Week 6 Flashcards
What is an ECG?
Electrocardiograph
- it is the electrical conduction of the heart.
What is the P wave?
The P wave is the SA node firing and atrial depolarisation.
Contraction=atrial systole
What is the PR interval?
PR interval is the impulse travel time
What is the QRS complex?
This is the depolarisation from the AV node through the ventricles.
(Contraction=ventricular systole)
What is the ST segment?
This is the start of repolarisation.
What does the T wave represent?
The T wave represents ventricular repolarisation.
(Refill=ventricular diastole)
Resting
What does the QT interval represent?
This is the total time for ventricular depolarisation & repolarisation.
If present what does the U wave represent?
Part of the latter phase of ventricular repolarisation.
What is the management of arrhythmias?
- treat the cause
- medication
- defibrillation/cardio version
- pacemaker
- cardio conduction surgery
What are some of the complications that can arise with arrhythmias?
-weakness/fatigue
-heart failure
-Thrombo-embolic event
-cardiac arrest
-death
This is all dependant on the rhythm.
What is a Myocardial Infarction (MI)?
A myocardial infarction arises when a region of the myocardium becomes irreversibly necrosed.
It is due to thromboembolic occlusion of the coronary artery supplying that area of the heart muscle.
When assessing chest pain what is the PQRST evaluation?
P-precipitating factors Q-quality R-radiation S-severity T-time of onset
How are we diagnosing a pt with chest pain?
- pt Hx
- symptoms
- ECG
- bloods= (ensuring they aren’t aenemic) looking at their Troponin levels and cardiac enzymes
What nursing observations/monitoring would you be conducting?
- reassuring the pt
- baseline obs
- is there a need for cardiac monitoring
- 12 lead ECG
- IV access
- Troponin levels and cardiac enzymes screening
- Contacting the Dr.
What does ABCD for initial care stand for?
A-airway
B-breathing
C-circulation
D-disability
List the 3 main thrombolytic agents that are used.
- streptokinase = widely used and the cheapest. can only be given 1 time as pt’s develop antibodies. It is a bacterial protein.
- Recombinant tissue-type plasminogen activator (tPA = a naturally occurring human protease that is fibrin specific. Works prodominantly on the clot, with less systemic bleeding. Is a more specific medication
- Retaplase = a new generation drug, that is as effective as streptokinase. Can be given as a bolus and non-antigenic.
Mr Jones, a 54 year old man lives with his wife and 17 year old son. He was diagnoses with angina 12 months ago and has been prescribed GTN spray for symptom control. He smokes 20 cigarettes per day and drinks approx 20 units of alcohol per week. he works as a bank manager and is over wieght. He has been trying to lose weight over the past 2 months without success and is refusing to discuss this with his GP.
Whilst driving to work this morning Mr Jones developed central crushing chest pain radiating to his L arm and jaw. He pulled his car over and took his GTN spray which gave no relief.
A passer by saw that he looked pale, sweaty and was SOB and called an ambulance.
List initial care you would give .
- ABCD assessment
- need to assess so we can prioritise care
- address by what will kill you first
- reassurance for pt = scared they are going to die
- rule out anything life threatening
- Full set of obs including top to toe assessment
- ECG
- IV
- blood work
List 2 reasons why a pt may have sinus bradycardia?
- they are using beta blocker drugs
- very fit= athletes
What is the immediate treatment for Ventricular Fibrillation?
This looks like saw teeth on an ECG.
-defib = this type usually can be given a shockable current
Apart from ventricular fibrillation what other ventricular type is shockable?
Ventricular Tachycardia
What is the two fold immediate treatment for asystole?
- Can be given drugs such as adrenaline to get an electrical current.
- Shock them = defib
What is M.O.N.A?
M- morphine = 300mg stat
O- oxygen = if below 94%
N- nitrates
A- apsrin
