AG2-Dysrhythmias

Question 1

What are PVCs associated with?

Answer 1

• 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

Question 2

What are ECG characteristics with a PVC?

Answer 2

P wave may be seen after ectopic beat, PR interval is not measurable, widened QRS (>0.12 seconds), large T wave.

Question 3

Who is in control during V tach?

Answer 3

The ventricles

Question 4

What is the ventricular rate?

Answer 4

150-250bpm

Question 5

ECG characteristics of V tach?

Answer 5

P wave is usually buried in the QRS complex, PR interval is not measurable, widened QRS (>0.12)

Question 6

What does stable V tach mean?

Answer 6

Patient has a pulse

Question 7

Possible complications of sustained V tach?

Answer 7

Hypotension, pulmonary edema, decreased cerebral blood flow, cardiopulmonary arrest.

Question 8

What is V fib?

Answer 8

When the ventricle is “quivering” with no contraction therefore no cardiac output. It is a lethal dysrhythmia.

Question 9

What are the characteristics of a V fib ECG?

Answer 9

HR is not measurable. Rhythm is irregular. P wave is not visible and PR interval and QRS are not measurable.

Question 10

What are some meds used to treat PVCs?

Answer 10

Beta blockers, procainamide, amiodarone

Question 11

How is pulseless VT treated?

Answer 11

CPR, vasopressors (Epi), antidysrhytmics (amio) if defibrillation is unsuccessful

Question 12

How is stable VT treated?

Answer 12

IV procainamide, sotalol, or amio . Cardioversion if drug tx is ineffective.

Question 13

How is VT with a prolonged baseline QT interval treated?

Answer 13

IV mag, isoproterenol, phenytoin, or anti-tachycardia pacing, discontinue drugs that prolonged QT interval, cardioversion if drug therapy is ineffective

Question 14

What is AIVR?

Answer 14

Accelerated Idioventricular rhythms

Question 15

T/F. Always treat the patient not the monitor.

Answer 15

True

Question 16

What meds do patients with V tach receive?

Answer 16

Adenosine and procainamide

Question 17

What does stimulation of the vagus nerve cause in the HR?

Answer 17

Decreased rate of firing of the SA node and slowed impulse conduction of the AV node

Question 18

What two electrolytes are important for cardiac function?

Answer 18

Na and K

Question 19

What does the PR segment represent?

Answer 19

Electrical impulse traveling through the AV node

Question 20

What does the QT interval represent?

Answer 20

Total time required for ventricular depolarization and repolarization

Question 21

What does the T wave represent?

Answer 21

Ventricular repolarization

Question 22

What are the factors needed in sinus rhythm?

Answer 22

Normal rate, one P wave for each QRS complex, PR interval of 0.12-0.20, QRS duration of 0.04- 0.10

Question 23

What are some symptoms that may accompany a sinus tachycardia?

Answer 23

Dizziness, dyspnea, and hypotension because of decreased cardiac output

Question 24

What drugs can cause a sinus tachycardia?

Answer 24

Epi, NE, atropine, caffeine, theophylline, or hydralazine

Question 25

What are some conditions that may cause sinus bradycardia?

Answer 25

Carotid sinus massage, valsalva maneuver, hypothermia, increased intraocular pressure, vagal stimulation, certain drugs (beta blockers, CCB)

Question 26

What diseases are associated with sinus bradycardia?

Answer 26

Hypothyroidism, increased intracranial pressure, and inferior MI

Question 27

What are some symptoms that may be seen with sinus bradycardia?

Answer 27

Pale, cool skin, hypotension, weakness, angina, dizziness or syncope, confusion or disorientation, and SOB.

Question 28

What medications may be used for symptomatic bradycardia?

Answer 28

IV atropine, dopamine (Intropin) or epi (Adrenalin) infusion