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Stack #121700

a MCPHS- Provider I- Ch 27 Management of Pts w/Dysrhythmias

QuestionAnswer
Dysrhythmias are disorders of Formation/Conduction of heart’s electrical impulses
Diagnose dysrhythmias ECG
Dysrhythmia naming Site of origin, Mechanism of formation, Conduction involved
Sympathetic stimulation vs. Parasympathetic stimulation r/t Heart rate, AV node conduction & Force of myocardial contraction S:all increase, P:all decrease
Chronotropy vs. Dromotropy vs. Inotropy C:heart rate, D:AV node conduction, I:force of myocardial contraction
# of electrodes r/t 12-lead ECG 10 w/6 on chest and 4 on limbs
Limb electrode placement Non-bony areas w/out major movement
12-lead ECG reflects electrical activity in Left ventricle
Horizontal axis r/t ECG strip Time & Rate
Vertical axis r/t ECG strip Voltage/Amplitude
Positive deflection vs. Negative deflection P:ECG waveform moves to top of strip, N:ECG waveform moves to bottom of strip
P Wave r/t Atria Atrial depolarization
QRS Complex r/t Ventricle Ventricular depolarization
T Wave r/t Ventricle Ventricular repolarization
Atrial Repolarization r/t ECG strip Occurs during QRS Complex
U Wave Repolarization of Purkinje fibers
PR Interval Time from SA node stimulation to conduction through AV node, Does not include ventricular depolarization
ST Segment r/t Isoelectric line Analyzed to determine if below/above isoelectric line
QT Interval Total time for ventricular depolarization and repolarization
Prolonged QT intervals put Pt at risk for Torsade de pointes
Type of dysrhythmia r/t Torsade de pointes Ventricular
TP Interval No electrical activity, Isoelectric line
PP Interval vs. RR Interval PP:determines atrial rhythm & rate, RR:determines ventricular rate & rhythm
Each small box on ECG strip represents .04 seconds
If RR & PP intervals are same or < .8 seconds Regular rhythm
Contributing factors r/t Bradycardia H’s and T’s
3 H’s r/t Bradycardia Hypovolemia, Hydrogen ions(acidosis), Hypoglycemia
3 T’s r/t Bradycardia Toxins, Thrombosis, Trauma
Sinus bradycardia vs. Sinus tachycardia vs. Normal sinus rhythm Only difference is rate
Sinus arrhythmia r/t Respiration Increases w/inspiration, Decreases w/expiration
Atrial flutter r/t AV node conduction Not all atrial impulses are conducted into ventricle, Therapeutic block at AV node
P-wave shape r/t Atrial flutter Saw-tooth shape
Occurs when AV node becomes pacemaker Junctional/Idionodal rhythm
When P waves cannot be identified Supraventricular tachycardia(SVT)
SVT indicates only that rhythm is not Ventricular tachycardia
Emergencies r/t Dysrhythmia Ventricular tachycardia, Ventricular fibrillation, Idioventricular rhythm, Ventricular asystole
Ventricular fibrillation characteristics Absence of: heartbeat, palpable pulse & respirations
AHA guidelines r/t Unconscious adults who experience cardiac arrest d/t Ventricular fibrillation Induce mild hypothermia for 12-24 hours
Idioventricular rhythm Purkinje fibers become pacemaker
Ventricular asystole synonym Flatline
AV blocks occur when AV node conduction is decreased/stopped
Created by: rpclothier
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