dysrhythmias - atrial flutter, a-fib

• chronic lung disease

• cardiomyopathy

• hyperthyroidism

• HTN

these are all diseases associated with what heart dysrhythmia

atrial flutter

what dysrhythmia is this

atrial flutter

what two med classes may be prescribed for atrial flutter

beta blockers and ca channel blockers

what are two procedures that can be done for atrial flutter if the medications are not sufficient

electrical cardioversion and radiofrequency ablation

name the procedure: sync HR with defibrillator before shock

electrical cardioversion

name the procedure: burn/free tissues in the heart causing the dysrhythmia (done in the cath lab)

radiofrequency ablation

during atrial flutter the atria are still doing what

contracting

during a-fib the atria are

quivering

what dysrhythmia is this

a-fib

what is the first thing the nurse should do if a patient has a hx of a-fib and complains of chest pain

get EKG

what two drugs are most common in a-fib to slow the ventricular response by increasing the AV block

amiodarone and ibutilide

what two procedures can be done for a-fib

electrical cardioversion and radiofrequency ablation

what med class is important for patients to take if they have a dx of a-fib, list two examples

anticoagulants - enoxaparin, warfarin

premature ventricular contractions (PVCs) are when the

ventricles contract too early

PVCs are a problem once they become

consecutive

• stimulants

• electrolyte imbalances

• hypoxia

• heart disease

these are all associated with what dysrhythmia

PVCs

what is a key assessment finding that is associated with PVCs

apical-radial pulse deficit

to treat PVCs the health care team aims to

correct the cause

name the med class and an example for what is prescribed for someone with consecutive PVCs

anti-dysrhythmic; amidoarone

looking at the picture, what kind of dysrhythmia is the arrow pointing to

PVCs

torsades de pointes is a type of what dysrhythmia

v-tach

v-tach and torsades de pointes are both considered

lethal

in torsades de pointes it is considered a polymorphic v-tach and is associated with what

prolonged QT interval

what is occuring during v-tach

the ventricles are beating extremely fast

unsustained v-tach is when it is ___________ and _____-__________

spontaneous; self-resolves

sustained v-tach is ____________ and _________ _____ _________

consistent; doesn’t stop itself

with polymorphic v-tach the _____________ changes

QRS complex

v-tach can progress to what other dysrhythmia

v-fib

what is the first line of defense pharmologically for v-tach

beta blockers

• heart disease

• electrolyte imbalances

• drugs

• CNS disorder

these are all associated with what dysrhythmia

v-tach

v-tach can be stable/__________ or unstable/__________

has pulse; pulseless

if a patient has stable v-tach they will be treated with what med class and/or procedure

antidysrhythmics, cardioversion

if patient with unstable v-tach they will be treated with

CPR and rapid defibrillation

v-tach can progress to

v-fib

• MI

• ischemia

• disease states

• procedures

• unresponsive, pulseless, apneic

these are all associated with what dysrhythmia

v-fib

in v-fib the ventricles are

quivering

what is the immediate treatment for v-fib

CPR and ACLS

what is the #1 drug that is used during v-fib

epi

for v-tach and v-fib the treatment includes

CPR and ACLS

what other med can be used during v-fib besides epi

vasopressin

vasopressin makes veins _________ which makes BP __________

constrict;increase

if a patient has asystole and is not responsive what three things should the nurse start assessing/doing

VS, perfusion, CPR

MAP should be > ___

65

asystole is a shockable rhythym T or F

FALSE

• usually result of advanced cardiac disease

• severe conduction, disturbance

• end stage HF

these are all associated with what dysrhythmia

asystole

what are the immediate treatment plans for someone with asystole

CPR and epi

what two meds are associated with asystole

epi and vasopressin

when there is pulseless electrical activity (PEA) what does that mean

electrical activity but no contractions

• hypovolemia

• hypoxia

• acidosis

• hypogylcemia

• hypothermia

these are all causes of what

PEA

• toxins

• tamponade (cardiac)

• thrombosis (MI and pulmonary)

• tension pneumothorax

• trauma

these are all causes of what

PEA

PEA is treated with what three things

CPR, intubation, IV epi

this is what dysrhythmia

v-tach

what dysrhythmia is this

v-fib

what dysrhythmia is this

torsades de pointes

which dysrhythmia is this

PVCs

a 3rd degree AV heart block is what kind of block

complete

what will you notice on a strip that shows 3rd degree AV heart block

a lot more P waves then QRS complexes

what is occurring during a 3rd degree AV heart block

no relationship between p wave and qrs complex

• severe heart disease

• some systemic disease

• certain drugs

• can lead to syncope, HF, shock

these are all associated with what kind of dysrhythmia

3rd degree AV heart block

what two ways is a 3rd degree AV heart block treated

pacemaker and meds

with an NSTEMI we can see what two things on an EKG (sometimes)

ST depression, T wave inversion

a single chamber pacemaker controls either the _________ or _________

atria or ventricle

a dual chamber pacemaker controls

both the atrium and ventricle

if the pacer spike is before the P wave it is an

atrial pacemaker

if the pacer spike is before the QRS complex it is a

ventricle pacemaker