Arrhythmias and Ectopic Beats Flashcards
Arrhythmias and Ectopic Beats:
Result in an irregular rhythm
The _______ of any arrhythmia or _______ beat is assessed by its impact on ________ output (CO). Because the ventricular arrhythmias are ________ likely to cause a decrease in _______, particularly if prolonged, they usually have a more detrimental effect on ________ functioning than do _______ arrhythmias.
severity ectopic cardiac more Cardiac output cardiac atrial
Many people have _____ beats during times of ______ or with use of stimulations such as _____ or _________.
Ectopic
stress
caffeine or nicotine
Important to educate cardiac pts about this….
No smoking for 2 hrs either before or after exercise
Ectopic beats:
- a beat that originates from a site other than the sinus node: hearts natural pacemaker
- Are usually transient
- Usually their severity depends on their effect on cardiac output
- PAC’s:
- PVC’s:
- Supraventricular beat
PAC’s:
Premature atrial contractions
PVC’s:
Premature ventricular contractions
- Usually will not compromise CO if LESS than 7 PER MINUTE
- If PVC’s increase with activity, STOP activity and pt should be assessed
Supraventricular beat:
an ectopic beat that originates in the atria or in the A-V node ( A-V node slows conduction signal to allow proper timing for the ventricles to contract) ( PJC or premature junctional contraction: unwanted contractions that fires without regulation from the A-V nodes)
PJC:
Or premature junctional contraction: unwanted contraction that fires without regulation from A-V nodes.
Atrial Fibrilation:
Atria (two upper chambers) beat chaotically)
- Pt may exhibit this rhythm continuously as their baseline rhythm
- Pt intervention may be appropriate for pts in a fib. If they have good ventricular response at rest, with appropriate hemodynamic and HR increase with exercise
- RULE OF THUMB: to avoid PT interventions if the pts resting heart rate is GREATER than 115 bpm, if the pt feels uncomfortable, or if there is inadequate hemodynamic response.
Paroxysmal Atrial Tachycardia
PAT: a run of PAC’s (premature atrial) occurring at a rate of 100 to 200 bpm
- Commonly caused by digoxin (medication that treats heart rhythm problems toxicity
- CONTRA-INDICATED for starting PT interventions during a PAT episode
- Usually last for short periods (min. not hrs) and activity may usually be resumed after the pt has been examined & etiology determined & corrected if possible
Supraventricular Tachycardia:
SVT: a run of PAC’s or PJC’s (premature junctional contraction) at a rate of 150-250 bpm
- usually last for short periods (min. not hrs) and activity may usually be resumed after the pt has been examined & etiology determined & corrected if possible
- CONTRA-INDICAtED for starting PT intervention during a SVT episode.
Ventricular Bigeminy:
Every other beat is a PVC
Ventricular Trigeminy:
Every 3rd beat is a PVC
-With Bigeminy or Trigeminy, PT intervention should be conservative and depends on the hemodynamic stability of the pt. If PVC’s should increase with acidity STOP activity/PT
Ventricular couplets:
When 2 PVC’s occur together
Ventricular Triplets:
When 3 PVC’s occur together
-STOP activity with the presence of a ventricular couplet or triplet and DO NOT RESTART PT/ activity until pt is cleared by MD.
Ventricular Tachycardia:
A run of 4 or more PVC”s
Sustained V-tach:
HR of at least 100 bpm and last for at least 30 seconds & is considered a medical emergency
Non-sustained V-tach
Occurs either in groups of 3 to 5 PVC’s known as Salvos, or a run of 6 or more PVC’s lasting up to 30 seconds
- Is considered a high risk indicator for potentially lethal arrhythmias.
- Pt may be symptomatic
- In the presence of non sustained V-tack to NOT start PT
Ventricular Fibrillation:
The ventricles do not contract, but instead fibrillate
-The pt is in a sate of cardiac standstill and there is no CO
In reference to BP:
If LOWER than 80/40 mmHg Cancel Treatment
- If HIGHER than 200 systolic or changes more than 20 mmHg diastolic CANCEL treatment.
- If 180-200 mm Hg systolic & c/o HA cancel treatment & inform MD
In addition, some conditions result in pt with _____ high blood pressure. In these cases it may be _____ to treat, monitor carefully & ______ with MD as you ______.
Chronic
ok
check
proceed
