Heart Rhythms + Meds Flashcards
What are Calcium Channel Blockers (CCBs) commonly compared to?
Valium for the heart
CCBs relax and slow down the heart.
What are the three negative effects of CCBs on the heart?
- Negative inotropy
- Negative chronotropy
- Negative dromotropy
These effects weaken myocardial contraction, decrease heart rate, and reduce conduction velocity.
What is positive inotropy?
Increase in cardiac contractile force
This leads to more complete ventricular emptying and improved cardiac output.
What does positive chronotropy refer to?
Increase rate of impulse formation at the SA node
This accelerates heart rate.
What is the definition of positive dromotropy?
Increase speed of impulses from SA node to AV node
This results in increased conduction velocity.
When are CCBs indicated for use?
- Antihypertensive
- AntiAnginal
- AntiAtrialArrhythmia
CCBs help decrease oxygen demand and manage hypertension.
What are common side effects of Calcium Channel Blockers?
- Headache
- Hypotension
These are common adverse effects associated with CCBs.
What is the common suffix for medications that are Calcium Channel Blockers?
Ends in ‘dipine’
Examples include amlodipine, but not all CCBs follow this rule (e.g., verapamil).
What parameters should be assessed before starting a patient on CCBs?
- Assess BP
- Hold if SBP <100
Blood pressure assessment is crucial to ensure patient safety.
What must nurses know about cardiac rhythms when administering CCBs?
Must know how to interpret rhythm
Understanding cardiac rhythms is essential for monitoring patients on CCBs.
What is the purpose of Cardizem (diltiazem) in CCB therapy?
Given as a continuous IV drip
Cardizem is often used in acute settings for rapid control of heart rate.
What is Normal Sinus Rhythm characterized by?
A P wave followed by a QRS followed by a T wave for every complex
The peaks of the P wave are equally distant from the QRS and fall within 5 small boxes.
What does Ventricular Fibrillation look like?
No pattern
What is the appearance of Ventricular Tachycardia?
Sharp peaks with a pattern
What does Asystole represent on an ECG?
A flat line
What does QRS depolarization indicate?
Ventricular activity
What does a P wave represent?
Atrial activity
What are the three levels of nursing knowledge?
- Stuff you need to know
- Stuff that is nice to know
- Stuff that is nuts to know
What is Asystole characterized by?
A lack of QRS complexes
Asystole is essentially a flat line on the ECG.
What does a saw tooth wave pattern of P waves indicate?
Atrial flutter
What does chaotic P wave patterns signify?
Atrial fibrillation (a-fib)
Chaotic is the term used to describe the irregular rhythm of fibrillation.
What does chaotic QRS complexes indicate?
Ventricular fibrillation (v-fib)
What are bizarre QRS complexes associated with?
Ventricular tachycardia (v-tach)
Bizarre is the term used to describe the irregular appearance of tachycardia.
What does periodic wide bizarre QRS complexes represent?
PVCs (Premature Ventricular Contractions)
Salvos of PVCs refer to short runs of ventricular tachycardia.
What are the three circumstances under which PVCs are elevated to moderate priority?
- 6 or more PVCs in a minute
- More than 6 PVCs in a row
- R on T phenomenon
What are the two lethal arrhythmias that can kill a patient in 8 minutes or less?
- Asystole
- Ventricular fibrillation (V-fib)
What is the consequence of low or no cardiac output (CO) due to lethal arrhythmias?
Inadequate or no brain perfusion, which may lead to confusion and death
Is ventricular tachycardia (V-tach) considered lethal?
Yes, it is potentially lethal but it has cardiac output
How does a patient present with absent cardiac output?
There is no pulse
How does a patient present with present cardiac output?
There is a pulse
What is the treatment for PVCs and V-tach?
Lidocaine
What is the medication that NCLEX boards may eventually want as the answer for treating ventricular rhythms?
Amiodarone
What are the treatments for supraventricular arrhythmias?
- Adenocard (Adenosine)
- Beta-blockers
- Calcium Channel Blockers (CCBs)
- Digitalis (digoxin, Lanoxin)
What is the administration method for Adenosine (Adenocard)?
Fast IV push (less than 8 seconds) followed by 20 mL NS flush
What are the negative effects of beta-blockers on the heart?
Negative inotropic, chronotropic, and dromotropic effects
What do beta-blockers treat?
- Antihypertensive
- AntiAnginal drugs
- AntiAtrialArythmia
What are common side effects of beta-blockers?
Headache and hypotension
What is the treatment for Ventricular fibrillation (V-fib)?
Defibrillation
What are the medications used for treating Asystole?
Epinephrine and Atropine
Fill in the blank: Treatment of ventricular arrhythmias includes _______ and Amiodarone.
Lidocaine
