Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio I - ECG > Meds/Management/Interventions > Flashcards

Meds/Management/Interventions Flashcards

1
Q

A-fib

A

Control ventricular rate via blocking AV node to increase filling time and CO
Convert A-fib or A-flutter to NSR
BBs/CCBAs/digoxin ==> rate control
Amiodarone ==> NSR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Ventricular arrhythmias

A

Treat underlying conditions
Prevent V-fib
PVCs - reduce vs. risk of premature death
BBs/amiodarone/flecanide/quinidine/procainamide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pacemaker indications

A 
Slow HR
Absent HR:
Sick sinus syndrome (SA node not firing well)
Symptomatic bradycardia
Tachy-brady syndrome
A-fib c slow ventricular response
3rd degree heart block
Chronotropic incompetence 
Paroxysmal A-fib (comes and goes c NSR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Areas of insertion for PM

A 
Subclavian v.
Axillary v.
Cephalic v.
RA
RV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

External PM use

A

Short-term or in emergencies

Temporary use after cardiac surgery - implanted during surgery and usually out s/p day 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Endocardial PM

A

Can be used in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How does a PM work?

A

Electrical stimulation of myocardium to depolarize it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Can you tell if someone has a PM by their telemetry strip?

A

Yes - it appears as a vertical line - vertical deflection before the complex it is trying to pace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If the PM is pacing the atria…

A

The black line appears before the P wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If the PM is pacing a ventricle…

A

The black line appears before the QRS complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of PMs

A

Fixed rate
Demand - sense depolarization and normal electrical activity (can change c activity) - if depolarization is absent or delayed, it fires at a present rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Single chamber PM…

A

Paces either the ventricles or atria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dual chamber PM…

A

Paces both the atria and the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

AV synchronous chamber PM…

A

Paces the atria and ventricles simultaneously and restores normal timing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How are PMs classified?

A

According to:
Chambers paced
Chambers sensed
Response to sensed impulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

1st letter PM code…

A

PACED chamber (A; V; D - both)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

2nd letter PM code…

A 
SENSED chamber (A; V; D - both)
*senses intrinsic electrical activity*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3rd letter PM code…

A

RESPONSE TO SENSED SIGNAL
I - inhibited by activity (PM withholds or inhibits response - doesn’t give a pace - if electrical activity sensed)
T - triggered by activity
D - dual - inhibited or triggered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

4th letter PM code…

A

PROGRAMMABILITY
P - simple programmability
M - multi-programmable (rate, sensing, output, refractory period)
C - communicating (telemetry)
R - rate response (can respond to physical activity, but doesn’t tell which type of sensory - RR vs. activity sensor)

20
Q

5th letter PM code…

A

ANTI-TACHYCARDIA FEATURES
O - no anti-tachy arrhythmia function
P - can pace the Pt. Out of tachy episode

21
Q

Which type of PM can be used c A-fib?

A

VVI
V - paces ventricles
V - senses ventricles
I - inhibited by sensed ventricular depolarization (PM will not pace if ventricle is depolarizing)

22
Q

PM ex: DDI

A

Paces both A/V
Senses both A/V
Inhibits PM output if normal electrical activity occurring in either/both chambers

23
Q

PM ex: AAT

A

Paces atria
Senses atria
Each sensed event triggers the pacer to fire within the P wave

24
Q

How does a VVI PM work c A-fib?

A

It tries to maximize communication between A/Vs
It waits for the ventricle to contract
Telemetry: PM spike, then QRS (wide) bc pacing ventricles and bc impulse from PM, not AV node
there is not great synchrony between A/Vs

25
Q

PM ex: DDD

A

Optimal, fully automatic, universal, physiologic
Both chambers paced and sensed
Sensed atrial signal causes PM to INHIBIT atrial output - timer starts that causes a triggered ventricular output after certain interval
If QRS occurs naturally, PM inhibits ventricular output
Intrinsic P wave and intrinsic QRS can inhibit pacing
Intrinsic P wave can trigger a paced QRS

26
Q

Which type of PM is the most common?

A

DDD

27
Q

Rate modulation - PM 4th code

A

Physiologically-based (minute ventilation - increases c activity ==> RR x TV)
requires a longer warm-up bc there is a slight delay to activity - need to extend warm-up and cool-down c exercise

28
Q

If there are no depolarization complexes on ECG c PM…

A

The PM fires normally but fails to capture

29
Q

PM failure to sense

A

Fails to sense underlying rhythm and fires in complete disregard for Pt.’s own rhythm - may compete c heart for control

30
Q

PM under- or over-sensing

A

PM can over-sense by misinterpreting muscle movement as depolarization

31
Q

Sx when PM isn’t meeting demands (CO sx if not keeping up c activity)…

A 
SOB 
Syncope
Angina
CHF sx (if decreased ventricular contraction)
Fatigue
Vertigo
Confusion
Dizziness
32
Q

If PM used for tachy-dysrhythmia, NOTE CUT-OFF RATE…

A

10 beats BELOW cut-off rate is MAX HR IN KARVONEN - otherwise PM will fire when not necessary

33
Q

If PM ATRIAL RATE IS FIXED, ventricular rate is affected

A

BLUNTED HR response to exercise ==> need prolonged warm-up/cool-down

34
Q

PM PT considerations

A

No lifting x 6 wks. (Fibrosis needs to occur over PM)
No overhead exercise until MD clears
Avoid contact sports (low-intensity competitive sports allowed if approved by MD)

35
Q

ICD (implantable cardiac defibrillator)

A

Monitors heart RHYTHM (PM ==> RATE) ==> prevents SCD
Delivers electrical shock if dangerous rhythm detected:
V-tach
V-fib

36
Q

ICD considered for…

A

Previous cardiac arrest (V-tach or V-fib)
I controlled dysrhythmia c meds
Cardiomyopathy c dysrhythmia (or at risk)
CAD, low LVEF, and episode of V-tach

37
Q

Digoxin toxicity can cause which types of heart problems?

A 
Sinus dysrhythmia 
A-fib
Junctional rhythm 
2nd degree AV block, Type II (Mobitz II)
3rd degree (complete) heart block
V-tach
V-fib
38
Q

Intervention for symptomatic sinus bradycardia

A

PM

Atropine (need adequate resting CO)

39
Q

Intervention for A-flutter

A

BBs

Cardioversion to reset electrical system

40
Q

Controlled A-fib

A

HR < 100 (V rate) ==> little impact on CO

41
Q

Uncontrolled A-fib

A

HR > 100 (V rate) ==> impacts CO - MONITOR VITALS

42
Q

Interventions for A-fib

A

Antiarrhyhmic meds

Cardioversion

43
Q

Interventions for junctional rhythm

A

Atropine to increase HR

PM

44
Q

Interventions for 3rd degree (complete) heart block

A

Permanent PM

Atropine

45
Q

Interventions for V-tach

A

Cardioversion; defibrillation

Meds to normalize rhythm

46
Q

Interventions for V-fib

A

Defibrillation
CPR
O2
Cardiac meds

Cardio I - ECG (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions