Class+12+Cardiac+Notes+Fall+2025

Learning Outcomes

  • Identify premature ventricular contractions (PVCs) and prioritize best-practice treatments.
  • Recognize patterns of PVCs on ECG.
  • Identify ventricular tachycardia (V-Tach) and apply current guidelines for care.
  • Understand the nursing process for cardioversion.
  • Educate patients on the difference between cardioversion and defibrillation.
  • Identify Torsade’s de pointes and apply ACLS treatments.
  • Provide evidence-based practice (EBP) care for cardiac arrest rhythms and emergencies.

Premature Ventricular Contractions (PVCs)

  • Characteristics:
    • Wide QRS intervals ( >0.12 sec)
    • Atrial rhythm may be regular; PVCs disrupt R-R interval.
  • Causes include hypokalemia, hypoxia, acidosis, and stress.

Types of PVCs

  • Unifocal: Same shape and size.
  • Multifocal: Different shapes and sizes.
  • Other patterns: Bigeminy, trigeminy, quadrigeminy, couplets,
    • Non-sustained V-Tach classified as NSVT if <15 seconds.

Ventricular Tachycardia (V-Tach)

  • Rate: 150-250 bpm, wide QRS, no P waves.
  • Emergency assessment and intervention needed.
  • Treatment options: Anti-dysrhythmic medications or electrical cardioversion if unstable.

Torsade’s de Pointes

  • Rate: 150-300 bpm, polymorphic.
  • Cause: Medications that prolong QT interval, electrolyte imbalances.
  • Treatment: CPR, defibrillation, magnesium.

Cardiac Arrest Rhythms

  1. Pulseless V-Tach
  2. Ventricular Fibrillation (V-Fib)
  3. Pulseless Electrical Activity (PEA)
  4. Asystole
  • Immediate CPR and defibrillation required for V-Fib and pulseless V-Tach.

Emergency Treatments

  • Epinephrine for PEA/asystole