Sinus Rhythms Flashcards
Sinus Bradycardia
originates in SA node
regular, rate <60 bpm
rhythm normal
normal PR interval and QRS
Sinus Brady: Causes (6)
HYPERkalemia (slows depolarization)
Vagal response
Digoxin toxicity
Late hypoxia
Medications
Myocardial infarction
Sinus Brady: Clinical Manifestations (6)
-lightheadedness or dizziness (especially with exertion)
-easy fatiguability
-syncope or near-syncope
-dyspnea
-chest pain or discomfort
-confusion
Symptomatic Bradycardia: Treatment
atropine: anticholinergic
if drug not effective: pacemaker
Sinus Tachycardia
originates in SA node
HR: 100-150 bpm
rhythm: regular
P waves similar (may be partially hidden)
Normal PR interval and QRS
Sinus Tachycardia: Causes (8)
-catecholamines:
-exercise
-pain
-strong emotions
-fever
-fluid volume deficit
-medications
-substances
-hypoxia (early)
Sinus Tachycardia: Treatment
BASED ON CAUSE
-hypovolemia= fluids
-fever= antipyretics (ex:
tylenol)
-pain= analgesics
-something else like a
cardiac disease state=
beta-blockers: to reduce
HR and myocardial
oxygen consumption
Paroxysmal Supraventricular Tachycardia (PSVT)
originates in AV node
HR: 150-250 bpm
usually NO P wave–> if present they look abnormal
QRS normal
typically begins and ends suddenly
often described as “feeling like my heart is racing”
PSVT: Causes (9)
*usually caused by a re-entry phenomenon
-over exertion
-emotional stress
-stimulants
-digoxin toxicity
-rheumatic heart disease
-CAD
-WPW (Wolff-Parkinson-White)
-right sided heart failure
PSVT: S/S (5)
palpitations
chest pain
fatigue
lightheadedness or dizziness
dyspnea
Premature Atrial Contractions (PACs): Definition
early P waves that usually look a little different (morphological changes)
normal PR interval
QRS does follow the PAC
Premature Atrial Contractions (PACs): Nursing Considerations
usually has no consequences, but if frequent, indicates that patient is at high risk for other dysrhythmia (usually afib)
CHECK ELECTROLYTES
May need O2
