Electrocardiography And Dysrhythmias Monitoring

Question 1

Dysrhythmias are classified by

Answer 1

+Site of origin: -SA node , atria, AV node, or ventricle

+effect on the rate and rhythm of the heart- Brady, tachy, heart block, premature beat, flutter, fibrillation, or asystole

Question 2

Bradycardia (any rhythm less than 60/min)

Answer 2

-treat if client is symptomatic
-medication:
Atropine & isoroterenol

-electrical management:
Pacemaker

Question 3

Atrial fibrillation,supraventricular tachycardia (SVT), or ventricular tachycardia with pulse

Answer 3

Medication: amiodarone, adenosine, and verapamil (A.A.V)

Electrical management:
Synchronized cardioversion

Question 4

Ventricular tachycardia without pulse or ventricular fibrillation

Answer 4

Medication:
Amiodarone, lidocaine, and epinephrine (A.L.E)

Electrical management:
Defibrillation

Question 5

Cardioversion

Answer 5

The delivery of a direct countershock to the heart synchronized to the QRS complex

Question 6

Defibrillation

Answer 6

Delivery of an unsynchronized, direct countershock to the heart.

Stops all electrical activity of the heart, allowing the SA node to take over and reestablish a perfusing rhythm

Question 7

Indications for a cardioversion

Answer 7

• atrial dysrhythmias
• supraventricular tachycardia
• ventricular tachycardia with a pulse

ASV

Question 8

Indications for defibrillation

Answer 8

Ventricular fibrillation or pulseless ventricular tachycardia

Question 9

Preprocedure

Answer 9

Those who have atrial fibrillation of unknown duration must receive adequate anticoagulation for 4-6 weeks prior to cardioversion therapy

Why? To prevent dislodgment of thrombi into the blood stream

Question 10

Intraprocedure

Answer 10

• administer sedation as prescribed
• administer antidysrhythmic agent or other prescribed medications
• digoxin is held for 48 hours prior to cardioversion
• cardioversion requires activation of the synchronized button which allows the shock to be in sync. Can lead to lethal dysrhythmia if not synchronized.

Question 11

Postprocedure

Answer 11

Assess airway patency & obtain ECG

Question 12

What you need to document?

Answer 12

• postprocedure rhythm
• number of defibrillation or cardioversion attempts, energy settings, time, and response
• clients condition and state of consciousness following the procedure
• skin under the electrodes

Question 13

Pulmonary embolism

Answer 13

• dyspnea
• chest pain
• air hunger
• decreasing SaO2

Question 14

Cerebrovascular accident

Answer 14

• Decreasing level of consciousness
• slurred speech
• muscle weakness/paralysis

Question 15

MI

Answer 15

• Chest pain

- ST segment depression or elevation