Week 3 Flashcards
Atrial fibrillation
SA node not functioning properly causing unorganized beats in the atria
Rate: usually over 100 bpm
Rhythm: regular
P wave: NONE
PR interval: NONE
QRS: normal
Signs and symptoms of A-Fib
Chest pain
Oxygen lower
Low BP
Lethargy
Anxiety
Palpitations
Shortness of breath
Elevated ventricle rate or heart rate
Dizziness or syncope (fainting)
A-Fib nursing interventions
Anticoagulants: such as warfarin because clots are a big risk (watch INR values)
Beta blockers: slow heart rate
Cardiac ablation: burn erratic cells
Digoxin: increase contractility of heart (hold if HR less than 60)
Cardioversion
Atrial flutter
Electrical signals spread through the atria in a fast but regular rhythm
Look like a flock of birds on the EKG
Rate: 75- 150
Rhythm: regular
P wave: none
PR interval: none
QRS: normal
Signs and symptoms of Atrial flutter
COLLAPSED
E however means “Even heart rate and rhythm”
A- flutter interventions
A B C D E
Anticoagulants
Beta blockers
Cardiac ablation
Digoxin
Electrocardioversion: given to reset SA node which is a “baby shock”
Ventricular tachycardia
A very fast heart rhythm that begins in the ventricles when the SA node and AV node fail to generate an impulse
V Tach is more controlled than the fib
Rate: 100-250 BPM
Rhythm: regularly spaced like tombstones
P wave : none
PR interval: none
QRS: wide and even
Signs and symptoms of V-tach
COLAPSED
V-tach interventions (with a pulse)
Assess the patient
Give the patient amiodarone to stabilize rhythm
Give a baby shock called cardioversion (reset SA node)
V-tach interventions (without a pulse)
Call a code
Start compressions
defib -> epi (1mg)
Lidocaine: relax ventricles
Amiodarone: stabilize rhythm
Normal cardiac arrest procedures
Ventricular fibrillation
Firework show in ventricles of the heart
MOST DEADLIEST RHYTHM
Rate: unknown
Rhythm: chaotic waveform
P wave: none
PR interval: none
QRS: none
EKG looks like a squiggly line all throughout
Signs and symptoms of V-Fib
COLLAPSED
V-Fib nursing interventions
Defibrillation
Epinephrine : increases the heart rate increases blood pressure and increases oxygen to the body
if these interventions don’t work after 3rd shock we will give LAM drugs
Lidocaine : relax ventricles
Amiodarone : stabilize rhythm
Magnesium sulfate : calm down the ventricles
Supraventricular tachycardia
Episodes of rapid heart rate that start in the part of the heart above the ventricles
Rate: 150 to 250 bpm
Rhythm: regular
P wave: buried in proceeding T wave
PR interval: usually not measurable
QRS: normal and narrow
Supraventricular tachycardia interventions
Valsalva manuevar: bear down to lower hr
Adenosine : lower hr immediately!
Cardiac ablation
Electrocardioversion
Torsades de pointes
Repeating upward and downwards of ventricular complexes
Rate: 200-250 BPM
Rhythm: irregular
P wave: none
PR interval: none
QRS: wide
Main cause is low magnesium
Torsades de pointes interventions
Magnesium sulfate
Isoproterenol infusion
Electrocardio version
Defibrillation only if they go into V tach or V fib
Pacemaker to help control rhythm in the future
Bradycardia treatment if client is symptomatic
Atropine
Dopamine or epi
Nonpharm: pacemaker
Atrial fib, SVT, Vtach with pulse
Amiodarone
Adenosine
Verapamil
Non pharm: cardioversion
V tach without a pulse or v fib
Lidocaine
Amiodarone
Epi
Nonpharm: defibrillation
Electrolyte imbalance for V tach
Hypokakemia
