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Kol- 410 Med Surg II > Dysrhythmia > Flashcards

Dysrhythmia Flashcards

1
Q

this is an early rhythm complex that occurs for the next SA impulse

A

premature complexes

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2
Q

PVC/PAC that occurs every other beat / every 2 beats / every 3 beats?

A

bigeminy , trigeminy, quadrigeminy

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3
Q

2 regular beats then PVC or PAC =

A

trigeminy

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4
Q

3 regular beats then PAC PVC =

A

quadrigeminy

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5
Q

sxs of prematures complexes

A

Palpitations or symptoms of low cardiac output –> check BP

*note: may be asxs as well

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6
Q

premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the atrium?

A

see P wave that is abnormal, narrow QRS complex

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7
Q

premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the ventricles?

A

no P wave, wider QRS complex

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8
Q

brady dysrthymia = HR < ____

A

60!

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9
Q

concerns with brady-dysrhythmia - what does it to diastole? what are 3 things we are checking in patient to assess their perfusion?

A

• 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

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10
Q

tachy dysrhythmia = HR >_____

A

100!

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11
Q

what does tachy-dysthymia do to diastole? what do we need to assess?

A

• 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

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12
Q

what will BP be with tach and brady dysthrhytmia

A

low if poor perfusion

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13
Q

causes of sinus tachy

A

• Anxiety, Pain, Fever, Hypoxia, Anemia, Drugs
• May be compensatory

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14
Q

sinus brady s/s

A

• Low BP, Confusion, SHOB, chest pain, dizzy, syncope

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15
Q

who might naturally have a low HR?

A

arthletes

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16
Q

is sinus brady always bad?

A

has therapeutic benefit of reducing myocardial O2 demand and allws for increased perfusion time

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17
Q

when do we use pacing- HR too slow or HR too fast?

A

hr too slow! –> patient not perfusing

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18
Q

type of pacing =

◦ Two large electrodes (Pads)
◦ Stimulates ventricular depolarization
◦ Emergency
A

• Temporary Transcutaneous Pacing

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19
Q

type of pacing: Lead Wires are threaded to right atrium of heart

=

A

• Transvenous Pacing

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20
Q

type of pacing- pacemaker Placed in SubQ pocket =

A

permanent pacemaker

21
Q

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….

A

what your patient is pacing

22
Q

wtf are pacer spikes?

A

= initiates something to happen in the heart

23
Q

3 types of atrial dysrthymias

A

• Premature Atrial Complexes (see above)
• Supraventricular Tachycardia
• Atrial Fibrillation

24
Q

this type of dysrhythmia =
• Rapid stimulation of atrial tissue
• 100 bpm to 280 bpm
- No visible P wave

A

Supraventricular Tachycardia (SVT)

25
Q

what is • Paroxysmal Supraventricular Tachycardia

A

short run of SVT and got back to normal

26
Q

interventions for SVT

A
  • take BP
    -identify cause
    -Vagal maneuver
    -Adenosine (6mg, 12mg, 12mg)
    -Fluids
  • BB, CCB
    -Cardioversion (= synchronous shock)
27
Q

adenosine protocol for SVT?

A

◦ causes period of asystole.
◦ feels like you are getting kicked in the chest
◦ Give 6 then 20 cc fluid, 12 then 12 if needed

28
Q

cardiovert or defib SVT?

A

cardiovert –> synchronous

29
Q

Atrial fibrilation- what are the main causes?

A

Related to atrial fibrosis and muscle mass
◦ Hypertension
◦ Heart Failure
◦ CAD

30
Q

this dysrhythmia = irritable atria, multiple rapid impulses depolarizing the atria causing decreased CO and NO P WAVE

A

atrial fibrillation

31
Q

do you see a P wave with A fib?

A

no P wave on afib

32
Q

A Fib interventions

A
  • O2
    -decrease anxiety
    -Meds (dilt (drip) + amiodoarone (drip) + anticoag)
    -Cardioversion (synchronized)
    -Ablation
33
Q

type of dysrhytmia with HR of 140-180 fired from ventricles

A

V tach

34
Q

risk factors for V tach

A

◦ Myocardial Ischemia
◦ Cardiomyopathy
◦ Low K+
◦ Drugs
◦ Shock

35
Q

V tach + pulse =

vs

V tach + no pulse =

A

V tach + pulse = check BP , cardioversion, ablation (stable enough)

V tach + no pulse = defibrillate, Antidysrhythmic (Amiodarone)

36
Q

type of dysrhythmia with electrical chaos is ventricles meaning the ventricles can’t contract =

A

v fib

37
Q

V fib is chill or not chill?

A

EMERGENCY, not okay, not chill – no blood perfusing to body

38
Q

V fib risk factors

A

• CAD
• MI
• Low K+
• Low Mg
• Surgery, Procedure
• Trauma

39
Q

interventions fr V fib =

A

defibrilate
CPR
• Antidysrhythmic

40
Q

you have a person in V fib and you shock their ass. Are they gonna be cool now?

A

must fix underlying cause— can go back into v fib after you defibrillate

41
Q

type of dysrthymia with no impulses being conducted in the ventricle leading to no cardiac output =

A

ventricular asystole

42
Q

ventricular aystole is a _____ rhythm

A

terminal

43
Q

interventions for ventricular asystole

A

CPR, ventilate, epinephrine

44
Q

type of defibrillator:

◦ Emergency ( have in pyblic places)
◦ BLS
A

• Automated External Defibrillator

45
Q

type of defibrillator:

◦ Similar to pacemaker
◦ Patient remains on an antidysrhythmia
A

• Implantable Cardioverter/ Defibrillator

46
Q

type of defibrillator

◦ Vest worn at all times other than bathing
◦ Ability to prevent shock
A

• Wearable Cardioverter Defibrillator

47
Q

3 types of defibrillators

A

-AED
-Implantable
-Wearable

48
Q

dysrhythmias are typically the result of another…..

A

pathology or disease state so we have to treat that!

Kol- 410 Med Surg II (27 decks)

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