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cardiovascular
Dysrhythmia//
| Question | Answer |
|---|---|
| sinus bradycardia | regular rhythm with rate less than 60 bpm |
| causes of sinus bradycardia | vagal nerve stimulation, hypothermia, beta blockers, calcium channel blockers |
| treatment of sinus bradycardia | iv atropine (only for symptomatic), pacemaker |
| symptomatic bradycardia | dizziness, hypotension, syncopal episodes, pale, cool skin, weakness, angina, confusion, SOB |
| treatment of symptomatic bradycardia | dopamine or epinephrine drips, atropine, pacemakers |
| sinus tachycardia | regular rhythm with rate of 101 to 200 bpm |
| causes of sinus tachycardia | anxiety, fever, exercise, caffeine, fear, heart failure, hypoxia, epi pen, norepinephrine, atropine |
| treatment of sinus tachycardia | adenosine, beta-blockers |
| premature atrial contraction | starts from ectopic focus that is not the SA node, rhythm is irregular |
| causes of PAC | emotional/physical stress, electrolyte imbalances, tobacco, hypokalemia, atrial injury, hyperthyroidism, COPD, CAD, valvular disease, caffeine |
| atrial flutter | reoccurring regular saw tooth shaped flutter waves, from single ectopic focus in right atrium, 200-350 bpm |
| atrial flutter treatment | calcium channel blockers - cardiazem, digoxin beta-blockers - metoprolol get back to SR- cardiazem, amioterone electrical cardioversion radiofrequency ablation |
| atrial fibrillation | no discernible p waves, comes from multiple different foci or impulses, 350-600 bpm |
| atrial fibrillation treatment | CCB- cardiazem (quick half-life, lowers BP), beta-blockers- digoxin, metoprolol electrical cardioversion anticoagulation ablation |
| if cannot convert out of afib | on warfarin for rest of life (monitor INR- 2.5-3.5) |
| premature ventricular contractions | contraction coming from ectopic focus other than SA node or AV node but coming from somewhere in ventricles , QRS complex is greater than 0.12 seconds, absent T waves |
| PVC treatment | correct the cause (electrolyte imbalances, hypoxia) beta blockers - pronestal, amioterone |
| ventricular tachycardia | rapid, life-threatening (150-250 bpm), may or may not have a pulse |
| stable V-Tach treatment | IV lidocaine, IV betapase, iv amioterone synchronized cardioversion if meds are not working |
| unstable V-Tach treatment (no pulse) | defibrillation |
| ventricular fibrillation | lethal dysrhythmia, chaotic pattern, HR is not measurable, no discernible p-waves |
| v-fib is associated with | MI, ischemia, HF, cardiomyopathy, cardiac pacing, cardiac catheterization |
| client presents in v-fib with | pulselessness, apneic, unresponsive |
| v-fib treatment | CPR immediately, defib, drug therapy (epinephrine, vasopressin) |
| pulseless electrical activity | electrical system is working, pump system is not working, no pulse |
| causes of pulseless electrical activity | H- hypovolemia, hypoxia, hyper/hypokalemia, hypoglycemia T- tamponade, thrombosis, trauma, tension pneumothorax |
| asystole | total absence of ventricular activity, patient unresponsive and pulselessness |
| treatment of asystole | CPR, DO NOT DEFIBRILLATE |
| AV blocks | block of conduction from atria to ventricles |
| causes of AV blocks | CAD, AMI, infections, enhanced vagal tone, digoxin, BB, CCB, hypokalemia, rheumatic fever |
| first degree AV block | delayed conduction from sinus node to AV node, prolonged PR interval - greater than 0.20 seconds, all QRS are present |
| treatment of first degree AV block | not serious, but can be a sign of higher AV blocks to come, just monitor for new changes |
| Second Degree AV Block Type 1 (Wenckebach) | steadily lengthening PR interval, QRS complex can be blocked |
| causes of Second Degree AV block type 1 | digoxin, beta blockers, CAD, ischemia |
| Second-degree AV block type 1 treatment | if symptomatic- atropine, pacemaker if asymptomatic- monitor closely |
| Second Degree AV Block type 2 | bundle branch is blocked, PR interval is fixed, atrial rate is normal, |
| second degree AV block type 2 causes | drug toxicities rheumatic heart disease, anterior MI, CAD |
| treatment of second degree AV block type 2 treatment | permanent pacemaker |
| complete heart block (third degree AV heart block) | atrial and ventricles beat independently of each other |
| causes of complete heart block | severe heart disease - CAD, MI, myocarditis, slcera derma, ALS, digoxin, BB, CCB |
| treatment of complete heart block | pacemaker, drugs to increase the heart rate while awaiting pacemaker - dopamine, epinephrine |
Created by:
ebrewer12
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