PN 141 test 1 book: Med surg nursing pg: 625
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| What is the name for the "normal heart rythm" | normal sinus rhythm (NSR)
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| What node do the electrical impulses origonate in? | the sinoatrial node (SA)
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| Def of Cardiac dysrhythmia | a disturbance or irregularit in the electrical system of the heart
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| Are all dysrythmias life threatening | no
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| Two are the two mechanisms to develop a dysrhythmia | altered formation of impulses or altered conduction of the impulse through the heart
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| def of ectopic beats | impulses that develop more rapidly or more slowly then normal, or may originate outside the SA node
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| Def of a heart block | an impulse that may be blocked or delayed as it moves through the conduction pathways of the heart
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| Def of reentry phenomonom | impulses that are delayed in one area of the heart but conduct normally through the rest ofthe heart
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| Where do supraventricular rhythms originate | above the ventrice
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| Where do ventricular rhythms originate | in the ventricles
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| what type of rhythms are fatal supraventricular or ventricular rhythms | ventricular
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| supraventricular rhythms: What are they (6) | normal sinus rhythm (normal), sinus tachycardia, sinus bradycardia, premature atrial contractions (PACs), Atrial flutter, Atrial fibrillation
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| sinus tachycardia: Definition | regular, HR >100 bpm
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| sinus tachycardia: tx | only if sympotomatic
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| Sinus Bradycardia: tx | only if sympotomatic, pacemaker or atropine
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| Sinus Bradycardia: Def | <60 bpm, regular
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| PACs: Def | irregular ectopic atrial beat occuring earlier then expected
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| PACs: tx | none needed
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| Atrial fibrillation: def | irregularly irregular, no identifiable p wave, variable ventricular rate
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| Atrial fibrillation: tx | synchronized CV medsto slow ventricular rate, anticoagulants to decrease the risk for stroke
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| Ventricular Rhythms: what are the names of them | premature ventricular contractions (PVCs), ventricular tachycardia (V-tach), Ventricular fibrillation (V-fib)
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| V-tach: def | rate 100-250 bpm, no p waves, QRS wide
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| V-tach: tx | iv meds, defiblillize
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| v-fib: def | grossly irregular, rate too rapid to count, no p wave, QRS bizarre and variable
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| v-fib: tx | immediate defibrillate
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| 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
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| Why are anitdysrhythmic drugs used | tx of acute or chronic dysrhythmias, to maintain an effective cardiac output by stabilizing cardiac rhythm
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| 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,
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| What is another name for defibrillation | cardioversion
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| 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
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| 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
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| 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
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| PAcemakers: what are they used for | to treat AV blocks
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| 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
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| 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
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| Pacemakers: what are the two functions of pacemakers | sensing and pacing
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| 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
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| Pacemakers: What does it do when it paces | it is the delivery of an electrical pulse to stimulate the heart to contract
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| Pacemakers: what causes it to pace | it occurs when the pt HR falls outside the programmed limits
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| 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
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| 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
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| s/s of decreased cardiac output | decreased LOC, taachycardia, tachypnea, hypotension, diaphoresis, decreased urinary output, cool, clammy, mottled skin, pallor, decreased peripheral pulses
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| What can a change in mental status indicate | lact of adequate blood and oxygen supply to cells of the brain
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| MEd: amiodarone (PACERONE)- what is the class | potassium channel blocker
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| MEd: amiodarone (PACERONE)- uses | life threatening ventricular arrhythmias
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| MEd: amiodarone (PACERONE)- action | prolonged repolarization. Acts directly on cardiac cell membrane.
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| MEd: amiodarone (PACERONE)- adverse reactions | malaise, fatigue, tremor, proarrhythmic effect, N/V, constipation, ataxia, anorexia, bradycardia, photosensitivity
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| what is the three goals of a pacemaker: | return the heart rhythm to regularity, increase CO, increase tissue perfusion
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| four reasons a pacemaker is placed | drug toxicity, electrolye imbalance, complications of MI or OH, dysrhythmias
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| difference between the single or dual chamber pacemakers | single is in 1 chamber of the heart, duel is two chambers
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| what is a fixed rate pacemaker | not used often anymore, constant same rate all the time, some one that doesn't need much compensation
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| what is a demand rate pacemaker | compensation piece is turned on as needs
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| what is an A/V sequential pacemaker: | dual one, they will use A or V or both chambers, intervene when needed
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| what is an ICD | used for life threatening ventricular dysrhythmias, shocks heart when it is out of rhythm.
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| ICD: how big is the shoc k | 25 joules
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| 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
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| pt with pacemakers: what is the electrical cautions | no MRI,
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| pt with pacemakers: post op left arm care | it should be in a sling
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| 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
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