Exam 1 Review- CV part Flashcards
this is an early rhythm complex that occurs for the next SA impulse
premature complexes
PVC/PAC that occurs every other beat / every 2 beats / every 3 beats?
bigeminy , trigeminy, quadrigeminy
sxs of prematures complexes
Palpitations or symptoms of low cardiac output –> check BP
*note: may be asxs as well
premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the atrium?
see P wave that is abnormal, narrow QRS complex
premature complexes can be generated by other parts of the heart, what do we see when the PAC starts in the ventricles?
no P wave, wider QRS complex
brady dysrthymia = HR < ____
60!
concerns with brady-dysrhythmia - what does it to diastole? what are 3 things we are checking in patient to assess their perfusion?
• Prolonged diastole → improved perfusion to heart
OR
• Decreased perfusion to heart if Cardiac Output decreases (low BP)
◦ check BP! to determine if CO is poor perfusion
◦ check LOC
◦ check urine output
tachy dysrhythmia = HR >_____
100!
what does tachy-dysthymia do to diastole? what do we need to assess?
• Shortens diastole –> heart itself doesn’t get as much O2
• Increased work of heart (heart needs more O2)
◦ uses too much energy
• get BP - low from decrease stroke volume
sinus brady s/s
• Low BP, Confusion, SHOB, chest pain, dizzy, syncope
who might naturally have a low HR?
arthletes
is sinus brady always bad?
has therapeutic benefit of reducing myocardial O2 demand and allws for increased perfusion time
when do we use pacing- HR too slow or HR too fast?
hr too slow! –> patient not perfusing
pacemakers can pace different parts of the heart -
◦ Atrial (Sick Sinus) - initiates p wave ◦ Ventricular ◦ Biventricular (Heart failure)
the take home from this is you need to know….
what your patient is pacing
wtf are pacer spikes?
= initiates something to happen in the heart
3 types of atrial dysrthymias
• Premature Atrial Complexes (see above)
• Supraventricular Tachycardia
• Atrial Fibrillation
this type of dysrhythmia =
• Rapid stimulation of atrial tissue
• 100 bpm to 280 bpm
- No visible P wave
Supraventricular Tachycardia (SVT)
what is • Paroxysmal Supraventricular Tachycardia
short run of SVT and got back to normal
interventions for SVT
- take BP
-identify cause
-Vagal maneuver
-Adenosine (6mg, 12mg, 12mg)
-Fluids - BB, CCB
-Cardioversion (= synchronous shock)
adenosine protocol for SVT?
◦ causes period of asystole.
◦ feels like you are getting kicked in the chest
◦ Give 6 then 20 cc fluid, 12 then 12 if needed
Atrial fibrilation- what are the main causes?
Related to atrial fibrosis and muscle mass
◦ Hypertension
◦ Heart Failure
◦ CAD
-mitralregurgitation
this dysrhythmia = irritable atria, multiple rapid impulses depolarizing the atria causing decreased cardiacoutput and NO P WAVE
atrial fibrillation
do you see a P wave with A fib?
no P wave on afib
A Fib interventions
- O2
-decrease anxiety
-Meds (dilt (drip) + amiodoarone (drip) + anticoag)
-Cardioversion (synchronized)
-Ablation