Dysrhythmias (Junctional and HB) + Equipment to monitor hemodynamic stability

Junctional Escape

40-60 bpm

Accelerated junctional

60-100 bpm

Junctional Tachycardia

>100 bpm

Paroxsymal SVT (supraventricular tachycardia)

150-200 bpm

Junctional rhythms typically have what type of regularity?

Regular Regularity (equal R-R interval)

Junctional Rhythms affect what wave? What are their characteristics?

P-wave

Inverted P-wave
Buried P-wave
Absent P-wave

1st Degree HB

long PR interval (greater than 0.20)

2nd Degree Type I (Wenckebach or Mobitz 1)

PR interval increases in length until QRS complex is missing (repeated pattern)

2nd Degree Type II (Mobitz II)

PR interval remains long and a QRS complex will be missing often (could be every other cycle)

3rd Degree HB (AV dissociation)

Atria and ventricles are beating separately from each other

Hemodynamic monitoring variables (4)

Heart Rate
Blood Flow
O2 delivery
Tissue perfusion

What determines the heart’s blood flow? (5)

heart rate
strength of contraction
blood vessels
degree of turbulence
pressure

Normal Cardiac Output

4 - 8L/min

Normal Ejection Fraction

60-70%

Preload

how much blood fills the ventricles before systole
LVEDV

Components of Stroke Volume

Preload
Afterload
Contractibility

Frank-Starling law

Increased stretch = increased volume = greater contraction = greater amount of blood ejected from the heart to the body

Afterload

pressure or resistance against the flow of blood to go out of the heart

Contractibility

force of contraction
“how well is the heart pumping?”

Arterial Line main function

monitoring a hemodynamically unstable pt.
assess the efficacy of medication

Central venous catheter main function

measure right heart filling process
estimate fluid status
administer large-volume fluids or medications

Pulmonary Artery Catheter function

Assess the left heart function
Directly measures Cardiac Output

Name two other pressure monitors

Right atrial pressure (RAP) monitor

Central venus pressure (CVP) monitor