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Med Surg > Dysrhythmias > Flashcards

Dysrhythmias Flashcards

1
Q

What is normal sinus rhythm

A

60-100

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2
Q

What does the vagus nerve do

A

slows down heart

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3
Q

What can the sympathetic system do to the AV node

A

let singles passs more often so increases HR

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4
Q

What can the parasympathetic do to the AV node

A

opposite of symp

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5
Q

Where does Digoxin work on

A

AV node

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6
Q

What actually matters when looking at an EKG

A

Heart Rate
1:1 ratio of atrial and ventricular Cx
narrow QRS (less than 0.1-0.12)

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7
Q

What does the time that the PR interval takes represent

A

how much AV resistance

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8
Q

What is the normal PR interval time

A

less than 0.12-0.2

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9
Q

On an EKG chart how many secs are the smallest boxs

A

0.04 secs

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10
Q

On an EKG chart how many secs are the big boxs

A

0.2

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11
Q

What is the first thing you should do if the EKG chart shows abnormal rhythms

A

make sure the leads are still connected

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12
Q

If we still have a sinus rhythm but its lower than 60 bpm what is it called

A

sinus bradycardia

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13
Q

Who gets sinus bradycardia

A 
carotid sinus massage 
hypothemia 
increased vagal tone 
parasympathomimetic drugs
Hypothyroidism
Increased intracranial pressure
Obstructive jaundice
Inferior wall MI
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14
Q

What do we give when sinus bradycardia is pathologic

A

atropine bec it reduces AV node resistance

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15
Q

What causes sinus Tach

A 
Exercise
Pain
Hypovolemia
Myocardial ischemia
Heart failure (HF)
Fever
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16
Q

What symptoms make sinus brady pathologic

A 
Hypotension 
Pale, cool skin
Weakness
Angina
Dizziness or syncope
Confusion or disorientation
Shortness of breath
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17
Q

What symptoms make sinus tach pathologic

A

Dizziness and hypotension due to decreased CO

Increased myocardial oxygen consumption may lead to angina

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18
Q

How do we treat sinus tach

A

fix problem like pain or reduce exercise

beta blockers

19
Q

What ratio are we going to have in atrial flutter

A

more atrial contractions than vent Cx

20
Q

How much CO do we lose with A flutter

A

10-20% of CO

21
Q

What are A flutter at higher risk for, why, and what might we do about it

A

clots because our blood is moving slower so we might give them coumadin

22
Q

Who gets A flutter

A 
CAD
Hypertension
Mitral valve disorders
Pulmonary embolus
Chronic lung disease
Cardiomyopathy
Hyperthyroidism
Drugs: Digoxin, quinidine, epinephrine
23
Q

What are you at risk for with A flutter

A

High atrial rates (>100) and resultant loss of the atrial “kick” can decrease CO (by 10 to 20%) and precipitate HF, angina
Risk for stroke due to risk of thrombus formation in the atria

24
Q

What drugs are the usually best for A flutter

A

beta blockers

then calcium channel blockers

25
Q

Who gets defibrillation

A

V fib
A systole
pulseless V tach

26
Q

Whats the first thing to check with someone with V tach

A

see if they have a pulse

27
Q

Difference of cardioversion from defibrillation

A

much less voltage

the machine reads the ECG and waits to shock until T wave isnt going

28
Q

What are the manifestations of A fib

A

same as A flutter

29
Q

Who gets A fib

A 
Underlying heart disease, such as rheumatic heart disease, CAD
Cardiomyopathy 
HF
Pericarditis
Thyrotoxicosis
Alcohol intoxication
Caffeine use
Electrolyte disturbance
Cardiac surgery
30
Q

What do we do for patients going in to get cardioversion for A fib and A flutter

A

put them on coumadine for 3 days prior

31
Q

How fast is the HR from cells in the middle of the heart

A

40-60 like AV node (junctional areas of the heart

32
Q

What is a 1 deg block

A

PR interval greater than .2

still has 1:1

33
Q

What is a 2nd deg block

A

PR interval > .2
every QRS has a P
but not evwery P has QRS
may have QRS’s that goes missing

34
Q

What is 3rd deg block

A

QRS and P are unrelated

For example, Atrium pumping at 60-100 and vents pumping at 20-40

35
Q

What is the progression of AV blocks

A

they progress into eachother

36
Q

Who gets 1 AV block

A 
MI
CAD
Rheumatic fever
Hyperthyroidism
Vagal stimulation
Drugs: Digoxin, -adrenergic blockers, calcium channel blockers, flecainide
37
Q

What is a unique trait about symptoms of 1 AV block

A

usu asymptomatic

38
Q

What is the first thing to check for with 1 AV block for treatment and why

A

check there meds bec a new drug may be causing it

39
Q

What causes 2 AV block

A

Drugs: digoxin, Beta-adrenergic blockers
CAD and other diseases that can slow AV conduction
rheumatic heart disease
Anterior MI

40
Q

What are some treatments of 2 AV block

A

atropine

temporary pacemaker

41
Q

What are we hoping for after giving atropine for 2 AV block

A

increased Vent rate

42
Q

What is a common symptoms caused by 2 AV block

A

hypotension

MI’s

43
Q

What are the steps for analyzing an ECG

A 
Rates (both atrial and vent)
Regularity (do they march out)
P wave shape (want it to be sharp)
Ratio of P waves to QRS 
PR interval time
QRS time

Med Surg (35 decks)

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