Arrhythmias and Ectopic Beats

Question 1

Arrhythmias and Ectopic Beats:

Answer 1

Result in an irregular rhythm

Question 2

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.

Answer 2

severity
ectopic
cardiac
more
Cardiac output
cardiac
atrial

Question 3

Many people have _____ beats during times of ______ or with use of stimulations such as _____ or _________.

Answer 3

Ectopic
stress
caffeine or nicotine

Question 4

Important to educate cardiac pts about this….

Answer 4

No smoking for 2 hrs either before or after exercise

Question 5

Ectopic beats:

Answer 5

• 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

Question 6

PAC’s:

Answer 6

Premature atrial contractions

Question 7

PVC’s:

Answer 7

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

Question 8

Supraventricular beat:

Answer 8

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)

Question 9

PJC:

Answer 9

Or premature junctional contraction: unwanted contraction that fires without regulation from A-V nodes.

Question 10

Atrial Fibrilation:

Answer 10

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.

Question 11

Paroxysmal Atrial Tachycardia

Answer 11

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

Question 12

Supraventricular Tachycardia:

Answer 12

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.

Question 13

Ventricular Bigeminy:

Answer 13

Every other beat is a PVC

Question 14

Ventricular Trigeminy:

Answer 14

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

Question 15

Ventricular couplets:

Answer 15

When 2 PVC’s occur together

Question 16

Ventricular Triplets:

Answer 16

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.

Question 17

Ventricular Tachycardia:

Answer 17

A run of 4 or more PVC”s

Question 18

Sustained V-tach:

Answer 18

HR of at least 100 bpm and last for at least 30 seconds & is considered a medical emergency

Question 19

Non-sustained V-tach

Answer 19

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

Question 20

Ventricular Fibrillation:

Answer 20

The ventricles do not contract, but instead fibrillate

-The pt is in a sate of cardiac standstill and there is no CO

Question 21

In reference to BP:

Answer 21

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

Question 22

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 ______.

Answer 22

Chronic
ok
check
proceed