AG2-Dysrhythmias Flashcards
What are PVCs associated with?
- Substance use like caffeine, alcohol, nicotine, aminophylline, epi, isoproterenol, and digoxin.
- Electrolyte imbalances, hypoxia, fever, exercise, emotional stress.
- MI, mitral valve prolapse, HF, cardiomyopathy, CAD
What are ECG characteristics with a PVC?
P wave may be seen after ectopic beat, PR interval is not measurable, widened QRS (>0.12 seconds), large T wave.
Who is in control during V tach?
The ventricles
What is the ventricular rate?
150-250bpm
ECG characteristics of V tach?
P wave is usually buried in the QRS complex, PR interval is not measurable, widened QRS (>0.12)
What does stable V tach mean?
Patient has a pulse
Possible complications of sustained V tach?
Hypotension, pulmonary edema, decreased cerebral blood flow, cardiopulmonary arrest.
What is V fib?
When the ventricle is “quivering” with no contraction therefore no cardiac output. It is a lethal dysrhythmia.
What are the characteristics of a V fib ECG?
HR is not measurable. Rhythm is irregular. P wave is not visible and PR interval and QRS are not measurable.
What are some meds used to treat PVCs?
Beta blockers, procainamide, amiodarone
How is pulseless VT treated?
CPR, vasopressors (Epi), antidysrhytmics (amio) if defibrillation is unsuccessful
How is stable VT treated?
IV procainamide, sotalol, or amio . Cardioversion if drug tx is ineffective.
How is VT with a prolonged baseline QT interval treated?
IV mag, isoproterenol, phenytoin, or anti-tachycardia pacing, discontinue drugs that prolonged QT interval, cardioversion if drug therapy is ineffective
What is AIVR?
Accelerated Idioventricular rhythms
T/F. Always treat the patient not the monitor.
True
What meds do patients with V tach receive?
Adenosine and procainamide
What does stimulation of the vagus nerve cause in the HR?
Decreased rate of firing of the SA node and slowed impulse conduction of the AV node
What two electrolytes are important for cardiac function?
Na and K
What does the PR segment represent?
Electrical impulse traveling through the AV node
What does the QT interval represent?
Total time required for ventricular depolarization and repolarization
What does the T wave represent?
Ventricular repolarization
What are the factors needed in sinus rhythm?
Normal rate, one P wave for each QRS complex, PR interval of 0.12-0.20, QRS duration of 0.04- 0.10
What are some symptoms that may accompany a sinus tachycardia?
Dizziness, dyspnea, and hypotension because of decreased cardiac output
What drugs can cause a sinus tachycardia?
Epi, NE, atropine, caffeine, theophylline, or hydralazine
What are some conditions that may cause sinus bradycardia?
Carotid sinus massage, valsalva maneuver, hypothermia, increased intraocular pressure, vagal stimulation, certain drugs (beta blockers, CCB)
What diseases are associated with sinus bradycardia?
Hypothyroidism, increased intracranial pressure, and inferior MI
What are some symptoms that may be seen with sinus bradycardia?
Pale, cool skin, hypotension, weakness, angina, dizziness or syncope, confusion or disorientation, and SOB.
What medications may be used for symptomatic bradycardia?
IV atropine, dopamine (Intropin) or epi (Adrenalin) infusion
