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NUR 213 > UNIT 2 Care of Patients with Dysrhythmias > Flashcards

UNIT 2 Care of Patients with Dysrhythmias Flashcards

1
Q

generate electrical impulse.

A

automaticity

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2
Q

respond to electrical impulse.

A

excitability

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3
Q

transmit electrical impulse

A

conductivity

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4
Q

shorten fiber length in response to electrical impulse

A

contractility

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5
Q

the pacemaker of the heart with an average rate of 60-100 bpm.

A

SA node

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6
Q

gatekeeper of the heart

A

av node

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7
Q

atrial depolarization

A

P Wave

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8
Q

ventricular depolarization

A

QRS complex

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9
Q

ventricular repolarization

A

T wave

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10
Q

how many seconds is a big block?

A

0.20 sec

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11
Q

how many seconds is in a small block?

A

0.04 sec

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12
Q

how many big blocks are in a 6 second interval ?

A

30 big blocks

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13
Q

what is the most reliable way to measure the HR?

A

apical pulse

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14
Q

the initial positive deflection

A

R wave

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15
Q

the negative deflection following the R wave

A

S wave

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16
Q

the first downward wave of the QRS complex. (often absent)

A

Q wave

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17
Q
  • determine the heart rate
  • determine the heart rhythm (regular or irregular)
  • analyze the P waves
  • measure the PR interval
  • measure the QRS complex
  • interpret the rhythm
A

rhythm analysis

18
Q

______ rhythm impulse originated in the SA node

A

sinus

19
Q
  • Heart rate 60 to 100 bpm
  • atrial and ventricular rhythm is regular
  • P waves present with each QRS complex
  • PR interval is 0.12 to 0.20 (3 - 5 small blocks)
  • QRS is 0.04 to 0.10 (1 - 2.5 small blocks)
A

criteria of a normal sinus rhythm

20
Q

_______ are caused by disturbances…

  • electrical conductivity and mechanical response
  • impulse formation
  • impulse conduction
  • combination of several factors
A

dysrhythmias (abnormal rhythms)

21
Q

bpm greater than 100

A

tachycardic dysrhythmias

22
Q

bpm less than 60

A

bradycardic dysrhythmias

23
Q
  • P wave present
  • bpm greater than 100
  • caused by fever, dehydration, stress and drugs
  • symptoms (if any): decreases CO, consider workload on heart
  • nursing intervention: oxygen, identify the cause*
A

sinus tachycardia

24
Q

assess patients with dysrhythmias for decreased ___ ____ _________. you have to assess cap refill, pulse strength, skin, intake and output, change in mental status and BP.

A

cardiac output

25
Q
  • P wave present
  • bpm less than 100
  • excess vagal stimulation
  • decreased speed of conduction
  • may decreased BP ( esp in coronary arteries) decreased CO could also mean ischemia so give O2.
  • assessment: signs of poor perfusion, and CO
  • nursing interventions: identify possible cause, treat cause, apply O2, atropine 0.5 to 1 mg, and pacemaker
A

sinus bradycardia

26
Q

how do you tell if atropine 0.5 to 1 mg is working to treat sinus bradycardia?

A

increased cardiac output

27
Q

sympathetic _____ up HR and heart contractility

A

speeds up

28
Q

parasympathetic _______ down HR and heart contractility.

A

slows down

29
Q
  • indistinguishable P wave
  • recognized by the rate. above 140 bpm
  • causes excessive stimulation from drugs, stress, dehydration, heart failure, thyroid disease, COPD.
  • symptoms: usually occur dependent on rate but there are signs of poor perfusion, decreased cardiac output, and chest pain.
  • treatment: oxygen administration and adenonsine
  • adenonsine : must be on the monitor, given rapidly, physician must be present. Stops the heart for 10-30 seconds and then restarts at a more tolerable pace.
  • educate patient on the procedure of giving adenonsine and then attempt to provide SUPPORT person. Educate in great detail. won’t lose consciousness, but the experience is terrifying for them.
A

supraventricular tachycardia or atrial tachycardia

30
Q
  • aging, obesity, COPD, and cardiovascular are the more prominent contributing factors to this.
  • rapid atrial depolarization at a rate of 300 - 600 times per minute.
  • rhythm is irregularly, regular. no pattern
  • no distinguishable P wave
  • symptoms Shob, flustering, light headed, fatigue**
  • fibrillation means not contracting or quivering
  • cardiac output can decrease by as much as 20 to 30%. the preload is decreased.
A

atrial fibrillation

31
Q
  • assess for signs of poor perfusion
  • assess for anxiety
  • assess for clot formation (right side lung, left side brain) and potential for heart failure
  • 12 lead ECG
  • prevent embolus formation
  • plan for prevention of heart failure
A

nursing process in regards to atrial fibrillation

32
Q

consistent atrial fibrillation is treated by controlling the heart rate with administration of _____-______ and ____ ______ ______

A

beta-blockers, and calcium channel blockers.

- anticoagulants only if medications are unable to get patient out of afib.

33
Q

people with afib are nearly ___x more likely to suffer a stroke. Stroke is the most serious complication of afib. Afib related strokes are nearly twice as fatal and twice as disabling as non-afib related strokes

A

5x

34
Q

____ _____ is a major problem for those with a ventricular rate of 150 bpm or greater.

A

heart failure

35
Q

A result of increased irritability of ventricular cells. early ventricular complexes followed by a pause.

  • there will be signs of poor perfusion
  • look for factors that contribute to the development of PVC’s such as electrolytes, oxygenation, caffeine, and stress.
A

premature ventricular complexes

36
Q

when cardiac dysrhythmias are present what are the two electrolytes that you should monitor and asess?

A

magnesium and potassium

37
Q
  • eliminate or treat the cause
  • antidysrhythmias
  • consider oxygen administration
A

treatment of PVC

38
Q

ventricular tachycardia is _____

A

lethal

39
Q

repetitive firing of an irritable ventricular ectopic focus, usually at a rate of 140 to 180 bpm. if present with no pulse must treat with defibrillation and CPR.

  • caused by extreme electrolyte imbalances and myocardial infarction.
  • assess ABC, LOC, alterations in O2 and CO/perfusion
A

ventricular tachycardia

40
Q

ventricular tachycardia is _____ with:

  • oxygen
  • antidysrhythmics
  • cardioversion of stable
  • if unstable/no pulse treat as vfib

priority treatment depends on if it is readily available (defibrillation).

A

treated

41
Q

a result of electrical chaos in the ventricles.

A

Ventricular fibrillation

- fatal in 3 to 5 minutes

42
Q

how do you treat ventricular fibrillation ?

A

defibrillation and CPR

NUR 213 (20 decks)

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