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High Acuity > Cardiac 2 Rhythms > Flashcards

Cardiac 2 Rhythms Flashcards

1
Q

PSVT Treatment

A

Vagal Stimulation (Valsava, coughing, etc.)
Adenosine
Synchronized Cardioversion

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2
Q

PVC Treatment

A

Beta-blockers
Amiodarone
Lidocaine

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3
Q

PSVT Causes

A

Overexertion
Emotional Stress (EMO STRESS)
Stimulants (caffeine)

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4
Q

A-fib/ A-flutter Goals

A

Control ventricular rate
Rhythm Control
Prevent embolic stroke

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5
Q

A-fib/A-flutter Meds Rate Control

A

Metoprolol
diltiazem
Verapamil

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6
Q

Tele (White)

A

Below clavicle; mid-clavicular

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7
Q

Tele (Brown)

A

Right sternal border 4th ICS

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8
Q

Tele (Green)

A

Lower chest
Just above the right umbilicus

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9
Q

Tele (Black)

A

Below Clavicle
Mid-clavicular

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10
Q

Tele (Red)

A

Lower
Just above left to the umbilicus

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11
Q

Key features of tachydysrhythmias and bradydysrhythmias

A

Angina
restlessness
anxiety
confusion
dizziness
syncope
Palpitations
pulse deficit
SOA, tachypnea
Pulmonary crackles (LHF)
Orthopnea (LHF)
Orthostatic hypotension
S3 or S4 heart sounds (gallops)
JVD (RHF)
Weakness, fatigue
Pale, cool, in, diaphoresis
N/V
Decreased Urine Output
Delayed cap refill

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12
Q

Causes Sinus Bradycardia

A

Excessive vagal stimulation (carotid sinus massage, vomiting/gagging, Valsalva maneuvers, eyeball pressure, giving parasympathomimetic drugs)
Digitoxin Toxicity
Hyperkalemia (slow depolarization)
MI

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13
Q

Sinus Brady Treatment

A

Symptomatic
Atropine - 1mg q3-5 minutes, 3 mg MAX) increases HR
IF NOT that, a pacemaker

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14
Q

Pacemaker Malfunctions

A

Failure to sense: Does not sense depolarization
Failure to capture: Stimulation does not result in myocardial activation
Failure to pace: Doesn’t stimulate as expected

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15
Q

Pacemaker complications

A

Infection
Hematoma
Pneumothorax
Atrial/ventricular septum perforation
Lead misplacement

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16
Q

Post Op. Care of pacemaker

A

OOB
Limit arm and shoulder activity
Observe insertion site for bleeding and infection
Pt. teaching

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17
Q

Education r/t pacemakers

A

Follow-up appointments
Incision care
Arm Restrictions
Avoid direct blows, high output generator
No MRI but microwaves ok
Avoid antitheft devices
No traveling restrictions
Monitor pulse
Pacemaker and Medic Alert ID

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18
Q

Sinus Tachycardia Causes

A

Physical Activity
Anxiety
Pain
Stress
Fever
Anemia
Hypoxia
Dehydration/hypovolemia, MI, HF

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19
Q

Sinus Tachycardia TX

A

Fluid replacement
Analgesic
Anti-pyretic
Anxiolytic
Beta Adrenergic Blockers (decrease HR and myocardial O2 consumption

20
Q

PAC causes

A

Stimulants
Electrolyte Imbalances
Stress

21
Q

A-Fib

A

Multiple sources of signal firing (atrial kick isn’t effective)
Atrial > 400 bpm Ventricular =100-175
R-R interval = irregularly irregular

22
Q

A-Fib Causes

A

Underlying heart disease
Electrolyte Imbalance
Hypoxia
Cardiac Surgery

23
Q

A-fib complication

A

Stroke r/t emboli forming with blood sitting in the atrium

24
Q

A-Flutter

A

Recurring, Regular r/t single source of impulse
R to R Interval = regular or irregular
Atrial >250 Ventricular Rate = slow
4 f waves:1 QRS complex

25
Q

A-Flutter Causes

A

Electrolyte Imbalances
Heart Condition

26
Q

A-Fib/ A-Flutter Tx

A

Ventricular rate control (B-blockers, CCB)
Rhythm Control (amiodarone, dofetilide)
Prevent Embolic Stroke (warfarin)
UNSTABLE = synchronized cardioversion
Maze Procedure/ Catheter Ablation

27
Q

Synchronized Cardioversion Nursing Care

A

Maintain patent airway
Administer oxygen
VS and LOC
Monitor for dysrhythmias
Emotional support
Document results of cardioversion

28
Q

Premature Ventricular Contractions

A

Contraction occur in the ventricle
Early before QRS complex
Widen QRS
“Ugly Lil Beats”

29
Q

PVC causes

A

Electrolytes
Hypoxia
Exercises
Stimulants/Caffeine
CVD
Fever

30
Q

Bigeminy

A

PVCs every other beat

31
Q

Trigeminy

A

Every 3rd beat

32
Q

Quadgeminy

A

Every 4th Beat

33
Q

V-Tach

A

3 or more PVCs
Rate = 150-200
Regular rate
No p wave (there cannot measure PR interval)
CAD, MI, CAD, significant electrolyte imbalances, heart failure, drug toxicity

34
Q

V-tach Tx

A

CHECK FOR A PULSE
Puleless? Defrib (ACLS)
Pulse? Cardiovert
TX THE CAUSE
Anti-Dysrhythmic Meds Beta blocker/ CCB/Amiodarone

35
Q

V-Fib

A

Irregular Waveforms “quivering”
No effective contractions = NO CO

36
Q

V-Fib Tx

A

CPR and ACLS (Defibrillation)

37
Q

Defribillating Care

A

Emergency
NO CO
200-360 Joules
Unconscious
ECG monitor

38
Q

First-Degree AV Heart Block

A

PROLONGED PR interval
Asymptomatic
Associated with increasing age, disease states, and certain drugs

39
Q

1st Degree AV Heart Block TX

A

Monitor changes in heart rhythm
No specific tx

40
Q

Second-Degree AV Block Type 1 (Mobitz I, Wenkebach)

A

Long Long Wekenbach
Ischemia
Well tolerated

41
Q

2nd-Degree Type 1 Tx

A

Asymptomatic - Monitor
Symptomatic - Atropine and pacemaker

42
Q

2nd-Degree, Type 2 (Mobitz II)

A

PR interval is =
QRS Complex dropped sometimes
Heart Disease and drug toxicity
Decreased CO

43
Q

2nd-Degree, Type 2 Tx

A

Pacemaker (no ventricular response)

44
Q

3rd-Degree Heart Block (Complete Heart Block)

A

The atrium and Ventricles are firing but no communication)
aka PURE CHAOS
Severe heart disease, some drugs, systemic diseases
Decreased CO, ischemia, HF, and Shock
Lead to syncope

45
Q

3rd Degree TX

A

Pacemaker
Drugs that increase HR while waiting for pacing (positive chronotropes)

High Acuity (7 decks)

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