Exam #1 Flashcards
What are some causes of Bradycardia
Sleep
Athletic pt
What is the tx for bradycardia
Treat the cause
What are some causes of sinus tachycardia? 5
-Physiologic stress
-Medications
-Stimulants
-Illicit drugs
-POTS (autonomic dysfunction)
What is the golden rule for sinus tach treatment?
TREAT THE CAUSE
Why and when is sinus tach bad?
- Decreases Cardiac Output
- Increases Cardiac Workload
- May lead to ischemia/HYPOtension
What arrhythmia occurs as extra & abnormal electrical activity ABOVE ventricles and AV node
**Reentering of electrical signals FROM vents to atria
Supraventricular Tachycardia
What are some causes of SVT
-High levels of stress
-Electrolyte imbalance
What are the treatments for SVT
** SVT and ABCD**
- Start with Vagal Treatment
- If vagal does not work:
*Adenosine
*Beta-blockers
*Cardiac Ablation
*Digoxin
Synched Cardioversion
Electrical impulse starts in the atria but not the SA node. A premature impulse before the SA even fires. – What arrhythmia is this?
Premature Atrial Contraction
What are some causes of PACs?
-Caffeine, nicotine, alcohol
-HYPERvolemia
-anxiety
-HYPOkalemia
-Atrial Ischemia
What are the treatments of PACs?
- Treatment is not usually needed
- If this happens frequently, treat the cause
The heart’s electrical signals spread through the atria, which are beating too quickly though at a regular rhythm – This describes which arrhythmia?
Atrial Flutter
Patient’s with atrial flutter are at risk for:
Pooling in the heart – Clotting
What are some causes of Atrial Flutter?
-CAD
-HTN
-HF
-Valvular Disease/Disorders
-HYPERthyroidism
-Lung disease
-Cardiomyopathy
What are the treatment options for a new diagnosis of A-flutter
Adenosine
Cardioversion
What are the treatment options for an old diagnosis of A-flutter?
-Anticoagulants
-Cardioversion
-Antiarrhythmic (Amiodarone)
Uncoordinated electrical activity in the atria that causes rapid and disorganized “fibbing” of muscles in the atrium – quivering instead of contracting – Describes which arrhythmia
Atrial Fibrillation
What are patients who have A-fib most as risk for?
Pooling in the heart – Clotting
What are some of the causes of A-fib?
-HF
-COPD
-HTN
-Ischemic heart disease
What are the treatment options for A-fib?
- Anticoagulants
Short term: Heparin drip
Long term: Coumadin, Rivaroxaban, Apixaban - Antiarrhythmic Meds (Amiodarone)
Early/Premature conduction of QRS complex. – Impulse starts in the ventricle before next normal beat fires from the SA node – this describes which arrhythmia?
Premature Ventricular Contraction
What are some of the causes of PVCs?
-Caffeine, nicotine, alcohol
-Cardiac ischemia
-Hypoxia
-Tachy
-Acidosis
-Dig. Toxicity
-HF
-Electrolyte imbalance
What are the treatment options for PVCs?
Treatment not usually needed – if frequently occurring, treat the cause
-The signal starts in the AV node, not the SA node – AV is now acting as the pacemaker of the heart
-P-wave can be→ inverted in front of QRS, buried in QRS, inverted behind QRS— This describes which kind of arrhythmia?
Junctional rhythms
How do you treat Junctional Rhythms?
If symptomatic, treat like bradycardia
Waveforms are irregular, coarse, and of different shapes. Ventricles are QUIVERING. No contraction. No Cardiac Output. CAN BE FATAL. – This describes which arrhythmia?
Ventricular Tachycardia
What are the common causes of ventricular tachycardia?
-MI
-Electrolyte imbalance
How do you treat V-tach with a pulse?
-Amiodarone
-Lidocaine
-Mag- Torsades
**If these do not work, cardiovert
How do you treat pulseless V-tach?
Start CPR and get the dfib!!
A rapid disorganized pattern of electrical activity in the ventricle in which electrical impulses arise from different foci – this describes which arrhythmia?
Ventricular Fibrillation
What are some of the common causes of Vfib?
-Untreated Vtach
-Electrolyte imbalance
-Cardiac Injury
What are the treatments for Vfib?
-DFIB THE VFIB
**NO PULSE → start CPR asap
What does asystole look like on an EKG?
Flatline
What is the treatment for Asystole?
- CPR and epi
THIS IS A NON-SHOCKABLE RHYTHM
Which rhythm shows the last bit of activity from the ventricles before a patient dies?
Idioventricular Rhythm
If a patient has an Idioventricular Rhythm WITH a pulse, how would you treat this?
Epi and vasopressors
If a patient has an Idioventricular Rhythm WITHOUT a pulse, how would you treat this?
Treat like asystole – cpr and epi
Which arrhythmia can look like any arrhythmia, but there is NO HR/ PULSE
pulseless electrical activity
How do you treat PEAs?
-Treat like asystole – CPR and Epi
-Hs & Ts
What are the Hs in Hs&Ts
- Hypov______
- Hypox______
-Hydrogen Ions (acidosis)
- Hypo/Hyper_______
- Hypog________
-Hypot______
- Hypovolemia
- Hypoxia
- Hydrogen Ions (acidosis)
- Hypo/Hyperkalemia
- Hypoglycemia
- Hypothermia
What are the Ts in Hs&Ts
-Tox_______
-Tam_______
-Thro_____
-Tension _______
-Tra______
-Toxins
-Tamponade
-Thrombosis
-Tension pneumo
-Trauma
Which arrhythmia shows prolonged PR intervals?
1st Degree Heart Block
What is the common treatment for 1st degree heart block?
Pacemakers (permanent/temporary)
Cardioversion is a _________ _________ of electrical current through a defibrillator. It must be synched with the patient’s ___ ________
timed delivery
QRS complex
Defibrillation is used to give an electrical current in hopes to break an arrhythmia. It should not be ________ because the pt will not have a pulse
Synched/timed
Chest pain (angina pectoris) is a syndrome characterized by episodes of pain or pressure in the anterior chest caused by insufficient __________ _______ _____ .
Coronary Blood Flow
What are treatments of Angina?
- Nitro
- Beta-blockers (metoprolol)
- Calcium Channel Blockers (Diltiazem)
- Antiplatelet/anticoag (asp, heparin)
This is caused by a partial block of one of the arteries causing reduced blood flow of oxygen to the heart muscle - this describes what?
NSTEMI
Non-St Elevation MI
What are the treatment options for NSTEMIs
-Medications to prevent blood clots such as (Heparin, Coumadin, Aspirin)
-In some cases CABG
-The goal is to reduce cardiac muscle ischemia and prevent further complications
cardiac muscle death. Caused by a full blockage of a major artery from plaque – Describes a:
STEMI
What are the treatment options for a STEMI?
-Coronary angioplasty
-Straight to cath lab within 60 minutes
-Slow heart rate (beta blocker IV)
-Reduce BP: nitro drip
-Thrombolytics within 30 minutes of onset of symptoms
What are cardiac cath tips for a pt postop?
-Monitor catheterization site for bleeding or hematoma
-Inactivity for 2-6 hours post procedure
-Evaluating color, cap refill, and pulses
-Monitoring for arrhythmias and chest pain in the patient
Systolic HF: left ventricle unable to _______ enough blood resulting _____ drop. This also causes blood to back up in the _________ system.
PUMP
EF (Ejection Fraction)
Pulmonary
Diastolic HF: left ventricle does not ______ properly resulting _______ _______ to decrease. This causes blood to back up in the ______ ventricle.
FILL
Stroke Volume
Left
___ __________ (Lisinopril): vasodilation, decreases afterload, prevents progression
ACE Inhibitor
_____________ ___ (Losartan): prescribed as an alternative for ACE; works similarly
Angiotensin II
_____ __________ (Metoprolol): prescribed in addition to ACE; improves capacity to exercise
Beta Blockers
___________ consent means that the patient or their proxy has been fully informed of the risks, benefits, and alternatives to a proposed treatment and has given their permission for the treatment to proceed.
Informed
________ Consent: This is when a patient is unable to provide consent and there is an emergency situation.
Implied
__________ _________ of ______ ________ of ________: creates rules and regulations for nursing practice. (Ex: complaint filed against nurse, NCSBN will investigate. They can also revoke nursing licenses.
National Council of State Boards of Nursing
________ __________ ___: primary legal document governing nursing practice and sets standards of nursing care.
Nursing Practice Act
__________ _________: legal documents that state a person’s wishes regarding their medical care in the event that they are unable to communicate those wishes themselves.
Advanced Directives
__________ ______ : spouse, children, parent, siblings, other relative or close friend. This is someone you trust to make decisions for you if you were unable to communicate.
Healthcare Proxy
An __________ is a localized dilation of an artery which enlarges __x the size of its normal diameter
aneurysm
2
dilation affecting the entire circumference of the artery – this is what type of aneurysm?
Fusiform
outpouching affecting only a distinct portion of artery – this describes which type of aneurysm?
saccular
formed when blood accumulates in the wall of an artery – which type of aneurysm is this?
Dissecting
sudden tear of the intima of aorta – which type of aneurysm is this?
Aortic dissection
Where are the 2 most common locations for aneurysms?
-Abdominal Aorta Aneurysm **most common
-Thoracic Aorta Aneurysm
What is the emergency treatment for an aneurysm rupture?
-Place 2 large IV bores
-Reduce and manage blood pressure
-Treat pain
-Prepare for surgery
D/C instructions following surgical repair of aneurysm :
- Cannot climb ______
- Should not _____
- Avoid _________/_________ activities
- Don’t life anything >_____ lbs
Stairs
Drive
Pushing/pulling
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