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What are the s/s of sinus Brady?
Syncope, dizziness, chest pain, pallor cool and clammy,
What are causes of sinus Brady?
Electrolyte imbalance, hypoglycemia, hypothermia, hypothyroidism, toxins, meds like beta blockers, sleep
What are treatments of sinus Brady?
Stable and symptomatic=atropine
Unstable and symptomatic= transcutaneous pacing (temporary pacemaker)
Stable and asymptomatic= monitor
What constitutes unstable in sinus Brady?
Assess LOC, low BP, decreased urine out put, low map, diaphoretic
What are risks associated with sinus Brady?
Low cardiac output
Nursing interventions of sinus bradycardia?
give O2 if needed, assess VS
What are causes of sinus tach?
Meds, stress/anxiety, electrolytes imbalances, hyperthermia, fever, stimulant drugs, htn, alc, caffeine, nicotine
What are treatments of sinus tach?
Treat cause of it
What are risks associated with sinus tach?
Reduced cardiac output put causing low O2, can lead to MI ischemia
Nursing interventions for sinus tach?
Check VS, treat causes acetaminophen for fever, stop stimulants, desires
What are causes of supraventricular tach?
Spontaneous usually, electrolyte imbalance, stimulants, medications,
STRESS, ATHEROSCLEROSIS
What are s/s of supraventricular tach?
Syncope, dizziness, chest pain, bounding pulses,
TIGHTNESS IN THROAT, FATIGUE, STRESS
What are treatments of supraventricular tachycardia?
Vagal maneuver, adenosine 2x, cardio version
If stable and symptomatic= vagal maneuver if it doesn’t work the adenosine x2 if it doesn’t work then cardiovert
If unstable and symptomatic= cardiovert immediately
What are risks associated with supraventricular tachycardia?
Decreased perfusion causing MI
Nursing interventions of supraventricular tach ?
Vagal maneuver, cardio version, adenosine
What is the difference between LBBB and RBBB? What does it looks like?
Right: caused by congenital heart defects, looks like an M
Left: caused by CAD, htn, aortic valve disease, cardiomyopathy, looks like a W
Bunny ears!! On qrs
What are s/s of PVC?
ONLY NON LETHAL, dizziness, palpitations, weakness, and hypotension
Treatments of PVC?
lidocaine/procainamide, treat the causes
Types of PVCs
Bigeminy: every other beat
Trigeminy: every 3rd beat
Quadreminy: every 4th breath
Run: 3 or more
Couplet: 2 in a row
What are s/s of supraventricular tachycardia
Syncope, chest pain, dizziness, sob, bounding pulses
Causes of supraventricular tachycardia?
Stimulants, hypoxia/hypokalemia, stress, atherosclerosis
Treatments of svt?
Adenosine, vagal maneuvers, cardio version
Risks associated with supraventricular tachycardia?
Low cardiac output and clots
Nursing interventions
Check BP, HR, LOC,
What are signs and sx of atrial flutter?
Syncope, anxiety, angina, sob, palpitations, weakness
Causes of atrial flutter?
COPD/emphysema, bradycardia, heart valve abnormalities, ventricular hypertrophy, cardiomyopathies
Treatments of atrial flutter?
Amiodarone which helps regulate contraction, beta blockers and CCB to help lower HR, anticoagulants to prevent clots, cardio version if unstable
Risk of developing what from a flutter?
Clots, and low cardiac output
Nursing interventions for a flutter
Checking for stability: check HR, BP, O2, IV, prepare cardio version
How is a fib read on an ekg?
No distinction of p wave and is a little crazy before QRS complex, irregular rhythm, tightness in chest
What are s/s of a fib?
Syncope, sob, chest pain, irregular rhythm, fatigue, tightness in chest
What are causes of a fib?
COPD or emphysema, problems w SA node, valve problems, rheumatic fever, pericarditis, htn hyperthyroidism, hypoglycemia, chef
What are treatments of a fib?
Amiodarone helps regulate rhythm, digoxin is specifically for a fib, ccb, beta blockers, anticoagulants, cardio version
What are you at risk of developing from a fib?
Clots CVA or PE, low cardiac output
What does a first degree heart block look like and what are the treatments?
Prolonged PR interval (over 0.2)
No treatment, usually benign
What is a 2nd degree type I heart block and what does it look like?
Electrical signals from the atria to ventricles are increasingly delayed until it is blocked
LOOKS LIKE: longer, longer, longer, DROP it’s a wenckebach!!
What are treatment options for 2nd degree type I (wenckebach)?
If symptomatic and bradycardic, give atropine
Can give a pacemaker if severe
What is a 2nd degree type II heart block and what does it look like?
Some electrical signals from atria to ventricles are blocked
PR is prolonged and there are intermittent dropped beats
Treatment for 2nd degree type II mobitz?
If unstable, transcutaneous pacing and then pacemaker
What is a 3rd degree heart block and what does it look like?
Complete disruption of signals from atria and ventricles causing no communication between P and QRS waves
Ps and QRSs are all over the place
Treatment for a 3rd degree heart block?
Transcutaneous pacing and then a permanent pace maker
What is torsades?
A type of ventricular tachycardia
Treatment of torsades?
Magnesium sulfate to correct arrhythmia
WITH PULSE: Cardiovert
NO PULSE: CPR and epi
Treat the cause such as electrolyte imbalances, DC QT prolongation rx