Cardiovascular Emergencies and Arrhythmia Management Flashcards
6 cards from real Acute Care Nurse Practitioner practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Cardiovascular Emergencies and Arrhythmia Management flashcards as text
Which anticoagulation strategy is recommended for acute massive pulmonary embolism (PE) with hemodynamic instability?
Answer: Systemic thrombolysis with alteplase + unfractionated heparin
Systemic thrombolysis (alteplase 100 mg IV) plus unfractionated heparin is indicated for massive PE with hemodynamic instability.
Which echocardiographic finding indicates right ventricular strain in pulmonary embolism?
Answer: RV dilation with septal flattening (D-sign) and McConnell's sign
RV dilation, D-shaped septum (septal flattening), and McConnell's sign (RV free wall akinesis with preserved apex) indicate acute RV strain from PE.
A patient with acute decompensated HF refractory to diuretics has worsening dyspnea and oliguria. Which intervention should be considered next?
Answer: Initiate ultrafiltration or aquapheresis
Ultrafiltration (aquapheresis) mechanically removes excess fluid in diuretic-resistant heart failure, providing reliable decongestion.
Intra-aortic balloon pump (IABP) counterpulsation improves hemodynamics through which mechanism?
Answer: Inflates in diastole to augment coronary perfusion and deflates in systole to reduce afterload
IABP inflates during diastole (augmenting coronary perfusion) and deflates just before systole (reducing afterload and myocardial oxygen demand).
Which serum biomarker is MOST specific for myocardial injury and is the preferred marker for diagnosing NSTEMI?
Answer: High-sensitivity troponin I or T
High-sensitivity troponin (hsTnI or hsTnT) is the most sensitive and specific biomarker for myocardial injury and is the gold standard for NSTEMI diagnosis.
A patient in cardiogenic shock post-MI has not responded to vasopressors. Which mechanical circulatory support device provides the highest cardiac output support?
Answer: Veno-arterial ECMO (VA-ECMO)
VA-ECMO provides the highest level of mechanical cardiac support, capable of delivering 4–6 L/min of flow to support both cardiac and respiratory failure.