cardio 9

Practice flashcards covering cardiac rhythms (VT, SVT, VF), medication protocols (Adenosine, Digoxin, ACE Inhibitors), and safety in pregnancy.

How can a clinician differentiate between Ventricular Tachycardia (VT) and Supraventricular Tachycardia (SVT) using the QRS complex?

By counting the little boxes between the Q and the S; VT has a wide QRS complex, while SVT has a narrow QRS complex.

What characterizes the QRS complex in Supraventricular Tachycardia (SVT)?

A narrow QRS complex which is less than $3$ boxes, measuring $< 0.12\,s$; it is described as "Skinny."

What characterizes the QRS complex in Ventricular Tachycardia (VT)?

A wide QRS complex which is greater than $3$ little boxes, measuring $> 0.12\,s$.

What is the first-line treatment for both VT and SVT if the patient is hemodynamically unstable (e.g., hypotensive, AMS, SOB)?

Synchronized cardioversion.

What medication is indicated for a patient in stable Ventricular Tachycardia?

Amiodarone.

What are the least invasive interventions for stable Supraventricular Tachycardia?

Carotid massage, Valsalva maneuver, and ice water immersion.

What is the drug treatment protocol for stable SVT when the least invasive methods fail?

Administer Adenosine as a $6\,mg$ bolus over $1$ to $2$ seconds via IV push closest to the heart, followed by a $20\,ml$ NS flush. This can be followed by two repeat $12\,mg$ boluses.

What is the expected transient rhythm and half-life associated with Adenosine administration?

Asystole is expected, as the drug has a very short half-life of $\sim 7\text{--}15\,s$.

What is the recommended treatment for the chaotic and impossible to synchronize rhythm known as Ventricular Fibrillation (VF)?

Unsynchronized Cardioversion.

Which arrhythmia is characterized by "M\u0027s and W\u0027s" in the strip, and what is its specific treatment?

Torsades de Pointe; the treatment is Magnesium.

What suffix is associated with ACE Inhibitors, and what are their three primary side effects?

They end in "-pril"; side effects include Angioedema, Cough, and Excess Potassium ($K+$).

What suffix is associated with ARBs, and how do they compare to ACE Inhibitors?

They end in "-sartans"; like ACE-I, they cause Excess Potassium and are teratogens, but they do not typically cause a cough.

What should a nurse do before administering Digoxin?

Check the heart rate and hold the dose if the heart rate is $< 60/\min$ in adults, $< 70/\min$ in pediatrics, or $< 90/\min$ in infants.

What is the narrow therapeutic index for Digoxin?

$0.5\text{--}2.0\,ng/mL$.

What clinical findings suggest Digoxin toxicity?

GI issues (N/V/D), visual disturbances (halo or yellow vision), and Neuro/Cardio Toxicity.

Which two conditions significantly increase the risk of Digoxin toxicity?

Hypokalemia (low levels of $K+$) and Renal Disease (decreased ability to excrete the drug).

According to the mnemonic "Hypertensive Mothers Love Nifedipine," which drugs are safe to use during pregnancy?

Hydralazine (H), Methyldopa (M), Labetalol (L), and Nifedipine (N).

What is the therapeutic range for Theophylline and Phenytoin?

$10\text{--}20\,mcg/mL$.

What is the therapeutic range for Lithium?

$0.6\text{--}1.2\,mEq/L$.

What is the therapeutic INR range for a patient on Warfarin?

$2\text{--}3$.