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MedSurge DYSRHYTHMIAS review

4 Properties of cardiac cells automaticity, excitability, conductivity, contractility
Automaticity is defined as? ability to initiate an impulse spontaneously and continuously
Excitability is defined as? ability to be electrically stimulated
Conductivity Ability to transmit an impulse along a membrane in an orderly manner
Contractility ability to respond mechanically to an impulse
Stimulation of the Vagus nerve (PNS) causes a _____ rate of firing of the SA node. decreased
Stimulation of the sympathetic nerves (SNS) _____ SA node firing. increases
Patient w/acute MI w/sinus tachycardia, if not treated, pt. likely to experience? ↑ myocardial O2 needs, leading to ↑ angina / ↑ ischemia / ↑ necrosis
Rhythm strip shows occasion distorted P wave, followed by normal AV & ventricular conduction, indicates ____, nurse should question pt. about ____? premature atrial contraction / use of: caffeine, smoking, tobacco, alcohol, stress
Normal rhythm, except prolonged PR interval, is characteristic of? first-degree heart block
Treatment for first-degree heart block? none; patient is observed for progression to higher degrees
Defibrillation is used ONLY for? ventricular fibrillation
Atropine is administered for? bradycardia
Pacemakers are used for? high-degree heart blocks
Symptoms of decreased cardiac output related to dysrhythmias include? ↓ BP, ↓ mentation, chest pain, dyspnea, weak peripheral pulses
PVC is? Premature Ventricular Contractions
PVCs in pt. w/acute MI indicates? ventricular irritability, may lead to ventricular tachycardia or fibrillation
Antidysrhythmics that can be used to control dysrhythmias include? a-adrenergic blockers, procainamide, amiodarone, or lidocaine
Valsalva maneuver may be used to treat? Paroxysmal supraventricular tachycardia
PRIORITY NURSING ACTION: Pt. w/acute MI, multifocal PVCs, ventricular couplets, alert, BP 118/78, irregular pulse 86 BPM? prepare to administer antidysrhythmic drugs per protocol
PVCs is an ectopic beat that causes? wide-distorted QRS complex > 0.12 sec (impulse not conducted normally)
an Ectopic beat is? a disturbance of the cardiac rhythm
Continuous wide QRS complexes w/rate between 110 - 250 are seen in? ventricular tachycardia
Saw-toothed P waves are characteristic of? atrial flutter
What does cardiac defibrillation do? depolarizes the cells of the myocardium to allow the SA node to resume pacemaker function
Initial treatment of asystole and pulseless electrical activity is? CPR (to maintain minimal CO and oxygenation), followed by intubation and administration of epinephrine and atropine
Why is defibrillation not an effective treatment of asystole and pulseless electrical activity? because the myocardial cells are in a state of depolarization
In preparation for defibrillation, the nurse should? apply conductive materials (e.g. saline pads, electrode gel, defibrillator gel pads)
Why are conductive materials applied? to ↓ impedance and prevent burns
Initial shock for defibrillation in joules? 200 joules, if 3rd shock is required, up to 360 joules
If ICD (implantable cardioverter-defibrillator) fires, pt. should? lie down, call health care provider
ICD (implantable cardioverter-defibrillator) fires when? pt. has experienced a lethal dysrhythmia
Pt. with pacemakers should avoid? high-voltage electrical generators, large magnets (as in MRI) - they reprogram the pacemaker
After the pacemaker is placed, arm should not be raised above shoulder for how long? 1 week
Pt. with external pacemakers may experience? uncomfortable chest muscle contractions
Following initiation of emergency call system (CODE BLUE), next nursing priority is to? begin CPR
Joules for monophasic defibrillators? 360 joules
Joules for biphasic defibrillators? 120 - 200 joules
Catheter ablation therapy is indicated for treatment of? tachydysrhythmias
Pt. w/chest pain, not responding to nitroglycerin, nurse should be most concerned with presence of? ST segment elevation
ST segment elevation indicates? injury / infarction of an area of the heart
Inverted T wave indicates? ischemia and resolves when blood flow is restored
Occasional PVCs may be due to? electrolyte imbalance or hypoxia, or may be normal
Pt. with neurocardiogenic (vasovagal) syncope experiences what symptoms? marked bradycardia and hypotension
Atropine is not indicated for? supraventricular tachycardia
Nurse should administer ___ for pt. experiencing supraventricular tachycardia vagal stimulation
Created by: fluency