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27 Cards in this Set
- Front
- Back
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What is sinus Tachycardia?
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its a normal rhythm but just faster rate, hard to destinquish if it gets above a 150 because its hard to see P waves.
-The Higher the rate the higher the PR interval |
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Causes of sinus Tachycardia are?
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Fever
-anxiety -Hypovolemia -Pain -infection -Drugs- street drugs, and decongestants -Caffeine -hypoxemia |
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How do you treat Tachycardia?
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Treat the underlying cause and while the heart rate is up give the client rest.
If you have a client with a high heart rate you are not gonna run them up and down the stairs. |
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What is bradycardia?
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Normal sinus but the rate is slower usually between 40-60 bpm.
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What are causes of Bradycardia?
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beta blockers + or CCB's like an overdose of Medications and antiarrhthmics.
Or anything that damages the sinus node |
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How will I treat Bradycardia?
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Just assess the patient!! see if they are tolerating the patient. Look for signs or symptoms change of LOC decreased BP, fatigued.
If its drug induced just hold the drugs. If patient has sever symptoms give them Atropine, Dopamine, Epinephran or Isuprel if sever. If the drugs don't work than you might have to temporary pace the patient |
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What is sinus Arrhythmia?
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-It is an irregular rate that fluctuates with respiratory rate.
-This is a normal finding in children and young adults. |
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What is a Sinus Arrhythmia with a PAC?
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Its a beat that happens off the railroad tracks.
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What causes a PAC?
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- By in large usually innocent.
-caffeine, nicotine, stimulants -Hypokalemia -Hypervolemia causes increased muscle stretch in senssitive individuals. -Any problem that decreases coronary blood flow to the atria. - |
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How do you treat a PAC?
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If treated at all, treat the underlying cause.
- look for Unifocal or Multifocal which in many areas ( pt can have 02 problems and or electrolyte disturbances. - Monitor for increased periods and Duration. we need to get patient back to bed. - Give the patient 02 :) - Give the patient rest :) |
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What is Sinus Arrest?
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Its when the a whole beat is dropped!!! The beat is regular but the sinus node fails to fire!!!
There is no beat where one should have occurred. This is a regular irregular rhythm. |
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What might your patient feel or say when they are having sinus arrest?
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"Oh I just got dizzy" "Oh my heart skipped a beat" " I thought I was gonna pass out"
Sinus arrest needs to be managed quickly patient can die because the sinus is sick!!! |
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What are the causes of sinus arrest?
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Anything that causes ischemiaor damage to the sinus node or the intranodal pathways
-DIGTOXICITY POTENTIALLY LIFE THREATING. when we see one beat we need to go into action. |
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How do you treat sinus arrest?
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-Give Digibind for digtoxicity
-Give 02 -Speed up heart rate with atropine if heart is slow -might temp pace, if it was an MI and cause the sinus node to become diseased permanently the patient will have to be permanently paced |
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What is Atrial Flutter?
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Atrial beat faster with fewer impulses reaching the ventricals.
The Atria can't fill or empty fully so the patient will lose 15-30% of cardiac output. |
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What causes atrial flutter?
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-Heart failure: heart is ingorged with blood and tissue over stretches
-CAD: no 02 -Valvular disease: impaires emptying -Hyperthyroidism -Alcohol ingestion: Holiday heart alcohol poising -Pulmonary disease: lack of 02 or increase of C02 -Post cardiac Surgery: cutting into the heart or inturupting the normal pathways of the heart -Aging changes in the SA Node: loses its cells and does not work as well, and atria become irritated because they are not getting enough oxygen. |
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What will your patient feels like/say in atrial flutter?
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My heart feels like its fluttering, low BP, Fatigue, weak, dizzy, can feel irregular rhythm.
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How do we treat Atrial flutter?
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Preserve CO
We need to slow impulses through he AV Node with CCB's and Beta Blockers Give Amiodarone to prolong repolarization which helps heart reverse. -Give 02 -Rest patient so we don't over tax the heart. -Might rapid atrial pacing to overcome the impulse - If all else fails we can do Electrical cardioversion which shocks the patient back into sinus Rhythm :) |
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What is Atrial Fibrillation?
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-Total irregular and ineffective atrial movement 300-600 bpm
QUIVERING OF THE ATRIA |
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What are the two types of Atrial Fibrillation?
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You have controlled and uncontrolled
Controlled is a rate less than 120 beats per minute and patient may be asymptomatic Uncontrolled: The rate is greater than 120 bpm patient will have more symptoms in uncontrolled due to loss of ventricular filling time thus impaired CO and perfusion |
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What are the causes of Atrial Fibrillation?
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-Same as A FIB
-Very common after cardiac Surgery |
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How will I treat Atrial Fibrillation ( A FIB)
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First we do not want CLOTS to form. In atrial fib the blood is just sitting in the atria and is pooling
- We need to get this undercontrol with in 48 Hours -We also need to control RATE is There is a big difference with a V rate of 160 and of 70. The patient at 160 the cardiac output is going to be more compromised. |
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How do I treat A FIB?
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We need to slow the ventricular rate in uncontrolled A VIB with covert, CCB's Beta Blockers and Amiodarone to allow for better ventricular filling.
- Have to anticoagulate patient than you can cardioversion. -If you patient is on Digoxin we need to tell the DR because we need to anticoagulate the patient take the patient off digoxin so we can cardiovert the patient. |
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What is superventricular tachycardia (SVT)
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Rate is 170-230bpm
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What causes of SVT?
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Same as tachycardia
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What would happen if you let SVT continue?
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Eventually you will over work the heart and eventually have Cardiac output problem.
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How do we Treat SVT?
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- Treat the underlying cause
-Have the patient cough -have the patient Gag -Have the patient bear down -You can use Adenosine Can only be used with SVT!!!!! -Also CCB's and Beta Blockers |
