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2.0 Adult Nursing Exam 1 > Dysrhythmias Foundations Quiz > Flashcards

Dysrhythmias Foundations Quiz Flashcards

1
Q

Questions to ask yourself when assessing a strip?

A
  1. Regular looking?
  2. Is there a p for every QRS?
  3. What is the rate
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2
Q

Equation to find the rate?

A

1500/boxes in between R

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3
Q

What strip is this? And how do you know?

A

Normal Sinus

Looks regular
P for every QRS
HR is between 60-100.

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4
Q

What is the treatment for Normal Sinus?

A

Continue to monitor

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5
Q

What strip is this? How do you know?

A

Sinus Bradycardia

Look regular
P for every QRS
HR is below 60 ***

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6
Q

Some clinical signs of sinus bradycardia?

A 
Fatigue
Thready pulse
Diaphoretic 
Low Urine Output
Confused
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7
Q

How do you treat Sinus Bradycardia?

A

Only treat sinus brady if they are symptomatic!

1) Atropine (0.5 mg IV push)+ flush at fast rates
2) Dopamine/Epi (2-10mcg)
3) Cardiac pacing

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8
Q

What strip is this? How do you know?

A

Sinus Tachycardia

Looks regular
P for QRS
HR between 100-150

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9
Q

Causes of sinus tachycardia?

What meds do we give for these?

A 
Pain - analgesics
Fever - antipyretic 
Caffeine - no caffeine
Hypovolemia - IV fluids
Stress - relax
HF
MI
Drugs (that raise HR and BP)
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10
Q

Treatment that we can give for sinus tachycardia?

A

CCB
Beta blockers

Analgesics
Antipyretic
IV fluids

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11
Q

Beta blockers examples?

CCB example?

A

Metroprolol
Labetolol
Coreg

Verpamil

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12
Q

What strip is this? How do you know?

A

Supraventricular tachycardia (SVT)

Doesn’t look regular. More smooshed.
Rhythm ..
Rate is 160-220 bpm

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13
Q

Treatment for Supraventricular Tachycardia (SVT)?

Alternative therapies?

A

Try Vagal Stem first
Use Adenosine IV to reset HR.
Verapamil
Cardioversion

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14
Q

What strip does this show?How do you know?

A

PAC or premature atrial contraction
Not regular. P wave comes too early.
You can still find the rhythm and HR.

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15
Q

PAC treatment?

A

(PAC = early p wave)

Beta blockers
Diltizaem
Amiodarone 
Magnesium! 
Reduce caffeine
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16
Q

What strip is this? How do you know?

A

A. Flutter

Not regular. Too many p waves for the ventricles.
No rate really. Know the ratio.

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17
Q

Treatment for patients with A. flutter? (just the med options)

A

Heparin drip (any anticoagulant like coumadin at home )

CCB
Beta Blockers
Antiarythmic

Amiodarone 
Diltizazem
Propafenone
Flecainide
Clonidine
18
Q

Nonpharm treatments for A. flutter?

A

Synchronized cardioversion

Radiofrequency catheter

19
Q

What strip is this? How do you know?

A

A. Fib

The whole picture will look squiggly
Rhythm is a. fib
Rate doesn’t really matter

20
Q

Treatment for A. fib patients? (just meds)

A

Heparin drip for stasis
or Coumadin at home

Digoxin

Beta Blockers

CCB

Amiodarone (to convert to rhythm)

21
Q

Alternative therapy for A. fib?

And what medication regimen might the a. fib patient have to be on?

A

DC conversion to sinus rhythm

If in a. fib for more than 48 hours - take anticoagulation drugs for 3-4 weeks beforehand. Then, take them for 4-6 weeks afterwards.

22
Q

What strip is this? How do you know?

A

PVC or premature ventricular contractions.

They don’t look regular. Very wide drop.
Rate can be found I think.
Rhythm is PVC + rate.

23
Q

Treatment for PVCs? (including medications)

A

Based on cause.
O2 for hypoxia.
Electrolyte replacement

Beta blockers
Amiodarone

24
Q

What strip is this? How do you know?

A

Vtach or ventricular tachycardia.

Looks like the strip has 3 or more pvcs (v- dips).
The rate will be 150-250 bpm.
- its temping to say sinus tachy but just know its not.

25
Q

Common causes of Vtach

A

MI
CAD
Hypoxia
Electrolyte levels

26
Q

What type of strip is this? how do you know?

A

Also a vtach strip due to 3 pvcs.

Its just a polymorphic one - wheres less uniform pvcs.

27
Q

So, you’ve identified the patient is in vtach .. what is your next course of action?

A

Check for a pulse. This will decide what you do next.

28
Q

Vtach patient treatment:
Pulsatile
Hemodynamically stable

Vtach
Pulsatile
Hemodynamically Unstable

A
  1. Treat cause of vtach
  2. Since they’re hemodynamically stable, you can also just monitor them.
  3. Treat cause of vtach
  4. Hemodynamically unstable - IV amiodarone or lidocaine to slow HR with a fast push.
    Cardioversion
29
Q

This time your patient is in Vtach but pulseless. What treatment do you do?

Do we give them any meds?

A
  1. CPR
  2. Defibrillation
  3. Epi or vasopressin.
  4. Amiodarone or lidocaine as well.
30
Q

Torsades polymorphic Vtach patient
Pulse
Stable

What treatments will you give?

A

(They’re doing fine)

ACLS algorithm measures

Beta blockers
Lidocaine
Amiodarone
Magnesium!!!!!!!!

31
Q

Vtach torsades polymorphic patient has no pulse.

What treatments do you do?

A

Automatically a code… just like you would for any other type of rhythm.

  1. Start the CPR
  2. Defibrillation
  3. Epi or vassopressin
  4. Amiodarone, lidocaine
32
Q

What will Torsades look like on the stip?

Main cause of Torsades?

A

Ribbon like. Proloned QT interval

Magnesium levels being low

33
Q

Vtach torsades polymorphic patient has a pulse and is stable.

What do you do?

A

You do ACLS measures

beta, lido, amio, MAGNESIUM

intubate, transcutaneous pacer, IV epi + atropine

34
Q

What will V.fib look like? What will pulse be? Will there be a rhythm?

A

A line of squiggles with no QRS anywhere to be seen.

There won’t even be a pulse
There will be a rhythm to shock

35
Q

V.fib treatment?

A
  1. CPR
  2. Defibrillation
  3. ACLS
  4. Epi/Vasopressin
  5. Amiodarone, Lidocaine, MAGNESIUM
36
Q

Asystole treatment? (flatline)

A
  1. CPR
  2. ACLS (intubate, pacer, IV epi + atropine)
  3. Amiodarone
37
Q

PEA treatment? (pulseless electrical activity)

A
  1. CPR
  2. ACLS (intubate + IV epi)
  3. Amiodarone
38
Q

1st degree av node block treatment

A

Monitor and observe for progression incase it progresses

  • why? It is common and can happen in athletes too
39
Q

2nd degree av node block type 1 (Wenkebach) treatment

A
  1. Decide if they’re symptomatic or asymptomatic

asymptomatic - monitor and keep transcutaneous pacer on standby

symptomatic - atropine or temporary pacemaker

40
Q

2nd degree av node block type 2 (Mobitz type II) treatment

A

Immediate transcutenous or transvenous pacing.

If not available - use atropine (but not if MI is on table).

41
Q

3rd degree av node block treatment?

A

Transcutenous pacing

2.0 Adult Nursing Exam 1 (11 decks)

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