week 3 - EKG & heart stuff Flashcards
First degree heart block
if R is far from P then you have a first degree
*longer than 0.2
Wenecke Block
*second degree type 1
distance between PR gets LONGER, LONGER, LONGER DROP then you have a wenecke block
*longer than 0.2
Mobitz 2
Second degree type 2
If some P’s don’t get through then you have a Mobitz 2
Third Degree heart block
if P’s and Q’s don’t agree then you have a third degree
Beta Blockers and Calcium Channel Blockers work to
slow the HR and drop BP
normal PR interval time
0.12 to 0.20
QRS complex time
0.10 or less
QT interval time
less than 0.44
in a scheduled cardioversion client must
be on anti-coags 4 to 6 wks prior
meds used for bradycardia
atropine
dopamine
& epi if atropine doesnt work
med for SVT
adenosine
meds for afib, vtach w pulse, and svt
amiodarone
verapamil
adenosine
v-fib and vtach no pulse meds
amiodarone
lidocaine
epi
7 steps to ECG
- rate - How man R’s?
- rhythm- distance between R’s the same?
- P- wave present? (atria contracting)
- space from P-R same? & within 0.12 to 0.20
- QRS less than 0.10 & same for all?
- T-wave present? upright?
- QT less than 0.44 for all?
bradycardia is treated w
pacemaker
atropine
dopamine
V-fib treated w
de-fib
v-tach w pulse
vs
vtach no pulse
WITH: meds (amiodarone, BB, & CCB), synchronized cardioversion
NO PULSE = d-fib
a nurse is admitting a client who has complete heart block as demonstrated by an ECG. the client’s heart rate is 34/min and blood pressure is 83/48. the client is lethargic and unable to complete sentences. which of the following actions should the nurse perform first?
- transport the client to the cardiovascular laboratory
- Prepare the client for insertion of a permanent pacemaker
- obtain a signed informed consent form for a pacemaker
- apply transcutaneous pacemaker pads
- apply transcutaneous pacemaker pads
symptoms to report w an ICD
HICCUPS
sob
chest pain
weight gain
dizziness
fatigue
teachings for ICD
take pulse for 1 min every morning
no arm movement 1-2 wks = sling
ID card at all times
no magnets – TSA & dentist
ID card at all times
anti - dysrhythmics
- Lidocaine
- Beta - Blockers
- Amiodarone
- calcium channel blockers
meds that slow heart rate are contraindicated in
pt w heart blocks
adv effects and considerations for lidocaine
short-term use no more than 24 hrs
altered LOC, parathesia, & seizures
beta-blockers are contraindicated in
asthma
heart blocks
DM
thyroid & liver
MASKS HYPOGLYCEMIA
adv effects of amiodarone
COUGH
dyspnea
crackles
neck vein distention
visual disturbances
meds to avoid w amiodarone
antibiotics
digoxin
grapefruit juice
antidote for calcium channel blockers
calcium gluconate
adverse effects of CCB
constipation
peripheral edema
a nurse is preparing to administer propanolol to a client who has a dysrhythmia. which of the following actions should the nurse plan to take?
- hold propanolol for an apical pulse greater than 100/min
- administer propanolol to increase the client’s blood pressure
- assist the client w sitting or standing up when taking this medication
- check for hypokalemia frequently due to the risk of propanolol toxicity
- assist the client w sitting or standing up when taking this medication
discharge teaching to a client w afib
avoid taking OTC decongestants
a nurse is providing discahrge teaching to SVT pt. what should be included?
- decrease oral fluids to 2L daily
- increase fiber intake to prevent constipation
- notify HCP if hiccups develop
- evaluate potential fall risks in the home
- evaluate potential fall risks in the home
SVT on EKG will show as
*indiscernible p-wave
NARROW qrs compplex <0.10
what to do for slow heart rates (brady’s)
- Atropine
- trancutaneous pacing
adenosine function
slows rate control
6 mg first then 12
rapid flush
treatment for torsades
magnesium sulfate
