Dysrhythmias Exam 2 Critical Care

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47 Terms

1
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What are the s/s of sinus Brady?

Syncope, dizziness, chest pain, pallor cool and clammy,

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What are causes of sinus Brady?

Electrolyte imbalance, hypoglycemia, hypothermia, hypothyroidism, toxins, meds like beta blockers, sleep

3
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What are treatments of sinus Brady?

Stable and symptomatic=atropine

Unstable and symptomatic= transcutaneous pacing (temporary pacemaker)

Stable and asymptomatic= monitor

4
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What constitutes unstable in sinus Brady?

Assess LOC, low BP, decreased urine out put, low map, diaphoretic

5
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What are risks associated with sinus Brady?

Low cardiac output

6
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Nursing interventions of sinus bradycardia?

give O2 if needed, assess VS

7
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What are causes of sinus tach?

Meds, stress/anxiety, electrolytes imbalances, hyperthermia, fever, stimulant drugs, htn, alc, caffeine, nicotine

8
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What are treatments of sinus tach?

Treat cause of it

9
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What are risks associated with sinus tach?

Reduced cardiac output put causing low O2, can lead to MI ischemia

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Nursing interventions for sinus tach?

Check VS, treat causes acetaminophen for fever, stop stimulants, desires

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What are causes of supraventricular tach?

Spontaneous usually, electrolyte imbalance, stimulants, medications,

STRESS, ATHEROSCLEROSIS

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What are s/s of supraventricular tach?

Syncope, dizziness, chest pain, bounding pulses,

TIGHTNESS IN THROAT, FATIGUE, STRESS

13
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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

14
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What are risks associated with supraventricular tachycardia?

Decreased perfusion causing MI

15
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Nursing interventions of supraventricular tach ?

Vagal maneuver, cardio version, adenosine

16
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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

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What are s/s of PVC?

ONLY NON LETHAL, dizziness, palpitations, weakness, and hypotension

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Treatments of PVC?

lidocaine/procainamide, treat the causes

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Types of PVCs

Bigeminy: every other beat

Trigeminy: every 3rd beat

Quadreminy: every 4th breath

Run: 3 or more

Couplet: 2 in a row

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24
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What are s/s of supraventricular tachycardia

Syncope, chest pain, dizziness, sob, bounding pulses

25
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Causes of supraventricular tachycardia?

Stimulants, hypoxia/hypokalemia, stress, atherosclerosis

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Treatments of svt?

Adenosine, vagal maneuvers, cardio version

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Risks associated with supraventricular tachycardia?

Low cardiac output and clots

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Nursing interventions

Check BP, HR, LOC,

29
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What are signs and sx of atrial flutter?

Syncope, anxiety, angina, sob, palpitations, weakness

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Causes of atrial flutter?

COPD/emphysema, bradycardia, heart valve abnormalities, ventricular hypertrophy, cardiomyopathies

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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

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Risk of developing what from a flutter?

Clots, and low cardiac output

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Nursing interventions for a flutter

Checking for stability: check HR, BP, O2, IV, prepare cardio version

34
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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

35
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What are s/s of a fib?

Syncope, sob, chest pain, irregular rhythm, fatigue, tightness in chest

36
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What are causes of a fib?

COPD or emphysema, problems w SA node, valve problems, rheumatic fever, pericarditis, htn hyperthyroidism, hypoglycemia, chef

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What are treatments of a fib?

Amiodarone helps regulate rhythm, digoxin is specifically for a fib, ccb, beta blockers, anticoagulants, cardio version

38
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What are you at risk of developing from a fib?

Clots CVA or PE, low cardiac output

39
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What does a first degree heart block look like and what are the treatments?

Prolonged PR interval (over 0.2)

No treatment, usually benign

40
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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!!

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What are treatment options for 2nd degree type I (wenckebach)?

If symptomatic and bradycardic, give atropine

Can give a pacemaker if severe

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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

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Treatment for 2nd degree type II mobitz?

If unstable, transcutaneous pacing and then pacemaker

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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

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Treatment for a 3rd degree heart block?

Transcutaneous pacing and then a permanent pace maker

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What is torsades?

A type of ventricular tachycardia

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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