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Arrhythmia Theory
Dysrhythmias
Question | Answer |
---|---|
What are the two major ions that are responsible for depolarization in the cardiac conduction system? | sodium and potassium |
What part of the heart is innervated by the Purkinje system? | ventricles |
What does the P wave represent? | atrial depolarization |
What is the major systemic problem for a patient with sinus tachycardia? | increases cardiac workload |
Name three causes of sinus tachycardia. | anxiety, exercise, uncompensated heart failure, fever, thyrotxicosis, dehydration, hypovolemia, smoking. |
Name two conduction slowing drugs which could cause sinus bradycardia. | calcium channel blockers, beta blocker, Digoxin (lanoxin) |
When should the patient with sinus bradycardia be treated? | signs/symptoms of decreased CO, PVCs or rate < 50 bpm |
Atropine should not be administered to patients who have either of which two problems? | urinary retention or glaucoma |
Name three potential causes of atrial arrhythmias. | ETOH, anxiety, stress, electrolyte imbalance, COPD, hyperthyroidism, caffeine, nicotine, stimulants (meds. |
What part of the nervous system is stimulated with vagal stimulation? | parasympathetic |
What is the purpose of Adenosine (Adenocard)? | return to NSR |
Synchronized cardioversion is used when the patient is _________. | unstable - without pulses |
what is the location of the paddles in cardioversion and defibrillation? | apex and sternum or apex and posterior left chest |
What is the purpose of the synchronizer? | avoid the refractory period |
A patietn with what arrhythmia whill have a pulse deficit? | atrial fibrillation |
What is the magic number in the treatment of atrial fibrillation? | 48 |
What are the two options in the treatment of atrial fibrillation? | rate control or conversion to NSR |
Name two side effects of Amiodarone (Cordarone). | bradycardia, hypotension |
What is the purpose of a TEE prior to cardioversion? | rule out atrial clots |
What is the treatment where short bursts of energy interrupt atrial pathways or destroy tissue that causes abnormal electrical signals? | radiofrequency catheter ablation |
Name three negative aspects to the administration of Dabigatran (Pradaxa)? | GI side effects, no antidote, high cost |
What is the major treatment for Mobitz I (Wenkebach)? | pacing |
Name two symptoms of third degree heart block. | dizziness, confusion, syncope |
What drug can increase the heart rate of a person in complete heart block? | Dopamine |
When are epicardial pacemeakers used most frequently? | cardiac surgery |
What symptoms would the patient exhibit with los of capture from his pacemaker? | dizziness, confusion, bradycardia, snycope |
When does a synchronous pacemaker fire? | when needed! |
Name three causes of PVCs. | hypokalemia, hypoxia, low magnesium, anesthesia, acid base imbalance, ischemia, digoxin toxicity |
What is the maximum number of mEqs that cansafely be administered per hour? | 10 |
What is the initial drug of choice for the treatment of PVCs? | Amiodarone (Cordarone) |
What is the treatment for the unstable (pulseless) patient in VT? | defibrillation |
What is the initial treatment for VF after identification of the rhythm and unresponsiveness and sending for help? | CPR |
What happens to brain cells when, in cardiac arrest, they are jolted by electricity and flooded with oxygen? | the body kills them |
What is the hallmark of PEA? | rhythm without pulses |
name three causes of PEA. | hypovolemia, hypoxia, acidosis, hypo/hyperkalemia, hypothermia, hypoglycemia, toxins, cardiac tamponade, tension pneumothorax, coronary or pulmonary thrombosis or trauma |
Name three complications of pacemaker or ICD insertion. | arrhythmias, pneumothrax, infection, hemmorhage, cardiac tamponade |
Should a ptient with an ICD drive cross country? | no |
Should CPR be started on a patient with an ICD? | yes |
Should an AED be used by a babysitter on an eighteen month old child? | no |