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Cardiac Dysrhythmia
PN 141 test 1 book: Med surg nursing pg: 625
| Question | Answer |
|---|---|
| What is the name for the "normal heart rythm" | normal sinus rhythm (NSR) |
| What node do the electrical impulses origonate in? | the sinoatrial node (SA) |
| Def of Cardiac dysrhythmia | a disturbance or irregularit in the electrical system of the heart |
| Are all dysrythmias life threatening | no |
| Two are the two mechanisms to develop a dysrhythmia | altered formation of impulses or altered conduction of the impulse through the heart |
| def of ectopic beats | impulses that develop more rapidly or more slowly then normal, or may originate outside the SA node |
| Def of a heart block | an impulse that may be blocked or delayed as it moves through the conduction pathways of the heart |
| Def of reentry phenomonom | impulses that are delayed in one area of the heart but conduct normally through the rest ofthe heart |
| Where do supraventricular rhythms originate | above the ventrice |
| Where do ventricular rhythms originate | in the ventricles |
| what type of rhythms are fatal supraventricular or ventricular rhythms | ventricular |
| supraventricular rhythms: What are they (6) | normal sinus rhythm (normal), sinus tachycardia, sinus bradycardia, premature atrial contractions (PACs), Atrial flutter, Atrial fibrillation |
| sinus tachycardia: Definition | regular, HR >100 bpm |
| sinus tachycardia: tx | only if sympotomatic |
| Sinus Bradycardia: tx | only if sympotomatic, pacemaker or atropine |
| Sinus Bradycardia: Def | <60 bpm, regular |
| PACs: Def | irregular ectopic atrial beat occuring earlier then expected |
| PACs: tx | none needed |
| Atrial fibrillation: def | irregularly irregular, no identifiable p wave, variable ventricular rate |
| Atrial fibrillation: tx | synchronized CV medsto slow ventricular rate, anticoagulants to decrease the risk for stroke |
| Ventricular Rhythms: what are the names of them | premature ventricular contractions (PVCs), ventricular tachycardia (V-tach), Ventricular fibrillation (V-fib) |
| V-tach: def | rate 100-250 bpm, no p waves, QRS wide |
| V-tach: tx | iv meds, defiblillize |
| v-fib: def | grossly irregular, rate too rapid to count, no p wave, QRS bizarre and variable |
| v-fib: tx | immediate defibrillate |
| def of AV conduction blocks | conduction defects that cause delayed or blocked transmission of sinus impulses through the AV node. There are three degrees ranges from benign to severe |
| Why are anitdysrhythmic drugs used | tx of acute or chronic dysrhythmias, to maintain an effective cardiac output by stabilizing cardiac rhythm |
| what different meds are used to treat dysrhythmias | beta blockers, class a1(quinidine), class IB (Lidocaine), class IC (Flecainide), Class III, Class calcium channel blockers, digoxin, |
| What is another name for defibrillation | cardioversion |
| What is defibrillation used for | to treat rhythms that effect cardiac output and the client's welfare (electrical shock is administered to depolarize all cells of the heart at the same time) it stops the abnormal rhythm |
| automatic implantable cardioverter- defibrillator: what is it | an AICD recognizes life-threatening changes in heart rhythm and automatically delivers an electric shock to convert the rhythm back into normal rhythm |
| automatic implantable cardioverter- defibrillator: Who is it used for | pt w/ recurrent ventricular tachycardia and people who have survived cardiac arrest not associated with an AMI |
| PAcemakers: what are they used for | to treat AV blocks |
| Pacemakers: What are temporary ones used for | they have an external generator attached to an electrode threaded intravenously into the right ventricle after cardiac surgery . . . JUST IN CASE IT IS NEEDED |
| Pacemakers: How are permenent ones implanted | there is a pulse generater attached to electrodes that are sewm directly onto the heart or passed into heart via subclavian vein |
| Pacemakers: what are the two functions of pacemakers | sensing and pacing |
| Pacemakers: what does it do when it senses | it detects the heart's beat, to assesses if the heart is in the right amount of BPM |
| Pacemakers: What does it do when it paces | it is the delivery of an electrical pulse to stimulate the heart to contract |
| Pacemakers: what causes it to pace | it occurs when the pt HR falls outside the programmed limits |
| Pacemakers: Post op nursing care | restrict movement of affected arm and shoulder for 24 hours, assist with gentle ROM after 24 hours, instruct pt to carry info on type of pacemaker at all times |
| PAcemaker: what a pt should report to MD | pulse rate 5 beats less then preset pacemaker rate, fever, weakness, chest pain, palpitations, **** let all care providers know that they have a pacemaker |
| s/s of decreased cardiac output | decreased LOC, taachycardia, tachypnea, hypotension, diaphoresis, decreased urinary output, cool, clammy, mottled skin, pallor, decreased peripheral pulses |
| What can a change in mental status indicate | lact of adequate blood and oxygen supply to cells of the brain |
| MEd: amiodarone (PACERONE)- what is the class | potassium channel blocker |
| MEd: amiodarone (PACERONE)- uses | life threatening ventricular arrhythmias |
| MEd: amiodarone (PACERONE)- action | prolonged repolarization. Acts directly on cardiac cell membrane. |
| MEd: amiodarone (PACERONE)- adverse reactions | malaise, fatigue, tremor, proarrhythmic effect, N/V, constipation, ataxia, anorexia, bradycardia, photosensitivity |
| what is the three goals of a pacemaker: | return the heart rhythm to regularity, increase CO, increase tissue perfusion |
| four reasons a pacemaker is placed | drug toxicity, electrolye imbalance, complications of MI or OH, dysrhythmias |
| difference between the single or dual chamber pacemakers | single is in 1 chamber of the heart, duel is two chambers |
| what is a fixed rate pacemaker | not used often anymore, constant same rate all the time, some one that doesn't need much compensation |
| what is a demand rate pacemaker | compensation piece is turned on as needs |
| what is an A/V sequential pacemaker: | dual one, they will use A or V or both chambers, intervene when needed |
| what is an ICD | used for life threatening ventricular dysrhythmias, shocks heart when it is out of rhythm. |
| ICD: how big is the shoc k | 25 joules |
| pt with pacemakers: why should they have an ID card/ med alert | for emergency, they should also have what kind of pacemaker they have on them |
| pt with pacemakers: what is the electrical cautions | no MRI, |
| pt with pacemakers: post op left arm care | it should be in a sling |
| pt with pacemakers: teaching | no driving until shock effect is known, take daily pulse to know if it is working, journal what happened with ICD, family should know CPR |
Created by:
jmkettel
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