Cardiac Dysrythmias Flashcards
P of PQRST complex
Atrial Depolarization
QRS of PQRST complex
Ventricular Depolarization
T of PQRST complex
Ventricular Repolarization
Normal HR range?
60 - 100 BPM
S/S Sinus Bradycardia
- Decreased C/O
- Pale, cool skin
- hypotension
- weakness
- angina dizziness
- syncope
- confusion
- SOB
Treatment of Sinus Bradycardia
- Atropine
- Pacemaker
- Adjust or hold medications
Sinus Bradycardia Can occur with?
- Carotid massage
- Valsalva maneuver
- Administration of medications (B-blockers, ACE)
A patient’s cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/minute. If the bradycardia is symptomatic, the nurse would expect the patient to exhibit? A) Palpitations. B) Hypertension. C) Warm, flushed skin. D) Shortness of breath
Ans: D
Sinus Tachycardia can occur with:
- Exercise
- fever
- pain
- hypotension
- hypovolemia
- anemia
- hypoxia
- MI
- HF
- administration of meds (Atropine, Epinephrine, Sudafed, Theophylline)
S/S of Sinus Tachycardia
- Decreased C/O
- dizziness
- dyspnea
- hypotension
- Can present as CP, or cause an MI
Treatment of Sinus Tachycardia
- Treat cause
- vagal maneuvers
- beta blockers
- calcium channel blockers
- Saw toothed flutter waves
- Atrial rate 200-350 bpm
- Ventricular rate approx. 150 bpm but can vary with conduction ratio
Atrial Flutter
Atrial Flutter Atrial rate
200-350 bpm
Atrial Flutter Ventricular rate
approx. 150 bpm but can vary with conduction ratio
Tx of choice for Sinus Tachycardia?
B-Blockers
Treatment of Atrial Flutter?
- B Blockers
- antidysrhythmics,
- Catheter ablation (treatment of choice)
- Cardioversion if hemodynamically stable
- Long term use of Coumadin if Aflutter continues
Tx of choice for Atrial Flutter?
Catheter ablation
Catheter ablation
Catheter is inserted into the right atrium between the inferior vena cava and tricuspid valve, electrical energy is used destroy the part of the heart causing the dysrythmia?
Cardioversion
external shock is applied (similar to CPR) to jolt pt back into a NSR
Atrial flutter tx is catheter ablation and cardionversion fail?
long term coumadin
Atrial Fibrillation Atrial rate
350-600 bpm
Controlled Atrial Fibrillation ventricular rate
60-100 bpm
Uncontrolled Atrial Fibrillation ventricular rate
> 100 bpm
Most common dysrhythmia?
Atrial Fibrillation
Treatment of Atrial Fibrillation?
- CC blockers
- B-Blockers
- Cardioversion (1st choice)
- Catheter ablation or Maze procedure (2nd choice)
- Long-term use of coumadin if Afib continues
Tx of choice for A-Fib?
Cardioversion
S/S of A-Fib
Decreased cardiac output
every other beat is a PVC?
Ventricular bigeminy
every third beat is a PVC?
Ventricular trigeminy
2 consecutive PVC’s in a row?
Couplet
S/S of PVC
- Can be benign
- Reduced cardiac output
- CP
- HF
- pulse deficit
Complication of PVC
Ventricular Tachycardia
Tx of PVC
- Treat cause
- β Blockers
A run of 3 or more PVC?
Ventricular Tachycardia
Ventricular Tachycardia Ventricular rate
150-250 bpm- regular or irregular
S/S of V-Tach
- Severe decreased C/O
- Hypotension
- pulmonary edema
- decreased cerebral blood flow
- cardio-pulmonary arrest
Complications of V-Tach
- Ventricular fibrillation
- Death
Treatment of V-Tach
- Treat cause
- B Blockers
- antidysrhythmics
- defibrillation
- The ventricle is quivering, no contraction, no cardiac output
- Heart rate is not measurable
- no pulse
Ventricular Fibrillation
S/S of V-Fib
- Unresponsive
- pulseless
- apneic
Complications of V-Fib
Death
Treatment of V-Fib
- Immediate CPR and ACLS, defibrillation
A patient in the coronary care unit develops ventricular fibrillation. The first action the nurse should take is to
A) Perform defibrillation.
B) Initiate CPR
C) Prepare for synchronized cardio-version.
D) Administer IV antidysrhythmic drugs per protocol.
Ans: B
Represents total absence of ventricular electrical activity
Asystole
Treatment of Asystole?
- CPR, ACLS, & Intubation
Organized electrical activity seen on ECG, but NO pulse present?
Pulseless Electrical Activity (PEA)
Causes of PEA?
- Common after defibrillation
- Hypoxia
- hypovolemia
- drug overdose
- hyper/hypokalemia
- metabolic acidosis
Treatment of PEA?
- CPR
- epinephrine
- intubate
- Treat underlying cause
Majority of SCDs result from
- ventricular dysrhythmias
- V-tach
- V-fib
most common cause of SCD?
V-Fib
