Ventricular Dysrhythmias

Question 1

Name three Ventricular Dysrhythmias.

Answer 1

Premature Ventricular Contraction (PVC)
Ventricular tachycardia
Ventricular fibrillation

Question 2

Where do Premature Ventricular Contractions come from?

Answer 2

Derived from an ectopic focus in the VENTRICLES.

Question 3

Does PVC come Earlier than the QRS should?

Answer 3

Yes

Question 4

What are the characteristics of QRS during a Premature Ventricular Contraction?

Answer 4

QRS is WIDE AND DISTORTED in shape (wide,ugly beat). Typically does not perfuse.

Question 5

Premature Ventricular Contractions follow a normal rhythm or p-wave (True/False)?

Answer 5

False

Question 6

What causes Premature Ventricular Contractions?

Answer 6

Stimulants 
ELECTROLYTES
hypoxia
fever
Exercise
Emotional stress 
Cardiovascular Disease (CVD)

Question 7

What drugs to use if patient has a tendency towards Premature Ventricular Contractions?

Answer 7

Beta-Blockers, lidocaine and amiodarone.

Question 8

How do we decrease the likelihood of Premature Ventricular Contractions?

Answer 8

Treat the cause.

Question 9

What are the Premature Ventricular Contraction (PVC) Subtypes?

Answer 9

Bigeminy- (every other beat). Every other beat is concerning because patient converting to Ventricular tachycardia. This is a CRISIS SITUATION!

Trigeminy- (every 3rd beat)

Quadrigeminy-(every 4th beat)

Question 10

When should we notify Healthcare provider (HCP) concerning PVC’s?

Answer 10

New in Onset and INCREASE in FREQUENCY.

Question 11

What is Ventricular Tachycardia?

Answer 11

Consists of 3 or more PVC’s together. Ectopic focus within the ventricles takes control and fires repeatedly. No ATRIAL contractions occurring.

Question 12

Why is Ventricular tachycardia SERIOUS?

Answer 12

Decreases cardiac output/Lack of perfusion. This can be DEADLY!

Question 13

What Ventricular tachycardia associated with?

Answer 13

MI (Myocardial Infarction)
CAD (Coronary Artery Disease)
Significant electrolyte abnormalities
Heart failure 
Drug toxicity & Other Bad Things!

Question 14

Ventricular tachycardia rate and rhythm?

Answer 14

150-200bpm, usually regular

Question 15

When a patient is in V-tach the P-wave is evident and PR is measurable (True/False)

Answer 15

False

Question 16

How do we treat Ventricular tachycardia?

Answer 16

ACLS Advance Cardiac Life Support (this is a course)➡️ depends on pulse, patient will be symptomatic very quickly unless converts back to baseline rhythm.

Question 17

What pharmalogy treatments are used for Ventricular tachycardia?

Answer 17

May need an anti-dysrhythmic medication (Beta-blocker, Calcium Channel Blockers or amiodarone), Electrolyte replacement (Check & replace)

Question 18

What is the First question to ask before treating Ventricular tachycardia?

Answer 18

Does patient have a pulse (implies perfusion)?

Is patient pulseless (implies no perfusion)?

Question 19

What occurs if we do not treat Ventricular tachycardia?

Answer 19

Patient can convert into Ventricular Fibrillation.

Note: The further they slip into Ventricular dysrhythmias, more intractable the treatment (tx doesn’t work well)

Question 20

Define Ventricular Fibrillation

Answer 20

Irregular waveforms of varying shapes and sizes (NO QRS).

The ventricles are just “quivering”. .

No effective Contractions=NO CARDIAC OUTPUT Life-threatening

Question 21

How do we treat Ventricular Fibrillation?

Answer 21

CPR & ACLS/defibrillation

Question 22

What is the difference between cardioverting and defibrillating at patient?

Answer 22

Cardioversion: Elective procedure, Client awake & Frequently sedated, Synchronized with “QRS” (SYNCH ON), 50-200 Joules, consent form & EKG monitor

Defibrillation: Emergency, V-fib/V-tach, No cardiac output, begin with 200 Joules UP TO 360, Client Unconscious, EKG monitor