Arrhythmias/Chest Tubes/Congenital Heart Defects/Infection Control&Transmission Flashcards
What does “QRS depolarization” going to be effecting?
Atrial or Ventricular?
Ventricular Issues
What is “P Waves” going to be effecting?
Atrial or Ventricular?
Atrial Issues
What is “supraventricular” going to be effecting?
Atrial or Ventricular?
Atrial dysrhythmia issues
What is NO QRS arrythmia going to be?
Asystole
NO QRS= NO Cardiac Output= Asystole
*This is Fatal
What are the 2 Lethal Arrythmias?
And 1 Potential Fatal Arrythmia?
Fatal Rhythms= Asystole & VFib
–> Body is not being perfused
Potential Fatal Rhythm= VTach
What does does the word Chaotic mean in an Arrhythmia?
What arrhythmias have chaotic rhythms?
Chaotic= Fibrillation
Afib & Vfib
What does does the word Bizarre mean in an Arrhythmia?
What arrhythmias have Bizarre rhythms?
Bizarre= Tachycardia
vTach & PVC
What is the treatment for Asystole?
Epinephrine (1st) & Atropine(2nd)
(Vasopressin), CPR
-No QRS waves= No cardiac output
-It is Fatal
Treatment for Atrial Flutter
ABCDs (All Atrial issues)
-Adenosine (fast IV push) then flush IV
-B-blocker
-CCBs
-Digoxin
-Rapid P waves depolarization–> Sawtooth pattern
Treatment for Afib
ABCDs
-Adenosine (fast IV push) then flush IV
-B-blocker
-CCBs
-Digoxin
-Chaotic P waves depolarization–> lack pattern
–Chaotic=fib problem
Treatment for vFib
Defibrillate 200 joules
–No pattern
-Chaotic QRS depolarization=no cardiac output
*Fatal
Treatment for vTach
Lidocaine/amiodarone
–Pattern
-Bizarre wide QRS
Potentially Fatal
Treatment for PVC
Lidocaine/amiodarone
-Periodic, wide, bizarre QRS, lo priority
-Only Concerned when:
6+/min, 6+ in a row, Falls off previous T-wave
Describe 3rd Degree Heart Block or Complete Block
What are the Ventricular Dysrhythmias (2)?
What is the TX for Ventricular Dysrhythmias?
PVC & V-tach (Vfib is under the lethal tx.)
*Tx: Lidocaine & Amiodarone
–> Vtach awake med you must take but Vtach & nap must Zap Zap Zap (Defib)
What are the Atrial Dysrhythmias (3)?
What is the TX for Atrial Dysrhythmias?
Supraventricular Tachycardia (SVT), Atrial Flutter, & aFib
*Tx: ABCD’s (For Atrial use ABCD’s)
-A= Adenosine (Fast IV Push)- impending doom drug tell family/pt.
-B= Beta-Blockers
-C= CCB (-dipine & -zem)
-D= Digoxin & Lanoxin
What are the Lethal Dysrhythmias (2)?
What is the TX for Lethal Dysrhythmias?
V-fib & Asystole
*Tx: Defib (In V-fib you Defib) &
Epinephrine (1st) & Atropine (2nd)
What should you only be concerned about with a PVC?
If….
-6+ PVC per minute
-6+ PVC in a row
-PVC Falls off previous T-Wave
Look for the reason & location of why they have a chest tube. What are the two locations of a chest tube?
Apical: up High remove AIR
Basilar: down Low remove BLOOD
What type of pressure is in the chest (- or +)?
Negative pressure, the lungs pulls in air creating a negative pressure
What are the four steps when a water seal breaks on a chest tube?
- Clamp tube
- Cut tube from chamber (discard entire system)
- Place tubing in sterile water
- Unclamp tubing (only clamp tubing for 15 sec.)
What are the 3 steps when a chest tube comes out?
- Cover the hole with a gloved hand
- Cover w/ Vaseline gauze dressing
- Apply sterile dressing & TAPE ON 3 SIDES
When is it bubbling ok when it is in the water sealed chamber?
Intermittent bubbling is good in the water sealed chamber
-Continuous bubbling is bad in the water sealed chamber–> indicates a leak must tape up leak
When is it bubbling ok when it is in the suction control chamber?
Continuous bubbling is good in the suction control chamber
-Intermittent bubbling is bad in the suction control chamber–> indicated suction pressure is to low (must increase suction pressure)
Congenital Heart Defects are either ______ or Not _______.
Trouble or Not trouble
What do all trouble Congenital Heart Defects start with?
T
1. tetralogy of Fallot
2. tricuspid arterioles
3. truncus arteriosus
4. transposition of the great arteries
5. tricuspid atresia
What direction doe congenital heart defects that are troubled and not troubled flow in?
Trouble–> Right to Left (R before L in trouble)
Not Trouble–> Left to Right
What congenital heart defects have cyanotic problems? (trouble or not trouble)
Trouble
B in trouble for Blue–> Cyanotic
All congenital heart defects (CHD) share what (2) side effects?
- Murmur present via shunting of blood
- Require at least 1 Echocardiogram
What are the 4 defects of Tetralogy of Fallot?
- Ventricular septal Defect (VD)
- Pulmonic Stenosis (PS)
- Overriding Aorta (OA)
- Right ventricular Hypertrophy (RH)
Trick: “VarieD PictureS Of A RancH …. or…..
How is Hep. A transmitted?
How does it enter the body?
Fecal-Oral
A in Hep A= Anus
–> fecAl-orAl
*Contaminated food/water
How is Hep B transmitted?
How does it enter the body?
Blood
B in Hep B= Blood
*Unpotected sex, needlesticks, blood transfusions before 1992
How is Hep C transmitted?
How does it enter the body?
Blood
-drug sharing, unprotected sex, blood products before 1992
What are the required PPE for Contact precautions?
Does Contact pt. have private or shared rooms?
Gloves
Gown
Hand Hygiene
-Disposable supplies
*Private room preferred, but can have a cohort room of apt. w/ same condition
What diagnosis/disease falls under Contact precautions (5)?
RSV
Staph
Enteric (INTESTINAL –> caught fecal-oral)
Hepatic
Herpes
What are the required PPE for Droplet precautions?
Does Droplet pt. have private or shared rooms?
Gloves
Mask
Hand Hygiene
-Pt. must wear a mask if they eave room disposable supplies
*Private room preferred, but can have a cohort room of apt. w/ same condition
What diagnosis/disease falls under Droplet precautions (5)?
Meningitis
H. Flu–> SE Cause Epiglottitis
Diphtheria
Pertussis
Mumps
What diagnosis/disease falls under Airborne precautions (4)?
SARS
TB
Measles
Varicella
What are the required PPE for Airborne precautions?
Does Airborne pt. have private or shared rooms?
Gloves
Mask (specific filter for TB)
-Pt. must wear mask if they leave room
*Private room, negative airflow room w/ door closed
What is the order for DONNING PPE?
- Gown
- Mask
- Goggles
- Gloves
-Reverse ABC order except Mask is always 2nd
What is the order for DOFFING PPE?
- Gloves
- Goggles
- Gown
- Mask
-ABC order
