Unit II
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| Most common dysrhythmia; total disorganization of atrial electrical activity due to multiple ectopic foci, resulting in loss of effective atrial contraction. | Atrial Fibrillation
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| Controlled A-Fib. | <100bpm
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| Dysrhythmia that originates in area of AV node. | Junctional Escape Rhythm
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| Every impulse is conducted to the ventricles, but duration of AV conduction is prolonged. | First Degree AV Block
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| Normal PR interval. | 0.12-.20 sec
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| Normal QRS interval. | <.010 sec
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| Gradual lengthening of the PR interval due to prolonged AV conduction time. | Second Degree Type 1(Mobitz 1/Wenkebach)
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| Considered life-threatening because of decreased CO and the possibility of deterioration to ventricular fibrillation; Run of three or more PVCs. | Ventricular Tachycardia
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| Develop when the intrinsic pacemaker rate (SA node or AV node) becomes less than that of a ventricular ectopic pacemaker. | Accelerated Idioventricular Rhythm
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| Severe derangement of the heart rhythm characterized on ECG by irregular undulations of varying contour and amplitude. | V-Fib
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| One small box on EKG strip. | 0.04sec
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| One big box on EKG strip. | 0.2 sec
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| Deliver successful shocks at lower energies and with fewer post shock ECG abnormalities; deliver energy in two directions. | Biphasic Defribrillation
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| What is normal Ejection Fraction. | >55%
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| Level of atria: intersection of 2 imaginary lines. | Phlebostatic axis
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| Intra-arterial Pressure Monitoring; Direct, continuous measurement of blood pressure. | Usually 10-15mm Hg >cuff
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| 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
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| What is normal CVP (RAP). | 2-8mmHg
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| Measures End Diastolic Volume, (Volume when Right AV valve is open and completely full). | Pulmonary Artery Wedge Pressure (PAWP)
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| A reflection of Left Atrial Pressure and Left End diastolic pressure. | PAWP
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| Potent, rapid-acting anti-hypertensive; Peripheral vasodilation through direct action on SM of blood vessels (Decreased afterload & preload); Effective almost immediately. | Nitroprusside (Nipride)
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| When giving Vasopressive drugs make sure you infuse in ______. | PICC line
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| 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
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| Usual infusion dosage for Nitroprusside. | 0.5 to 10mcg/kg/min
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| Vascular SM relaxant & vasodilator; affects arterial & venous beds; coronary vasodilator (Decreased preload & MVO2); Reduces afterload at high doses. | Nitroglycerin (Tridil)
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| 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
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| Medications that increase BP. | Vasopressor's
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| Positive Inotrope; Dose-dependent actions- alpha, beta, & dopaminergic receptor stimulating actions; Promotes release of norepinephrine from sympathetic nerve terminals. | Dopamine Hydrochloride
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| High dose; Increase BP, Vasopressor dose. | Alpha Dose
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| Inotrope, Increase Contractility. | Beta-1 Dose
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| 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
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| Low doses: β-adrenergic agonist (cardiac stimulation, bronchial dilation, peripheral vasoconstriction), Higher doses: stimulates alpha receptors, causing profound vasoconstriction,↑ Stroke volume,↑ SVR. | Epinephrine
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| β1-Adrenergic agonist (cardiac stimulation α-Adrenergic agonist (peripheral vasoconstriction); Renal/splanchnic vasoconstriction; Used for hypotension unresponsive to adequate fluid resuscitation. | Norepinephrine (Levophed)
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| Administer via central line (infiltration leads to tissue sloughing); Monitor for dysrhythmias secondary to ↑MvO2 requirements. | Norepinephrine (Levophed) Monitoring
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| Time when cardiac muscle does not respond to any stimuli. | Absolute Refractory Period
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| If present may represent depolarization of the purkinje fibers or it may be associated with hypokalemia. | U-wave
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| What is normal Cardiac Output. | 4 to 8 L/min
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| Signals the beginning of systole and is associated with w/ the closure of the tricuspid and mitral valves. | S₁
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| Is the direct study and manipulation of the electrical activity of the heart using electrodes placed inside the cardiac chambers. | Electrophysiology Study (EPS)
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| The measurement of pressure, flow, and oxygenation within the cardiovascular system. | Hemodynamics Monitoring
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| What is normal Pulmonary artery wedge pressure (PAWP) or left atrial pressure (LAP). | 6-12 mmHg
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| What is normal Pulmonary artery diastolic pressure (PADP). | 4-12 mmHg
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| The Volume within the ventricle at the end of diastole. | Preload
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| 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
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| 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
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| Vasodilator drug therapy (i.e. milrinone[Primacor]) can reduce ______. | Afterload
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| The _____ notch indicates aortic valve closure. | Dicrotic
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| Before insertion of A-line perform an _____ test to confirm that ulnar circulation to the hand is adequate. | Allen’s
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| PAD pressure and PAWP ______ in heart failure and fluid volume overload. | Increase
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| Monitoring __ pressures permits precise therapeutic manipulation of preload. | PA
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| For accurate data, obtain PA measurements at ___ of expiration. | End
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| What is normal SvO₂/ScvO₂? | 60%-80%
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| The treatment of choice to terminate VF and pulseless VT. | Defibrillation
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| Deliver successful shocks at lower energies and with fewer postshock ECG abnormalities than monophasic defibrillators. | Biphasic Defibrillators
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| 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
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| 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
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| A pacing technique that resynchronizes the cardiac cycle by pacing both ventricles, thus promoting improvement in ventricular function. | Cardiac Resynchronization Therapy (CRT)
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| Is used to provide adequate HR & rhythm to the pt in an emergency situation. | Transcutaneous Pacemaker (TCP)
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