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Nursing Theory IV A- Cindy'S Class > Test Two: Cardiac Dysrhythmias > Flashcards

Test Two: Cardiac Dysrhythmias Flashcards

1
Q

What is a dysrhythmia?

A

Abnormal cardiac rhythm
- Disorder of the formation or conduction of the electrical impulses in the heart

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2
Q

What are the three disturbances of dysrhythmias?

A
  1. rate
  2. rhythm
  3. both
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3
Q

What is used to diagnoses dysthymia’s?

A

ECG

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4
Q

What is the P wave in the conduction system of the heart?

A

depolarization of the atria

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5
Q

What is the Q, R, S wave in the conduction system of the heart?

A

depolarization of the ventricles

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6
Q

What is the T wave in the conduction system of the heart?

A

repolarization of the ventricles

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7
Q

What is the U wave in the conduction system of the heart?

A

may represent repolarization of the Purkinje fibres

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8
Q

What are five ways to evaluate dysrhythmias?

A
  1. Holter monitoring
  2. Event recorder monitoring
  3. Exercise treadmill testing
  4. Signal-averaged ECG
  5. Electrophysiological study (invasive)
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9
Q

What is ECG monitoring?

A

Graphic tracing of electrical impulses produced by the heart

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10
Q

What are some pt preparation that needs to be done before ECGs?

A
  • clip excessive hair on chest wall
  • rub skin with dry gauze
  • may need to use alcohol for oily skin
  • apply electrical conductor gel
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11
Q

What is telemetry monitoring?

A

a non-invasive, portable way to observe the HR and rhythm at a distant site
type types:
–> centralized monitoring system
–> sophisticated alarm system alerts when it detects dysrhythmias, schema, or infarction

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12
Q

What is a normal sinus rhythm?

A
  • sinus node fires 60-100bpm
  • follows normal conduction pattern
  • Rhythm= regular and R-R constant
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13
Q

What is sinus bradycardia?

A
  • sinus nodes fires <60bpm
  • rhythm= regular and R-R constant
    this is considered normal in aerobically trained athletes and during sleep
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14
Q

What are symptoms of sinus bradycardia?

A

-hypotension, pale, cool skin, weakness, angina, dizziness, confusion, SOB

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15
Q

What is the treatment of sinus bradycardia?

A
  • atropine
  • pacemaker if needed
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16
Q

What are causes of sinus bradycardia?

A
  • beta-blockers
  • CCB
  • athletes
  • hypothermia
  • hypothyroidism
  • vagal stimulation
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17
Q

What is sinus tachycardia?

A
  • rate = >100bpm
  • rhythm = regular and R-R constant
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18
Q

What are symptoms of sinus tachycardia?

A

dizziness and hypotension (due to decreased co), angina, palpations, alterations in bp, dizziness, SOB, diaphoresis

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19
Q

What are causes of sinus tachycardia?

A

exercise, pain, hypovolemia, anemia, myocardial ischemia, heart failure, fever, shock, hypoxia, stress, medications, caffeine

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20
Q

What is the treatment for sinus tachycardia?

A
  • determine underlying cause and correct it!!
  • oxygen, fluids
  • medications
    –> analgesics, antipyretics, B-adrenergic blockers
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21
Q

What is premature atrial contraction?

A
  • extra heartbeats that begin in one of your heart’s two upper chambers (atria)
  • may be stopped, delayed, conducted normally at the AV node
    ** may be an ideation of a more serious dysrhythmia in heart disease**
22
Q

What is the causes of premature atrial contraction?

A

low potassium
- emotional stress, caffeine, tobacco, alcohol, hypoxia, COPD, valvular disease

23
Q

What is the treatment of premature atrial contraction?

A
  • individualized, depends on cause
  • B-adrenergic blockers
24
Q

What is a atrial flutter?

A

-known as ‘saw tooth’ or ‘picket fence’ shaped flutter waves
- rhythm = regular/irregular
- upper chambers (atria) to pump very rapidly
-arrhythmias

25
Q

What is the causes of atrial flutter?

A

CAD, HTN, mitral valve disorders, pulmonary embolus, chronic lung disease, cardiomyopathy, hyperthyroidism
drugs
- dioxin, quinidine, epinephrine

26
Q

What is the symptoms of an atrial flutter?

A

decreased BP and syncope

27
Q

What is the treatment of an atrial flutter?

A
  • radiofrequency catheter ablation
  • vagal stimulation
  • medications: warfarin, antidysrhythmia drugs
28
Q

What is an atrial fibrillation?

A

linked to brain tumours
- total disorganization of atrial electrical activity due to multiple ectopic foci, resulting in loss of effective atrial conduction
- irregular and often very rapid heart rhythm (arrhythmia)
- rate = atrial > 400-600
- rhythm = irregularly irregular. wiggly
MOST COMMON

29
Q

What is the causes of atrial fibrillation?

