Week 3

Question 1

Atrial fibrillation

Answer 1

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

Question 2

Signs and symptoms of A-Fib

Answer 2

Chest pain
Oxygen lower
Low BP
Lethargy
Anxiety
Palpitations
Shortness of breath
Elevated ventricle rate or heart rate
Dizziness or syncope (fainting)

Question 3

A-Fib nursing interventions

Answer 3

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)

Question 4

Cardioversion

Question 5

Atrial flutter

Answer 5

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

Question 6

Signs and symptoms of Atrial flutter

Answer 6

COLLAPSED
E however means “Even heart rate and rhythm”

Question 7

A- flutter interventions

Answer 7

A B C D E
Anticoagulants
Beta blockers
Cardiac ablation
Digoxin
Electrocardioversion: given to reset SA node which is a “baby shock”

Question 8

Ventricular tachycardia

Answer 8

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

Question 9

Signs and symptoms of V-tach

Answer 9

COLAPSED

Question 10

V-tach interventions (with a pulse)

Answer 10

Assess the patient
Give the patient amiodarone to stabilize rhythm
Give a baby shock called cardioversion (reset SA node)

Question 11

V-tach interventions (without a pulse)

Answer 11

Call a code
Start compressions
defib -> epi (1mg)
Lidocaine: relax ventricles
Amiodarone: stabilize rhythm
Normal cardiac arrest procedures

Question 12

Ventricular fibrillation

Answer 12

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

Question 13

Signs and symptoms of V-Fib

Answer 13

COLLAPSED

Question 14

V-Fib nursing interventions

Answer 14

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

Question 15

Supraventricular tachycardia

Answer 15

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

Question 16

Supraventricular tachycardia interventions

Answer 16

Valsalva manuevar: bear down to lower hr
Adenosine : lower hr immediately!
Cardiac ablation
Electrocardioversion

Question 17

Torsades de pointes

Answer 17

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

Question 18

Torsades de pointes interventions

Answer 18

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

Question 19

Bradycardia treatment if client is symptomatic

Answer 19

Atropine
Dopamine or epi

Nonpharm: pacemaker

Question 20

Atrial fib, SVT, Vtach with pulse

Answer 20

Amiodarone
Adenosine
Verapamil

Non pharm: cardioversion

Question 21

V tach without a pulse or v fib

Answer 21

Lidocaine
Amiodarone
Epi

Nonpharm: defibrillation

Question 22

Electrolyte imbalance for V tach

Answer 22

Hypokakemia