Dysrythmias

Question 1

P wave indicative of ?

Answer 1

atrial contraction, atrial depolarization

Question 2

QRS wave indicative of?

Answer 2

ventricular contraction, ventricular depolorization

Question 3

T wave indicative of?

Answer 3

ventricular relaxation, ventricular replorization

Question 4

Normal INR=

Answer 4

1-2

Question 5

INR on anti-coag therapy normal is

Answer 5

2-3

Question 6

INR on mechanical ventilation norm is

Answer 6

3-4

Question 7

Triad of I’s

Answer 7

Injury, Ischemia, Infarction

Question 8

what is happening with ischemia during waves?

Answer 8

ST depression or T wave inversion

Question 9

what is happening with injury during waves?

Answer 9

elevated ST segment (STEMI ALERT)

Question 10

what is happening during infarction during waves?

Answer 10

death of tissue, Q wave is the indicator

Question 11

deep q wave is indicative of what?

Answer 11

past MI

Question 12

ST elevation is indicative of?

Answer 12

injury

Question 13

ST depression is indicative of?

Answer 13

ischemia

Question 14

sinus tach characteristics?causes? treatment?

Answer 14

rate 100-150 beats/min

causes: stimulants, exercise, dehydration
treatment: digoxin, Beta blockers, sedative, vagal maneuver

Question 15

SVT characteristics? treatment?

Answer 15

rate 160-250 beats/min

treatment: oxygen, vagal maneuver, Adenosine, anti-arythmics, shocks

Question 16

how do you give Adenosine?

Answer 16

6 mg, 12mg, 12 mg

Question 17

Symptomatic bradycardia S/S? caused by? treatment?

Answer 17

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

Question 18

If asymptomatic bradycardia, what do you give?

Answer 18

nothing

Question 19

Atrial Flutter or A fib? which one is worst?

Answer 19

A flutter

Question 20

A flutter: treatment?

Answer 20

Ca channel blockers, beta blockers, dig, synch shock

Question 21

A fib., what is it?

Answer 21

erratic impulse formation, no distinguishable P wave

Question 22

with A fib, what do you want to watch out for? inc. risk of what?

Answer 22

pulmonary/systemic emboli

Question 23

Treatment for A fib.:

Answer 23

Goal: slow heart rate

cardizem, anticoags if needed

Question 24

what is the CHADS score?

Answer 24

Congestive HF
Hypertension
Age
Diabetes
Stroke Prior
(if score high, give warfarin (coumadin) if moderate or low give aspirin

Question 25

Premature Ventricular Contractions

Answer 25

bizarre and wider than normal beats, can be unifocal, or multifocal (up and inverted) or couplets or bigeminy or trigeminy.

Question 26

treatment for PVC's?

Answer 26

``` goal: treat cause hypoxia --give O2 Ischemia dehydration (electrolytes) antiarythmic ```

Question 27

importance to notice multifocal PVC's b/c?

Answer 27

multifocal PVC's have higher chance of causing V Tach

Question 28

how many PVC's in a min is considered bad?

Answer 28

greater or equal to 6, call doctor!

Question 29

What is V tach?

Answer 29

Wide QRs, may/may not have pulse treat pulseless like V fib: defib, cpr, epi, if has pulse: shock, cpr, amiodorone, lidocaine

Question 30

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.

Answer 30

Torsades de pointes

Question 31

relevance of Torsades de Pointes?

Answer 31

can quickly deteriorate into V fib

Question 32

treatment for Torsades de pointes?

Answer 32

- CPR, cardioversion | med: MAGNESIUM SULFATE

Question 33

Chaotic, no readable PQRST waves, coarse vs. fine

Answer 33

V fib

Question 34

treatment for V fib?

Answer 34

MEDICAL EMERGENCY: DEFIB!!! | cpr, epi, coronary perfusion

Question 35

nurse sees pt in v fib? what should she do?

Answer 35

feel pulse, call code, shock

Question 36

kinda looks like normal rhythm but no P wave, narrow QRS? treatment?

Answer 36

junctional rhythm, | med: atropine, pacemaker, dopamine drip, epi drip

Question 37

what do you do for asystole? what do you not do?

Answer 37

NO shock | -CPR, atropine, check in 2 leads, confirmation of death

Question 38

for renal pt with wide QRS, what do you do?

Answer 38

give calcium chloride slowly

Question 39

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?

Answer 39

Regitine