A

CAD, HF, MI, HTN,
rheumatic heart disease

30
Q

What is the S&S of atrial fibrillation?

A
  • Pulse deficit with rates > 90
  • ↓BP
  • Syncope
31
Q

What is the treatment of atrial fibrillation?

A
  • Decrease ventricular rate
  • Prevent embolic stroke
  • Drugs for rate control: digoxin, β-adrenergic blockers, calcium channel blockers
  • Long-term anticoagulation: Coumadin
32
Q

What is premature ventricular contractions?

A

Premature occurrence of a wide and distorted QRS complex. rate depends upon underlying rhythm.
- extra heartbeats that begin in one of the heart’s two lower pumping chambers (ventricles)

33
Q

What is the cause of premature ventricular contractions?

A
  • Stimulants: caffeine, alcohol, nicotine, aminophylline, epinephrine, isoproterenol
  • Digoxin
  • Electrolyte imbalances
  • Hypoxia
  • Fever
  • Disease states: MI, mitral va
34
Q

what is the S&S of premature ventricular contractions?

A

Palpitations

35
Q

What is the treatment of premature ventricular contractions?

A
  • Medication
  • Treatment of underlying cause
  • Oxygen therapy for hypoxia
  • Electrolyte replacement
36
Q

What is ventricular tachycardia?

A
  • Run of three or more PVCs
  • Rate = atrial rate not determined
  • Rhythm = Regular but can be slightly irregular
  • Considered life-threatening because of decreased CO and the possibility of deterioration to ventricular fibrillation
  • lower chamber of the heart beats too fast to pump well and the body doesn’t receive enough oxygenated blood.
37
Q

What is the cause of ventricular tachycardia?

A

MI, CAD, Electrolyte imbalances, Cardiomyopathy, Heart Failure

38
Q

What is the symptoms of ventricular tachycardia?

A

↓BP, Absent Pulse, Confusion, Syncope

39
Q

What is the treatment of ventricular tachycardia?

A

Assess the patient, Medication
Code Blue!!!! 5555

40
Q

What is ventricular fibrillation?

A
  • Severe derangement of the heart rhythm characterized on ECG by irregular undulations of varying contour and amplitude
  • No effective contraction or CO occurs
  • Unresponsive, pulseless, and apneic state
  • If not treated rapidly, death will result
41
Q

What is the treatment of ventricular fibrillation?

A

Immediate initiation of CPR and advanced cardiac life support (ACLS) measures with the use of defibrillation and definitive drug therapy

42
Q

What is the cause of ventricular fibrillation?

A
  • Accidental 
electric shock
  • Hyperkalemia
  • Hypoxia
  • Acidosis
  • Drug toxicity
43
Q

What is asystole?

A
  • Represents total absence of ventricular electrical activity
  • No ventricular contraction (CO) occurs because depolarization does not occur
  • Almost flatlining
44
Q

What is the five H’s and T’s of systole

A
  • Hypoxia, Hypothermia, Hypokalemia, Hypovolemia, Hydrogen ion (acidosis)
  • toxins (drug overdoses), Tamponade (cardiac), Tension pneumothorax, Thrombosis –heart (AMI), Thrombosis- lungs (pulmonary embolus)
45
Q

What is the symptom of asystole?

A

Loss LOC, Pulselessness, Respiratory arrest, PATIENT IS DEAD!

46
Q

What is the treatment of asystole?

A
  • Assess the patient, Confirm the absence of pulse
    DNR Order??, Perform immediate CPR!, Code Blue 5555 (CKHA), Confirm the rhythm in TWO leads.
  • Explore possible cause and treat it = ASAP
47
Q

What is defibrillation?

A

Most effective method of terminating VF and pulseless VT
- unsynchronized

48
Q

What is synchronized cardio version?

A

Choice of therapy for hemodynamically unstable ventricular or supraventricular tachydysrhythmias

49
Q

What is implantable cardioverter-defibrillator(ICD)?

A

A device that detects and terminates life-threatening episodes of tachycardia or fibrillation

50
Q

What is a pacemaker?

A
  • An electronic device that provides electrical stimuli to the heart muscle
  • Used for slower-than-normal impulse formation, to control some tachycardias, or for advanced heart failure
  • May be permanent or temporary
51
Q

What is the complications of pacemakers?

A
  • Infection
  • Bleeding or hematoma formation
  • Dislocation of the lead
  • Skeletal muscle or phrenic nerve stimulation
  • Cardiac tamponade
  • Pacemaker malfunction

Nursing Theory IV A- Cindy'S Class (17 decks)

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