MED SURG FINAL STUDY GUIDE

MED SURG FINAL STUDY GUIDE

1.       Cardiac

a.       Full Cardiac Arrest!

i.            Follow AHA guidelines for CPR

ii.            Defibrillate first or CPR first?

1.       Depends on the situation

2.       Unresponsive adult, get an AED

a.     If you are alone – get it yourself

b.     If others are with you – send them to get the AED and call 911 while you start CPR

b.       Asystole

i.            No electrical activity – can you shock?

1.       NO! This is not a shockable rhythm, the heart needs to have activity to be shockable

2.       You need to do CPR and push EPI first to obtain a rhythm before shocking them

3.       Pulseless Vtach and Vfib ARE shockable

ii.            CPR and epinephrine

c.        Ventricular Fibrillation

i.            Defibrillate as soon as possible

ii.            CPR

iii.            Drugs?

1.       The vasopressor that is used for the treatment of VF/Pulseless VT is epinephrine. Epinephrine

is primarily used for its vasoconstrictive effects. Vasoconstriction is important during CPR because it will help increase blood flow to the brain and heart.

d.       Ventricular Tachycardia

i.            Depends upon – pulse vs no pulse; stable vs unstable

1.       Pulseless – defibrillate

2.       Pulse, but unstable – synchronized cardioversion

3.       Pulse and stable - antiarrhythmic meds,

Amiodarone

e.       Pulseless Electrical Activity (PEA)

i.            EKG appears NSR, but no palpable pulse

ii.            CPR and epinephrine

iii.            Find and treat the cause

f.        Supraventricular Tachycardia (SVT)

i.            Stable – Adenosine

ii.            Unstable – synchronized cardioversion

g.       Sinus Bradycardia

i.            Only treat if symptomatic

ii.            Atropine is drug of choice

1.       Dose? Frequency? Max dose?