Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PathoPharm 2 > ch 35 dysrhythmias > Flashcards

ch 35 dysrhythmias Flashcards

1
Q

what does the P wave represent

A

depolarization of atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the QRS wave represent

A

depolarization of ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what does the T wave represent

A

repolarization of ventricles (refractory period)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cardiac output = ? x ?

A

heart rate x stroke volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what happens to K, Na, and Ca during depolarization

A

K moves out
Na and Ca move in
contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what happens to K, Na, and Ca during repolarization

A

K moves in

Na and Ca move out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the steps to rhythm analysis (5)

A
  • what is heart rate?
  • is rhythm regular/irregular?
  • is there a P for every QRS?
  • is there a QRS for every P?
  • measure intervals (PR, QRS)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is considered a normal QRS interval

A

<0.12 seconds (3 small boxes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is considered a normal PR interval

A

0.12-0.2 seconds (1 big box)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what can cause artifact

A

bad adherence to chest

movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

S+S sinus bradycardia

A
  • hypotension
  • pale cool skin
  • weakness
  • angina
  • dizziness/fainting
  • SOB
  • confusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

causes of abnormal sinus bradycardia (6)

A
  • hypothyroidism
  • hypoglycemia
  • increased intracranial pressure
  • hypothermia
  • b blocker or calcium channel blocker
  • vagal stimulation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

atropine toxicity S+S

A
  • “hot as a hare” = increased temp
  • “mad as a hatter” = confused
  • “red as a beet” = flushed
  • “dry as a bone” = thirst
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment for symptomatic sinus bradycardia (3)

A
  • atropine: 0.5 IVP and flush with NS fast
  • pacemaker
  • stop offending drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

max dose in 24 hr for atropine

A

3 mg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how to calculate max sinus tachycardia

A

220 - person’s age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the HR for sinus bradycardia

A

<60 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the HR for sinus tachycardia

A

101-180 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the HR for paroxysmal supraventricular tachycardia

A

151-220 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the HR for atrial flutter

A

200-350 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the HR for atrial fibrillation

A

350-600 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is the HR for ventricular tachycardia

A

150-250 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

S+S sinus tachycardia

A
  • dizziness
  • dyspnea
  • hypotension
  • chest pain
  • decreased cardiac output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

causes sinus tachycardia (2)

