Dysrythmias Flashcards
P wave indicative of ?
atrial contraction, atrial depolarization
QRS wave indicative of?
ventricular contraction, ventricular depolorization
T wave indicative of?
ventricular relaxation, ventricular replorization
Normal INR=
1-2
INR on anti-coag therapy normal is
2-3
INR on mechanical ventilation norm is
3-4
Triad of I’s
Injury, Ischemia, Infarction
what is happening with ischemia during waves?
ST depression or T wave inversion
what is happening with injury during waves?
elevated ST segment (STEMI ALERT)
what is happening during infarction during waves?
death of tissue, Q wave is the indicator
deep q wave is indicative of what?
past MI
ST elevation is indicative of?
injury
ST depression is indicative of?
ischemia
sinus tach characteristics?causes? treatment?
rate 100-150 beats/min
causes: stimulants, exercise, dehydration
treatment: digoxin, Beta blockers, sedative, vagal maneuver
SVT characteristics? treatment?
rate 160-250 beats/min
treatment: oxygen, vagal maneuver, Adenosine, anti-arythmics, shocks
how do you give Adenosine?
6 mg, 12mg, 12 mg
Symptomatic bradycardia S/S? caused by? treatment?
dizziness, chest pain, sweatiness, palps
caused by: digoxin, Ca+ channel blockers, beta blockers
treatment: O2, atropine (give half, if nothing happens, give the rest, transcutaneous pacemaker, Dopamine drip
If asymptomatic bradycardia, what do you give?
nothing
Atrial Flutter or A fib? which one is worst?
A flutter
A flutter: treatment?
Ca channel blockers, beta blockers, dig, synch shock
A fib., what is it?
erratic impulse formation, no distinguishable P wave
with A fib, what do you want to watch out for? inc. risk of what?
pulmonary/systemic emboli
Treatment for A fib.:
Goal: slow heart rate
cardizem, anticoags if needed
what is the CHADS score?
Congestive HF Hypertension Age Diabetes Stroke Prior (if score high, give warfarin (coumadin) if moderate or low give aspirin
Premature Ventricular Contractions
bizarre and wider than normal beats, can be unifocal, or multifocal (up and inverted) or couplets or bigeminy or trigeminy.
treatment for PVC’s?
goal: treat cause hypoxia --give O2 Ischemia dehydration (electrolytes) antiarythmic
importance to notice multifocal PVC’s b/c?
multifocal PVC’s have higher chance of causing V Tach
how many PVC’s in a min is considered bad?
greater or equal to 6, call doctor!
What is V tach?
Wide QRs, may/may not have pulse
treat pulseless like V fib: defib, cpr, epi,
if has pulse: shock, cpr, amiodorone, lidocaine
specific form of polymorphic ventricular tachycardia in patients with a long QT interval. It is characterized by rapid, irregular QRS complexes, which appear to be twisting around the ECG baseline.
Torsades de pointes
relevance of Torsades de Pointes?
can quickly deteriorate into V fib
treatment for Torsades de pointes?
- CPR, cardioversion
med: MAGNESIUM SULFATE
Chaotic, no readable PQRST waves, coarse vs. fine
V fib
treatment for V fib?
MEDICAL EMERGENCY: DEFIB!!!
cpr, epi, coronary perfusion
nurse sees pt in v fib? what should she do?
feel pulse, call code, shock
kinda looks like normal rhythm but no P wave, narrow QRS? treatment?
junctional rhythm,
med: atropine, pacemaker, dopamine drip, epi drip
what do you do for asystole? what do you not do?
NO shock
-CPR, atropine, check in 2 leads, confirmation of death
for renal pt with wide QRS, what do you do?
give calcium chloride slowly
dopamine you never want to push because it’s a vesicant, if you do , what subcut injections around affected limb can you give to ease the sloughing?
Regitine
