Dysrhythmias Flashcards
may herold sign for a-fib, especially in patients with HF and usually asymptomatic. can be caused by stress, caffeine, alcohol, poor sleep, meds
premature atrial contraction (irritable atria)
rhythm regular. atrial rate really high (250-500). chest pain, SOB, hypotension. Causes are MI, arthrosclerosis, dig toxicity. Common first week after heart surgery
a-flutter. Saw tooth
how do you help a-flutter. saw tooth
slow vent rate. CCB, BB, dig, amioderone. If hemodynamically unstable, cardioversion (give anticoagulants before surgery)
atrial rate irregularly irregular
a-fib. greater than 100bpm is uncontrolled. main cause is valve failed, CAD, HF, COPD
what do do for a-fib
control rate to maintain CO. Warfarin to lower risk of emboli. Hemodynamically unstable - synchronized cardioversion. Dig, CCB, BB, slow vent response. PREVENT CLOTS!
rhythm is irregular. QRS wide and bizzare. Causes can be catecholamines (epi, norepi, dop). Electrolyte issue, myocardial injury
PVC. Bi occur every other beat and tri third beat. If the PVC falls on relative side of T wave VTACH! Sensation of skipped beat
What is a shockable rate
V-Tach
flat, wide, ugly. Pt. may be unresponsive and pulseless. Code blue
VTach
what do you do for Vtach
Unresponsive: lidocaine/amioderone, defib (no pulse), Pulse: cardioversion (pulse). Lidocaine/amioderone/pray
Vtach can become
V-Fib
uncoordinated quivering. Start CPR.
VFib
what do you do for vFib
give epi or vasopressin (makes shock more receptive) q 2 min. Start CPR to get meds circulating. Defib.
asystole
no heartbeat, pulse, or respiration. CPR, code, intubate, NOT SHOCKABLE. Atropine
sinus tachy treatment
BB, CCB if needed. Fluid if hypovolemic, no caffeine, rest
treatment of NSR with frequent PVCs
treat cause. eliminate caffeine, nic,. Lidocaine, amioderone, BB, CCB. May have palpitations, and low LOC if not perfusing. Low BP would be diaphoretic
