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NUR326 Cardiac > Dysrhythmias > Flashcards

Dysrhythmias Flashcards

1
Q

normal electrical conductivity of heart

A 
Rate 60-100
Regular rhythm
P waves: upright and round, one before every QRS, regular rhythm
PR interval 0.12-0.20 sec
QRS: <0.12 sec
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2
Q

sinus arrythmia

A

normal
variability in HR 60-100bpm
common in young people
HR fluctuates with respiration or Autonomic nervous system

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3
Q

what is a dysrhythmia

A

abnormality of cardiac rhythm

problems with impulse generation or conduction

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4
Q

what causes dysrhythmia’s?

A

inappropriate automaticity

triggered activity re-entry

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5
Q

what are the different types of sinus rhythms?

A 
sinus rhythmmia
sinus arrhythmia
sinus tachycardia
sinus bradycardia
paroxysmal supraventricular tachycardia
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6
Q

sinus bradycardia

A

SA node
regular rate less than 60
normal rhythm
normal PR (.12-.20) and QRS interval (< 0.12)

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7
Q

causes of sinus brady

A 
hyperkalemia
vagal response
digoxin toxicity
late hypoxia
meds
MI
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8
Q

manifestations of sinus brady

A 
lightheadedness/ dizziness with exertion
easily tired
syncope or near syncope
dyspnea
chest pain/discomfort
confusion
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9
Q

treatment of symptomatic bradycardia

A

atropine: anticholenergic

if drug not effective: pacemaker

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10
Q

sinus tachycardia

A 
SA node
HR: 100-150
regular rhythm
p wave similar or partially hidden
normal PR (.12-.20)interval and QRS (<0.12)
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11
Q

causes of tachycardia

A 
catecholamines: (exercise, pain, strong emotions)
fever
fluid volume deficit
meds (epi, albuterol, beta agonists)
substances (caffeine, nicotine, cocaine)
hypoxia
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12
Q

treatment for sinus tachycardia

A

based on cause
hypovolemia= fluids
fever= anti-pyretic
pain= analgesics

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13
Q

paroxysmal supraventricular tachycardia (PSVT)

A 
caused by re-entry phenomenon
begins and ends suddenly
"feel like my heart is racing"
HR 150-250
AV node
usually no P wave if present, abnormal
QRS looks normal (<0.12)
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14
Q

causes of PSVT

A 
over exertion
emotional stress
stimulants
digitalis toxicity
rheumatic heart disease
CAD
Wolff- Parkinson-White
right sided heart failure ( Cor pulmonale)
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15
Q

clinical signs and symptoms of PSVT

A 
palpitations
chest pain
fatigue
lightheaded/dizziness
dyspnea
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16
Q

premature atrial contractions (PACs)

A 
early P waves that look different
normal PR interval (12-20)
QRS does follow PAC
usually not a problem but frequent PAC's cause pt high risk for dysrhythmia's
check electrolytes may need O2
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17
Q

two types of atrial dysrhythmias

A

atrial flutter

atrial fibrillation

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18
Q

atrial flutter

A 
AV node, overrides SA node
re-entry impulse that is repetitive and cyclic
Atrial pulse Rate >250 bpm,
regular atrial rhythm
ventricular rate is slower
P was "SAWTOOTH"
QRS narrow
may be 2:1, 3:1, or 4:1 ( ex: 2 p wave per 1 QRS complex)
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19
Q

causes of atrial flutter

A 
CHD
cardiomyopathy
heart valve disease
congenital heart disease
inflammation of heart (myocarditis)
high BP
overactive thyroid, lung disease
electrolytes
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20
Q

atrial fibrillation

A

multiple irritable spots in atria (all sending signals)
irregularly irregular (atrial and ventricular)
HR 100-175
no identifiable P wave
fibrillation waves

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21
Q

clinical manifestations of Atrial Fibrilation

A 
palpitations
heart racing
fatigue
dizziness
chest discomfort
sob
may be asymptomatic
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22
Q

complications and causes of Afib

A 
electrolytes
hypoxia
cardiovascular disease
decreased cardiac output
heart failure
embolus/ stroke
23
Q

untreated a-fib doubles your risk of heart-related ____, and causes a 4-5 times greater risk of ____

A

death, stroke

24
Q

treatment of Afib

A

beta blockers, CCB, digitalis, amiodarone
stroke prevention: anticoagulants, antiplatelets
ablation
cardioversion

25
Q

types of ventricular dysrhytmias

A

PVC’s
VTACH
VFIB

26
Q

PVCs

A

contraction coming from ectopic focus in ventricles
PVC’s come earlier than QRS and doesn’t follow normal rhythm or p-wave
wide and distorted QRS ( >.12)
no atrial contraction, no P wave

27
Q

causes of PVC’s

A 
stimulants
electrolytes
hypoxia
fever
exercise
emotional stress
CVD
28
Q

treatment of PVC’s

A

treat cause

29
Q

three sub-types of PVC’s

A

bigeminy
trigeminy
quadrigeminy

30
Q

VTACH

A

3 or more PVC’s together
seriously decreases cardiac output
ectopic focus within the ventricles takes control and fires repeatedly, NO atrial contractions
DEADLY RHYTHM

31
Q

VTACH presentations

A

Rate: 150-200, usually regular

no p-wave evident, PR measurable

32
Q

VTACH associated with

A

MI, CAD, significant electrolyte abnormalities, HF, drug toxicity

33
Q

treatment of VTACH

A

ACLS
depends on pulse, pt symptomatic very quickly unless converts back to rhythm
may need anti-dysrhythmic (beta blocker or CCB)
electrolyte replacement

34
Q

VFIB

A

irregular wave forms of varying shapes and sizes
ventricles are QUIVERING
NO CARDIAC OUTPUT

35
Q

cardiac muscle cells have

A

automacity
excitability
conductivity
contractility

36
Q

automacity

A

ability to generate electrical impulse

37
Q

excitability

A

ability of cell to interpret impulse

38
Q

conductivity

A

ability to receive and conduct signal

39
Q

contractility

A

ability to shorten in respond to impulse. “squeezing”

40
Q

depolarization

A

light switch turning on, occurs during systole causing squeezing

41
Q

repolarization

A

makes cells ramp up

42
Q

atrial depolarization

A

P wave

43
Q

ventricular depolarization

A

QRS complex

44
Q

ventricular repolarization

A

T wave

45
Q

atrial repolarization

A

do not typically see

46
Q

what does potassium-ATP pump cause

A

causes action potentials

47
Q

SA node

A

stimulates atria to contract
P wave
atrial contraction

48
Q

AV node

A

makes ventricular go off

After P wave and before QRS

49
Q

perkinjie fibers

A

LT ventricular contractions

50
Q

what causes dysrhythmias?

A

inappropriate automaticity
triggered activity
re-entry

51
Q

inappropriate automaticity

A

a cell initiates action potential when its not supposed to

52
Q

triggered activity

A

an extra impulse generated during or just after repolarization

53
Q

re-entry

A

cardiac impulse in one part of the heart contributes to depolarization after main impulse has finished

54
Q

wolfe-parkinson-white

A

precipitates PSVT, r/t other rhythm abnormalities

NUR326 Cardiac (6 decks)

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