A
  • vagal inhibition

- sympathetic stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what meds can cause sinus tachycardia (3)
- atropine - epinephrine - albuterol
26
treatment for sinus tachycardia (3)
- vagal maneuver - meds: B blockers, adenosine, or calcium channel blockers - synchronized cardioversion
27
what is the minimum amount of time you should give an IVP of B blocker over
atleast 5 mins
28
causes premature atrial contractions (PAC)
- stress - fatigue - caffeine - alcohol - tobacco - hypoxia - electrolyte imbalance - disease states
29
S+S premature atrial contractions
palpitations
30
treatment premature atrial contractions (2)
- remove offending agent | - b blocker
31
S+S paroxysmal supraventricular tachycardia (PSVT) (3)
- hypotension - dyspnea - angina
32
causes PSVT (6)
(abrupt onset and ending) - overexertion - stimulants - disease - digitalis toxicity - deep inspiration - stress
33
1st priority for PSVT treatment
call a code!
34
treatment PSVT
- vagal stimulation - IV adenosine rapid push with NS flush - IV b blocker - synchronized cardioversion if adenosine not effective
35
ECG characteristic of PSVT
- can't distinguish P from T waves - change occurs suddenly - HR 150-220
36
risks with atrial flutter and atrial fibrillation
- blood clot in atrium | - stroke
37
ECG characteristics of atrial flutter
- sawtooth pattern | - irregular rhythm
38
treatment A flutter and A fib (4)
- O2 - if HR > 100 = digoxin, calcium channel blockers, b blockers, amiodarone - stroke prevention = enoxaparin, warfarin, or factor 10a inhibitor - radiofrequency ablation or cardioversion if amiodarone didn't work
39
toxicity S+S digoxin (5)
- fatigue - dysrhythmias - visual disturbances ** - anorexia - hypokalemia
40
how do you give amiodarone
through a filter
41
ECG characteristics of atrial fibrillation
- irregular rhythm | - wavy baseline
42
causes atrial flutter and fibrillation (2)
- ectopic pacemakers in atria | - decreased cardiac output, blood pools in atria
43
what endocrine imbalance can long term use of amiodarone lead to
hypothyroidism
44
most common dysrhythmia after heart attack
1st degree AV block
45
ECG characteristics of 1st degree AVB
long PR interval (>0.2) | -HR can be brady, normal, or tachy
46
treatment for 1st degree AVB
none | continue to monitor
47
ECG characteristics of 2nd degree AVB type 1
- irregular rhythm - dropped beats ** - not QRS for every P - PR intervals increasingly prolonged across ECG strip
48
treatment 2nd degree AVB (types 1 and 2)
if symptomatic: - atropine - temporary pacemaker
49
ECG characteristics of 2nd degree AVB type 2
- irregular rhythm - not QRS for every P - P waves are punctual and normal ** - same PR interval * - dropped beats
50
what could be indicated by T wave not beginning at baseline
MI
51
S+S 3rd degree AVB
- hypotensive | - unconscious
52
ECG characteristics of 3rd degree AVB
- regular rhythm with dropped beats - not QRS for every P - wide QRS (>0.12) - PR intervals all different
53
treatment 3rd degree AVB (2)
- dopamine or epinephrine | - emergency pacemaker
54
causes premature ventricular contractions (PVC)
- stress - fatigue - caffeine - electrolyte imbalance
55
ECG characteristics premature ventricular contractions
- wide QRS | - early beats
56
what does multifocal PVC mean
PVCs don't look the same
57
what is a couplet
2 PVCs in a row
58
what is bigeminy
PVC q2nd beat
59
what is trigeminy
PVC q3rd beat
60
treatment PVC (2)
- address underlying condition (maybe O2 or electrolyte replacement) - amioderone
61
2 shockable pulse rhythms
vtach and vfib
62
causes V Tach (3)
- head injuries - MI - electrolyte imbalances
63
S+S V Tach
- severe hyperthermia | - "R on T phenomenon" next beat starts before ventricles are repolarized
64
ECG characteristics V Tach
- regular rhythm - QRS >0.2 - HR 150-250 bpm
65
what can sustained V Tach lead to
- hypotension - pulmonary edema - decreased cerebral blood flow - cardiopulmonary arrest
66
treatment for V Tach with pulse
-antidysrhythmics or cardioversion
67
treatment for V Tach without a pulse
- CPR and rapid defibrillation | - amiodarone can prevent going back into V Tach
68
what is torsades de pointes
occurs with V Tach | next beat starts before ventricles are repolarized, varying heights of R waves
69
#1 cause of MI
v fib
70
ECG characteristics V Fib
- wavy baseline | - extremely irregular rhythm
71
treatment for V Fib
CPR and debrillation
72
causes v fib
- MI - HF - electrolyte imbalances - severe alkalosis - drug toxicity - hypoxia
73
ECG characteristics of asystole
- absence of electrical impulses | - pt unresponsive and pulseless
74
treatment asystole (5)
- CPR - epinephrine 1 mg IVP q3-5 mins - intubation - temporary pacemaker - treat 5 Hs and 5 Ts
75
5 (6) Hs with asystole
- hypovolemia - hypoxia - hydrogen ion (acidosis) - hyper/hypokalemia - hypoglycemia - hypothermia
76
5 Ts with asystole
- toxins - tamponade - thrombosis (MI + pulmonary) - tension pneumothorax - trauma
77
ECG characteristic of pulseless electrical activity (PEA)
any electrical pattern without pulse
78
treatment PEA
- CPR - epi IVP q3-5 mins - intubation
79
how to use cardioversion
- 50-100 J - sync to R wave - for supraventricular tach, a fib, a flutter, 2nd degree type 2 avb
80
how to use defibrillation
- 120-200 J - don't sync to R wave - shock when clear
81
what to tell pts about ICDs
- don't lift arm until cleared - avoid large magnets and MRIs - if fires once, call hcp; if once and sick or twice, call 911* - keep incision dry for several days after implant - avoid direct blows to site
82
emergency management of dysrhythmias (6)
- monitor ABCs - apply O2 - take VS - 12 lead ECG - identify dysrhythmia - IV access
83
what effect can b blockers and calcium channel blockers have on ECG strips (3)
- bradycardia - prolonged PR interval - AV block
84
who might need a pacemaker (6)
- AV block - A fib - cardiomyopathy - HF - symptomatic bradycardia - tachydysrhythmias (V tach)
85
who might need a temporary pacemaker (5)
- maintaining HR and rhythm during surgery, cardiac cath, before permanent implant, drug therapy that may cause bradycardia - prophylaxis after open heart surgery - acute MI with 2nd or 3rd degree AVB - acute MI with symptomatic bradycardia - to evaluate pt with brady/tachydysrhythmias

PathoPharm 2 (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions