Exam 1: dysrhythmias, SC injuries, pacemakers, chest tubes Flashcards
normal sinus rhythm
indicates that the electrical impulse sent from the SA node is being adequately transmitted following the normal conduction pathway
criteria for NSR (rate, rhythm, p wave, PR interval, QRS complex)
- rate 60-100
- rhythm: regular
- p wave: one consistently shaped p wave before QRS
- pr interval: 0.12-0.2 seconds
- QRS complex: <0.12 seconds
causes of sinus arrhythmia
respiratory patterns, digitalis, morphine
s/s of sinus arrhythmia
HR increases during inspiration and decreases during exhalation
cardiac output formula
heart rate x stroke volume
sinus dysrhythmia
originates in the SA node + conducted through normal pathway
bradycardia strip presentation
- rate: <60
- rhythm: regular
- p wave: normal
- pr interval: 0.12-0.2 seconds
- QRS: <0.12 (wdl)
causes of bradycardia (NOT MEDS)
- MI
- vagal stimulation (suctioning, Valsalva maneuvers)
- neuro disorders
- hypothyroidism
- prolonged hypoxia
meds that cause bradycardia
- acetylcholine
- amiodarone
- beta blockers
- calcium channel blockers
- digitalis
- lithium
bradycardia: impact on client
- assess CO
- symptomatic: unable to complete ADLs w/o fatigue or SOBm may have syncopal episodes
interventions for bradycardia
- implement fall risk
- d/c meds causing bradycardia
- administer atropine
- apply O2
- temporary pacing
tachycardia strip presentation
- rate: >100
- rhythm: regular
- p wave: normal
- pr interval: 0.12-0.2 seconds
- QRS: <0.12 (wdl)
causes of tachycardia
- physical activity
- anxiety
- fever
- pain
- stress
- anemia
- hypoxemia
- hyperthyroidism
- compensatory response to decreased cardiac output/BP (shock)
- dehydration
- infection
- heart failure
- illicit drugs
- caffeine
- nicotine
atrial dysrhythmias
abnormal electrical activity that results in stimulation outside the SA node
premature atrial contractions (PACs)
benign cardiac rhythm occurrence that causes the heart’s electrical conduction system to activate an early heartbeat/impulse from one of the two atrial chambers
causes of PACs
- stress
- cardiac irritability
- anxiety
- fatigue
- inflammation
- infection
- alcohol
- tobacco
- caffeine
s/s of PACs
- usually asymptomatic
- sometimes palpitations
supraventricular tachycardia (SVT)
impulses originating from above the AV node that cause excessive excitability of the atrial tissue
SVT appearance phrase
if you can’t tell if it’s a p or a t, you have to call it an SVT
paroxysmal supraventricular tachycardia (PSVT)
tachycardia of sudden onset and termination
causes of PSVT
- stress
- smoking
- alcohol
- caffeine
- HF/heart disease
- HTN
- DM
- renal disease
- pregnancy
- chronic lung disease
- Wolff-Parkinson-White Syndrome
s/s of PSVT
- rapid ventricular response
- chest pain
- palpitations
- weakness
- fatigue
- SOB
- anxiety
- hypotension
- syncope
1st degree block
- conduction between atrium and ventricles is slower
- pr interval: <0.20
-no threat, no symptoms, no treatment
2nd degree block type 1
- more Ps than QRS
- PR interval gets longer and longer, drops QRS, then restarts
- irregular rhythm
- caused by MI, drugs
