MED-SURG---Cardiac Rhythm & Dysrhythmias Flashcards
Mark Lieb, MSN, RN, CEN
Multiple PVC’s in a row (3 or more) is known as ________________
Ventricular Tachycardia
VTACH
what are the “4” rhythms that can be cardioverted?
1) A-Fib
2) A-Flutter
3) SVT
4) V-Tach with pulse
Two main systems in the heart
1) Electrical (Conduction)
2) Mechanical (Contraction)
most common Dysrhythmia?
atrial fibrillation
Delivery of unsynchronized, direct countershock to the heart–Stopping all electrical activity of the heart –allowing the SA NODE to take over nd reestablish a perfusing rhythm.
Defibrillation
Calcium Channel Blocker
- INDICATIONS
- ACTIONS
*RATE \ RHYTHM control of rapid Atrial rhythms (A-fib with RVR) A-Flutter, SVT
- SLOWS SA NODAL FIRING= decreased automaticity
- SLOWS TRANSMISSION THROUGH AV NODE = reduced ventricular rate
TX for VTACH (w/o Pulse)
1) DRUGS (3)
2) Electrical Mangemet
Amiodarone
Lidocaine
Epinephrine
Defibrillation
What is “R on T phenomenon”?
PVC’s falling on the T WAVE
EQUATION FOR CARDIAC OUTPUT?
Heart Rate x Stroke Volume == CO
Vagal Maneuvers (4)
1) blowing through straw
2) Valsalva Maneuver (holding breath and bear down)
3) Ice to face (for babies)
4) Carotid sinus massage (cannot be done by nurse-clot could break off and occlude the carotid)
TX for VTACH (with pulse)
1) Drugs (3)
2) Electrical management
Amiodarone
Adenosine
Verapamil
Synchronized Cardioversion
indications for adenosine
SVT (regular, narrow QRS of 0.10 or less with rate >150)
Immediate intervention needed for V-FIB
CPR / Defibrillation
IF allowed to continue—VTACH can deteriorate into ________________
Ventricular Fibrillation
PVC that is noted to be EVERY THIRD BEAT
Ventricular Trigeminy
INDICATIONS FOR DEFIBRILLATION
1) V-Fibrillation (V-FIB)
2) VTACH (without a pulse)
Cardiac cells possess 4 similar properties
AUTOMATICITY ability to depolarize itself. can start an electrical impulse by themselves without any outside initiation
EXCITABILITY–ability to respond to a stimulus
CONDUCTIVITY–ability to transmit a stimulus to a neighboring cell
CONTRACTILITY–ability to respond to a an electrical impulse with a pump or contraction
Type of ventricular tachycardia associated with LON QT Syndrome
Torsades de Pointes
side effects of ADENOSINE
chest discomfort lightheadedness syncope bradycardia asystole
ability to respond to a stimulus
EXCITABILITY
describe the “action” of adenosine
slows conduction through the AV node and interrupts reentry pathways
EKG complexes and what do they represent
P WAVE—represents atrial depolarization
QRS WAVE–represents ventricular depolarization
T WAVE –represents ventricular repolarization
The EKG reading states that your patient is in ASYSTOLE…what do you do first?
1) Check your patient
2) Check EKG lead (Disconnected lead?)
**IF REAL—BEGIN CPR IMMEDIATELY
INDICATIONS for Cardioversion (3)
1) Elective treatment of atrial dysrhythmias
2) SVT
3) VTACH (with a pulse)
**tx of Choice for Clients that are symptomatic
first line treatment for dsyrhtymias
adenosine, CCB, BB