Dysrhythmia Flashcards
this is an early rhythm complex that occurs for the next SA impulse
premature complexes
PVC/PAC that occurs every other beat / every 2 beats / every 3 beats?
bigeminy , trigeminy, quadrigeminy
2 regular beats then PVC or PAC =
trigeminy
3 regular beats then PAC PVC =
quadrigeminy
sxs of prematures complexes
Palpitations or symptoms of low cardiac output –> check BP
*note: may be asxs as well
premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the atrium?
see P wave that is abnormal, narrow QRS complex
premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the ventricles?
no P wave, wider QRS complex
brady dysrthymia = HR < ____
60!
concerns with brady-dysrhythmia - what does it to diastole? what are 3 things we are checking in patient to assess their perfusion?
• Prolonged diastole → improved perfusion to heart
OR
• Decreased perfusion to heart if Cardiac Output decreases (low BP)
◦ check BP! to determine if CO is poor perfusion
◦ check LOC
◦ check urine output
tachy dysrhythmia = HR >_____
100!
what does tachy-dysthymia do to diastole? what do we need to assess?
• Shortens diastole –> heart itself doesn’t get as much O2
• Increased work of heart (heart needs more O2)
◦ uses too much energy
• get BP - low from decrease stroke volume
what will BP be with tach and brady dysthrhytmia
low if poor perfusion
causes of sinus tachy
• Anxiety, Pain, Fever, Hypoxia, Anemia, Drugs
• May be compensatory
sinus brady s/s
• Low BP, Confusion, SHOB, chest pain, dizzy, syncope
who might naturally have a low HR?
arthletes
is sinus brady always bad?
has therapeutic benefit of reducing myocardial O2 demand and allws for increased perfusion time
when do we use pacing- HR too slow or HR too fast?
hr too slow! –> patient not perfusing
type of pacing =
◦ Two large electrodes (Pads) ◦ Stimulates ventricular depolarization ◦ Emergency
• Temporary Transcutaneous Pacing
type of pacing: Lead Wires are threaded to right atrium of heart
=
• Transvenous Pacing
type of pacing- pacemaker Placed in SubQ pocket =
permanent pacemaker
pacemakers can pace different parts of the heart -
◦ Atrial (Sick Sinus) - initiates p wave ◦ Ventricular ◦ Biventricular (Heart failure)
the take home from this is you need to know….
what your patient is pacing
wtf are pacer spikes?
= initiates something to happen in the heart
3 types of atrial dysrthymias
• Premature Atrial Complexes (see above)
• Supraventricular Tachycardia
• Atrial Fibrillation
this type of dysrhythmia =
• Rapid stimulation of atrial tissue
• 100 bpm to 280 bpm
- No visible P wave
Supraventricular Tachycardia (SVT)
what is • Paroxysmal Supraventricular Tachycardia
short run of SVT and got back to normal
interventions for SVT
- take BP
-identify cause
-Vagal maneuver
-Adenosine (6mg, 12mg, 12mg)
-Fluids - BB, CCB
-Cardioversion (= synchronous shock)
adenosine protocol for SVT?
◦ causes period of asystole.
◦ feels like you are getting kicked in the chest
◦ Give 6 then 20 cc fluid, 12 then 12 if needed
cardiovert or defib SVT?
cardiovert –> synchronous
Atrial fibrilation- what are the main causes?
Related to atrial fibrosis and muscle mass
◦ Hypertension
◦ Heart Failure
◦ CAD
this dysrhythmia = irritable atria, multiple rapid impulses depolarizing the atria causing decreased CO and NO P WAVE
atrial fibrillation
do you see a P wave with A fib?
no P wave on afib
A Fib interventions
- O2
-decrease anxiety
-Meds (dilt (drip) + amiodoarone (drip) + anticoag)
-Cardioversion (synchronized)
-Ablation
type of dysrhytmia with HR of 140-180 fired from ventricles
V tach
risk factors for V tach
◦ Myocardial Ischemia
◦ Cardiomyopathy
◦ Low K+
◦ Drugs
◦ Shock
V tach + pulse =
vs
V tach + no pulse =
V tach + pulse = check BP , cardioversion, ablation (stable enough)
V tach + no pulse = defibrillate, Antidysrhythmic (Amiodarone)
type of dysrhythmia with electrical chaos is ventricles meaning the ventricles can’t contract =
v fib
V fib is chill or not chill?
EMERGENCY, not okay, not chill – no blood perfusing to body
V fib risk factors
• CAD
• MI
• Low K+
• Low Mg
• Surgery, Procedure
• Trauma
interventions fr V fib =
defibrilate
CPR
• Antidysrhythmic
you have a person in V fib and you shock their ass. Are they gonna be cool now?
must fix underlying cause— can go back into v fib after you defibrillate
type of dysrthymia with no impulses being conducted in the ventricle leading to no cardiac output =
ventricular asystole
ventricular aystole is a _____ rhythm
terminal
interventions for ventricular asystole
CPR, ventilate, epinephrine
type of defibrillator:
◦ Emergency ( have in pyblic places) ◦ BLS
• Automated External Defibrillator
type of defibrillator:
◦ Similar to pacemaker ◦ Patient remains on an antidysrhythmia
• Implantable Cardioverter/ Defibrillator
type of defibrillator
◦ Vest worn at all times other than bathing ◦ Ability to prevent shock
• Wearable Cardioverter Defibrillator
3 types of defibrillators
-AED
-Implantable
-Wearable
dysrhythmias are typically the result of another…..
pathology or disease state so we have to treat that!
