (reduce pain, improve physical and psychological wellbeing)
S-sedation (titrate to the 3c’s=calm, cooperative, comfortable)
T-thromboembolic prophylaxis (prevent DVT)
H-head of bed elevate (up to 45* to reduce reflux and VAP)
U-ulcer prophylaxis (prevent stress ulcers)
G- glycaemic control (maintain normal BGLs)
what is the pt management for hypovolaemic shock?
- focuses on fluid loss minimisation and restoring blood volume after A and B are secure
- more than 1 large bore cannulae should be inserted
- maintain pt body temp above 35 to avoid complications
- fluid resuss is a 1st line treatment
- for moderate to severe hypovolaemia, blood is used to improve O2 carrying capacity
- document= fluid type, volume and rate and target end points
