common dysrhythmias Flashcards
what is any heart rhythm that originates from the SA node?
sinus rhythm
normal lub dub
PR interval: 0.12 - 0.20
QRS: less than or equal to 0.12 seconds
Rate: 60-100 bpm
palpable pulse and BP
normal sinus rhythm
Normal intervals but it irregularly marches out
irregular rhythm
sinus arrhythmia
Heart rate: usually between 60-100 bpm
Rhythm: irregular
P waves: identical, seen before each QRS
PR Interval: 0.12 - 0.20 seconds
QRS: less than 0.12 seconds
heart rate increases slightly with inspiration, decreases slightly with expiration
rhythm is irregular, varies with respiration patteren
Sinus Arrhythmia
variant of normal sinus rhythm
normal in:
- young children
- athletes
Rate: les than 6o
Rhythm: regular
P wave: identical, seen before every QRS
PR Interval: 0.12 - 0.20
QRS: less than or equal to 0.12
- (R-R, P-P) march equally
Sinus Bradycardia
can be normal for some people
A patient is experiencing bradycardia, could be on what class of medications?
beta blockers
calcium channel blockers
digoxin
sometimes in sinus bradycardia you will see a prolongation of the QT wave, what should the nurse do?
asses the patient then notify the HCP
The prolongation can interfer with the new heart beat/ next p wave and therefore cause different dysrhythmias
causes of sinus bradycardia
being an athlete;
sleep –> relaxation;
excessive vagal tone when acetylcholine* is released by PSNS and can slow down the SA Node from firing; medications such as beta blockers, calcium channel blockers, and digoxin are negative chronotropes for HF and can slow down HR from firing; low oxegenation (hypoxia) is a late sign, inferior wall MI as the lower part of the heart causes problems of the SA Node firing
*plays a vital role in the central and peripheral nervous system.
watch for digtoxicity
How will a nurse treat Sinus Bradycardia?
- if the patient is hemodynamically stable, nothing
- if the patient is hemdynamically UNstable, …
- asses the patient, BP, Cap Refill, Urinary Output
- ## treat an underlying cause, check medications
digon toxicity
may need anticholenergics (ATROPIN) if to much vagal tone
atropine has a short half life and the effectiveness wears off, if this is continous the patient may need a pacmaker to keep it beating
hypoxic, give medications
avoid straining when consitpated bc it can contribute to too much vagal stimulation
Rate: 101 - 160 (Adults)
Rhythm: regular
P wave: identical, seen before every QRS, may be buried in preceding T wave
PR interval: 0.12 - 0.20
QRS: less than or equal to 0.12
Sinus Tachycardia
Increased metabolic demands that can cause sinus tachycardia
-fever, pain, anxiety, exercise
this may be a normal compensatory rxn
What medications can cause Sinus Tachycardia
-catecholamines
- anticholinergics
- caffine
- nicotine
- albuterol
- thyroid hormone
sinus tachycardia treatment
fever –> acetaminophen;
pain –> pain medication;
axiety –> antiaxiety, teach breathing techniques;
simulents – remove them;
hypovolemia bc of fluid loss –> give fluids;
hypovolemia bc of blood loss –> give blood;
infection –> give antibiotics;
hypoglycemic –> food/sugar/carbs;
Increased HR –> BB and CCB to decrease HR
Ablation
can be a normal compensatory mechanism but need to treat underlying cause
hypovolemin, low BP with high HR
Ventricular and atrial rates are the same in sinus rhythm.
A. True
B. False
A. True
- impulse originates outside of sinus node (from atrial tissue or AV node)
- narrow complex QRS less than or equal to 0.12
P wave and T waves collide and the R’s still march out
Atrial Dysrhythmias
Atrial (narrow) dysrhythmias
aka* supraventricular tachycardia*
The P wave and the T wave become one because the heart is beating so fast
firing above in the SA Node
