Cardiac Rhythm Analysis Flashcards
automaticity
ability to initiate impulse spontaneously and continuously
excitability
ability to be electrically stomulated
conductivity
ability to transmit impulses along a membrane in an orderly manner
contractility
the mechanical response to an impulse
SA node
where the beat starts (P wave)
pacemaker of the heart
60-100 bpm normally
AV node
fires 40-60 bpm normally
escape beat
parasympathetic nervous system effect on SA node
decreases rate
sympathetic nervous system effect on SA node
increases rate
dysrhythmias
disorder of impulse formation, conduction of impulses or both
P wave
depolarization of the atria
QRS complex
depolarization of the ventricles
T wave
repolarization of the whole heart
artifact
electrodes are not secre, muscle interference or electrical interference
How fast is normal sinus
60-100 BPM
where does normal sinus start
SA node and follows normal conduction pathways
when can sinus brady be normal
aerobically trained athletes and during sleep
what nervous system contributes to sinus brady
parasympathetic
S/s sinus brady X7
hypotension pale, cool skin weakness angina dizziness or syncope confusion or disorientation SOB
sinus brady tx X3
atropine
pacemaker
stopping offending drugs
atropine class
anticholinergic
atropine MOA
raises HR
how much atropine can you give without an order
max of 3 mg titrating up from 0.5
what class of drugs can cause sinus brady
beta blockers
how fast is sinus tachy
101-200 bpm
what causes sinus tachy X3
vagal inhibition
sympathetic stimulation
drugs
sinus tachy s/s X6
dizziness dyspnea hypotension angina r/t CAD diaphoresis SOB
sinus tachy treatment X3
treat by cause
vagal maneuver
beta blockers
SVT HR
150-220 bpm
what is SVT assosicated with X7
overexertion stress deep inspiration stimulants disease dig toxicity
what does SVT over 180 lead to
decreased cardiac output and stroke volume
SVT s/s 4
hypotension
dyspnea
angina
chest pain
WILL BE SYMPTOMATIC
SVT Tx X6
vagal stimulation Adenosine beta blockers ca channel blockers amiodarone cardioversion
IV adenosine half life
10 seconds
adenosine admin rate
1-2 second fast push followed immediately by fast 20 mL flush
adenosine dosage
6 mg first dose
12 mg second dose
a fib treatment X6
amiodarone ibutilide cardioversion anticoag ablation maxe procedure
what does a flutter increase the risk of
stroke
a flutter tx X3
drugs
cardioversion
ablation
what are PVC’s associated with X4
stimulants
electrolyte imbalances
hypoxia
heart disease
are PVC’s harmful
not in normal heart
PVC tx X2
correct cause
antidysrhythmics
V tach rate
150-200 BPM
why is v tach bad
life threatening d/t decreased CO and possibility of moving to v fib
torsades de points
v tach with different sized waves
what is v tach associated with X4
heart disease
electrolyte imbalances
drugs
CNS disorder
V tach symptoms X4
hypotension
pulmonary edema
decreased cerebral blood flow
cardiopulmonary arrest
stable v tach tx X2
antidysrhythmics
cardioversion
unstable v tach tx X2
CPR
rapid defibrillation
what is v fib associated with X5
MI ischemia disease procedures electrolyte imbalances
v fib s/sx X3
unresponsive
pulseless
apneic
v fib tx X3
CPR
defibrillation
ACLS drug protocol
asystole s/sx X3
unresponsive
pulseless
apneic
what is asystole the result of X3
cardiac disease
severe conduction disturbance
end-stage HF
asystole tx X3
CPR
ACLS drug protocol
Intubation
pulseless electrical activity
electrical activity is observed on the EKG
PEA causes (H’s and T’s
Hypovolemia Hypoxia Hydrogen ion (acidotic) Hyper/hypo kalemia Hypoglycemia Hypothermia
Toxins Tamponade Thrombosis Tension pneumothorax Trauma
PEA tx X4
CPR
intubation
ACLS
fix underlying cause
1st degree Heart block s/sx
not symptomatic
1st degree heart block tx
no tx
third degree heart block tx X2
pacemaker
drugs to increase HR
when is ST elevation significant
if 1 mm over the isoelectric line
initial biphasic defibrillation
120-200 Joules
initial monophasic defibrillation
360 joules
when does CPR begin with defibrillation
immediately after
where shoul dyou never put defibrillator pads
over a pacemaker or implantable cardioverter/defibrillator
what is cardioversion ideal for X2
stable v tach
SVT
what is cardioversion
shock is given on the R wave
initial biphasic cardioversion
70-75 joules
initial monophasic cardioversion
100 joules
what do you do if patient goes pulseless during cardioversoin
turn sync button off and defibrillate
