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Unit II

Most common dysrhythmia; total disorganization of atrial electrical  activity due to multiple ectopic foci, resulting in loss of effective atrial contraction. Atrial Fibrillation
Controlled A-Fib. <100bpm
Dysrhythmia that originates in area of AV node. Junctional Escape Rhythm
Every impulse is conducted to the ventricles, but duration of AV conduction is prolonged. First Degree AV Block
Normal PR interval. 0.12-.20 sec
Normal QRS interval. <.010 sec
Gradual lengthening of the PR interval due to prolonged AV conduction time. Second Degree Type 1(Mobitz 1/Wenkebach)
Considered life-threatening because of decreased CO and the possibility of deterioration to ventricular fibrillation; Run of three or more PVCs. Ventricular Tachycardia
Develop when the intrinsic pacemaker rate (SA node or AV node) becomes less than that of a ventricular ectopic pacemaker. Accelerated Idioventricular Rhythm
Severe derangement of the heart rhythm characterized on ECG by irregular undulations of varying contour and amplitude. V-Fib
One small box on EKG strip. 0.04sec
One big box on EKG strip. 0.2 sec
Deliver successful shocks at lower energies and with fewer post shock ECG abnormalities; deliver energy in two directions. Biphasic Defribrillation
What is normal Ejection Fraction. >55%
Level of atria: intersection of 2 imaginary lines. Phlebostatic axis
Intra-arterial Pressure Monitoring; Direct, continuous measurement of blood pressure. Usually 10-15mm Hg >cuff
Catheter used to monitor PAP& RAP; Yields information on LV function, circulatory status, vascular tone; Inserted into vein & advanced to PA; guided by waveform observation. Pulmonary Artery Catheter
What is normal CVP (RAP). 2-8mmHg
Measures End Diastolic Volume, (Volume when Right AV valve is open and completely full). Pulmonary Artery Wedge Pressure (PAWP)
A reflection of Left Atrial Pressure and Left End diastolic pressure. PAWP
Potent, rapid-acting anti-hypertensive; Peripheral vasodilation through direct action on SM of blood vessels (Decreased afterload & preload); Effective almost immediately. Nitroprusside (Nipride)
When giving Vasopressive drugs make sure you infuse in ______. PICC line
Monitor BP (mandatory; prefer a-line); Monitor thiocyanite levels with large doses; Administer in mcg/kg/min; Wrap in opaque material to protect from light 24hrs. Nitroprusside Monitoring
Usual infusion dosage for Nitroprusside. 0.5 to 10mcg/kg/min
Vascular SM relaxant & vasodilator; affects arterial & venous beds; coronary vasodilator (Decreased preload & MVO2); Reduces afterload at high doses. Nitroglycerin (Tridil)
Administer in mcg/min; No nitrates for 24 hours after sildenafil (Viagra) or other similar medications due to life-threatening hypotension; Glass bottle & non-PVC tubing. Nitroglycerin Monitoring
Medications that increase BP. Vasopressor's
Positive Inotrope; Dose-dependent actions- alpha, beta, & dopaminergic receptor stimulating actions; Promotes release of norepinephrine from sympathetic nerve terminals. Dopamine Hydrochloride
High dose; Increase BP, Vasopressor dose. Alpha Dose
Inotrope, Increase Contractility. Beta-1 Dose
Direct-acting inotropic agent possessing beta-stimulator activity. Increases SV with minimal effect on HR, BP;Indications: ST inotropic support in cardiac decompensation. Dobutamine hydrochloride
Low doses: β-adrenergic agonist (cardiac stimulation, bronchial dilation, peripheral vasoconstriction), Higher doses: stimulates alpha receptors, causing profound vasoconstriction,↑ Stroke volume,↑ SVR. Epinephrine
β1-Adrenergic agonist (cardiac stimulation α-Adrenergic agonist (peripheral vasoconstriction); Renal/splanchnic vasoconstriction; Used for hypotension unresponsive to adequate fluid resuscitation. Norepinephrine (Levophed)
Administer via central line (infiltration leads to tissue sloughing); Monitor for dysrhythmias secondary to ↑MvO2 requirements. Norepinephrine (Levophed) Monitoring
Time when cardiac muscle does not respond to any stimuli. Absolute Refractory Period
If present may represent depolarization of the purkinje fibers or it may be associated with hypokalemia. U-wave
What is normal Cardiac Output. 4 to 8 L/min
Signals the beginning of systole and is associated with w/ the closure of the tricuspid and mitral valves. S₁
Is the direct study and manipulation of the electrical activity of the heart using electrodes placed inside the cardiac chambers. Electrophysiology Study (EPS)
The measurement of pressure, flow, and oxygenation within the cardiovascular system. Hemodynamics Monitoring
What is normal Pulmonary artery wedge pressure (PAWP) or left atrial pressure (LAP). 6-12 mmHg
What is normal Pulmonary artery diastolic pressure (PADP). 4-12 mmHg
The Volume within the ventricle at the end of diastole. Preload
A measurement of pulmonary capillary pressure, reflects left ventricular end-diastolic pressure under normal conditions (i.e. when there is no mitral valve dysfunction, intracardiac defect or dysrhythmia.) PAWP
Measures the right atrium or in the vena cava close to the heart, is the right ventricular preload or right ventricular end-diastolic pressure (i.e. in the presence of no cardiac abnormality.) CVP
Vasodilator drug therapy (i.e. milrinone[Primacor]) can reduce ______. Afterload
The _____ notch indicates aortic valve closure. Dicrotic
Before insertion of A-line perform an _____ test to confirm that ulnar circulation to the hand is adequate. Allen’s
PAD pressure and PAWP ______ in heart failure and fluid volume overload. Increase
Monitoring __ pressures permits precise therapeutic manipulation of preload. PA
For accurate data, obtain PA measurements at ___ of expiration. End
What is normal SvO₂/ScvO₂? 60%-80%
The treatment of choice to terminate VF and pulseless VT. Defibrillation
Deliver successful shocks at lower energies and with fewer postshock ECG abnormalities than monophasic defibrillators. Biphasic Defibrillators
The therapy of choice for the patient w/ hemodynamically unstable ventricular (e.g. VT w/ pulse) or SVT (e.g. A-Fib w/ a rapid ventricular response.) Synchronized Cardioversion
Monitors the HR & Rhythm & identifies VT or VF; Approx. 25 seconds after the sensing system detects a lethal dysrhythmia the defib mechanism delivers 25 joules or less shock to the pts heart. Implanted Cardioverter-Defibrillator
A pacing technique that resynchronizes the cardiac cycle by pacing both ventricles, thus promoting improvement in ventricular function. Cardiac Resynchronization Therapy (CRT)
Is used to provide adequate HR & rhythm to the pt in an emergency situation. Transcutaneous Pacemaker (TCP)
Created by: BOjangles1006
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