Cardiac: ECG

Question 1

What are risk factors for dysrhythmias? (4)

Answer 1

Electrolyte imbalance
Medications/Drugs
Ischemia
Acidosis/Alkalosis

Question 2

What does it mean when the ST segment of a ECG is depressed?

Answer 2

some problem: ischemic event, not circulating

Question 3

Define sinus bradycardia

Answer 3

less than 60 bpm

Question 4

what are S&S of sinus bradycardia? (7)

Answer 4

dizziness
lightheaded
chest pain
poor circulation
edema
pressure changes
hypotension (cardiac output decreased)

Question 5

What are interventions to treat bradycardia?

Answer 5

monitor VS, need fluids, O2 PRN, administer atropine, hold beta blockers, pacemaker if unstable

Question 6

Define sinus tachycardia

Answer 6

> 100 bpm

Question 7

What are S&S of tachycardia? (3)

Answer 7

dizziness
SOB
high temp

Question 8

What are interventions for tachycardia?

Answer 8

find underlying cause
CCBs if rate unstable (too high)

Question 9

What kind of dysrhythmia does this describe? Uncoordinated atrial electrical activation that causes a rapid disorganized, and uncoordinated twitching of atrial musculature = irregular irregular rate

Answer 9

atrial fibrillation

Question 10

What are the S&S of atrial fibrillation (3)

Answer 10

atria quiver = formation of thrombi = TIA’s, stroke, MI

tachyarrhythmia = SOB/chest pain

May have pulse deficit

Question 11

What are some complications of atrial fibrillation? (3)

Answer 11

cardiac arrest, heart failure, thromboembolic event

Question 12

what are the interventions for atrial fibrillation? (6)

Answer 12

BB, CCB, Digoxin, amiodarone, warfarin therapy, cardioversion

Question 13

What are S&S of ventricular tachycardia? (4)

Answer 13

pulse or pulseless
may be conscious or unconscious
rapid rate
- can lead to arrest

Question 14

What are interventions for ventricular tachycardia? (4)

Answer 14

Sync cardioversion or defib
VS monitoring incl O2
Valsalva maneuver
antiarrhythmics

Question 15

S&S of ventricular fibrillation (3)

Answer 15

patient unconscious
no cardiac output/pulse/BP
death in minutes if not reversed

Question 16

What are interventions for V.fib? (4)

Answer 16

Defibrillation protocols + CPR
VS monitoring incl O2
Epinephrine during code
Amiodarone

Question 17

What is cardioversion?

Answer 17

Reduced dose of energy than a defibrillation

Synchronized countershock to convert an unstable rhythm

Question 18

Which wave is cardioversion synchronized to? and why?

Answer 18

Synchronized to the client’s R wave to avoid discharging shock during vulnerable T wave period

Question 19

Is cardioversion ever unsynchronized?

Answer 19

in v. fib

Question 20

What is a carotid sinus massage?

Answer 20

HCP massages over ONE carotid artery for few seconds to determine if rhythm changes on monitor

Question 21

What type of intervention does this describe:
Hold your nose, close your mouth, and try to blow the air out = slow heart rate

Answer 21

Induce vagal stimulation of cardiac conduction system = vagal maneuver

Question 22

what intervention does this describe: Bear down or induce gag reflex

Answer 22

Valsalva maneuver

Question 23

What are some antiarrthymic drugs and their action?

Answer 23

Sodium channel blockers - prevents depolarization i.e. procainamide

Potassium-channel blockers -delays repolarization & lengthens refractory period i.e. amiodarone

Question 24

What do beta blockers do in dysrhythmias?

Answer 24

Beta blockers - slows conduction across myocardium i.e. propranolol

Question 25

what do calcium channel blockers do in dysrhythmias?

Answer 25

Reduce automaticity & slows conduction velocity i.e. diltiazem, verapamil

Question 26

What are some drugs that slow conduction of through the AV node?

Answer 26

• digoxin
• adenosine
• ibutlide