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61 Cards in this Set
- Front
- Back
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what is a dysrhythmia?
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an abnormality in an otherwise normal rhythmic pattern, as of cardiac waves being recorded by an ecg
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what are common nursing diagnosis for patients with dysrhythmias?
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decreased cardiac output
altered tissue perfusion anxiety- feel changes, air hunger, lots of ppl in the room pain- lack of o2, lactic acidosis, r/t tissue perfusion |
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what is automaticity?
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ability of cells to do something authomatically initiate impulse on own
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what is rhthmicity?
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maintain intrinsic internal rhythm- sinus rhythm
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what is conductivity?
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ability to contract after an impulse
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what is absolute refractory period?
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cells can't respond to external stimulus no matter how strong
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what is relative refractory period?
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stronger than normal impulse may produce depolarization
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what is re-entry phenomena?
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abnormal rhythm re-enters at the same wrong spot ex: atrial flutter
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what is sinus bradycardia?
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sinus rate <60 bpm with a regular rhythm
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what are often causes of sinus bradycardia?
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-vasovagal stimulation- straining on toilet
-hypoxia -drug toxicity: street drugs, cardio drugs, chemo drugs, resp drugs -MI -hyperkalemia -normail in healthy adults- who run all the time |
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how do you treat sinus bradycardia?
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-monitor
-correct underlying cause -atropine (stimulate hrt & inc. HR) -pacemaker -nothing if it is a healthy person |
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what are symptoms of low cardiac output?
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-syncope
-confusion -hypotension -low urine output -CHF symptoms |
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what is sinus tachycardia?
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sinus rate >100 bpm and a regular rhythm
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often the cause of sinus tachycardia is?
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stress, fever, dehydration, pain, axiety, flight or fight, caffeine, nicotine, & drugs
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what are symptoms os sinus tachycardia?
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lightheadedness, racing heart which leads to syncope, confusion, hypotension, low uo
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whats the treatment of sinus tachycardia?
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correct the underlying cause (fever, stress) or may monitor
-slow it down w/ drugs: adenosine, esmolol |
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what is a premature atrial contraction (PAC)?
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p-wave is premature and abnormally shaped, and may be lost in previous t-wave
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what can be the cause of a PAC?
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-can be triggered by alcohol, anxiety, caffeine, and infectious diseases
-may be associated w/ CHD/VD, resp failure/hypoxia, and electrolyte balances |
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s/s of PAC?
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often asymptomatic but can lead to further dysrhythmias
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what is the treatment for PAC?
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correct underlying cause (cut out caffeine) or may monitor
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how do you treat sinus bradycardia?
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-monitor
-correct underlying cause -atropine (stimulate hrt & inc. HR) -pacemaker -nothing if it is a healthy person |
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what are symptoms of low cardiac output?
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-syncope
-confusion -hypotension -low urine output -CHF symptoms |
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what is sinus tachycardia?
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sinus rate >100 bpm and a regular rhythm
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often the cause of sinus tachycardia is?
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stress, fever, dehydration, pain, axiety, flight or fight, caffeine, nicotine, & drugs
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what are symptoms os sinus tachycardia?
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lightheadedness, racing heart which leads to syncope, confusion, hypotension, low uo
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what is atrial fibrillation?
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-asbsence of a p-wave with irregular ventricular response
-chaotic, asynchronous electrical activity of the atria - ventricles only respond to the impulses that make it through the atria -R-R interval irregular |
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what happens if the ventricle response is fast in atrial fribrillation or atrial flutter?
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the patient is usually worse off because there is less blood getting to the body
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what are causes of atrial fibrillation?
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-cardiac surgery
-hypotension -pulmonary embolism -electrolye imbalances -valve disorders -hypoxia -chf -cad Or normal if caffeine, alcholol, nicotine, or fatigue |
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S/s of atrial fibrillation are?
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-lightheadedness
-racing heart -anxious - sob -syncope -confusion -hypotension -low uo |
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how do you treat atrial fibrillation?
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-correct underlying cause
-synchronized cardioversion -monitor -slow it down with digoxin or cardiazem |
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wha tis synchronized cardioversion?
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controlled shock, delivers the QRS, so make sure it isn't during the T wave
- can sedate pt if it isn't an emergency |
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atrial fibrillation puts a patient at risk for what?
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clots and embolisms becuase blood is pooling in heart
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how do you count atrial fibrillation?
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find the longest & shortest R-R rate range, count small boxes
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what is atrial flutter?
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-abnormal P-wave that produces a saw toothed appearance
-a type of supraventricular tachycardia; rentry phenomenon -atrial rate 220-430/minute |
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common causes of atrial flutter are?
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-mitral valve disease
-hyperthyroidism -myocardial disease -post-cardiac surgery -copd -hypoxia |
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what are s/s of atrial flutter?
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-lightheadedness
- racing heart -angina -syncope -confusion -low uo -hypotension |
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how do you treat atrial flutter?
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correct underlying cause
slow it down w/drugs synchronized cardioversion monitor |
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if atrial flutter is caused by an imbalance in electrolytes how do you treat it?
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supplement potassium or whatever it is low in
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if atrial flutter is caused by an MI how do you treat it?
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morphine, oxygen, nitroglicerin, and aspirin
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is it better for our body to have more flutters or less flutters between QRS complexes in atrial flutter?
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better for body to have more flutters because it leads to more ventricular filling
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what is premature ventricular contractions? (PVC)
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-widened QRS complex, appear as early beats
-electrical irritability in the ventricle -can be unifocal or multifocal -can occur in clusters (bigeminy, trigeminy, quadrageminy) |
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What are PVCs often caused by?
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- electrolyte disturbances (K++, Mg++, Ca++) -caused by lasix, post-op, puking
-metabolic acidosis -MI -drug use -sympathetic stimulation |
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PVCs can lead to what?
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more serious dysrhythmias
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what is unifocal?
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from the same spot in the ventricle, looks the same
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what is multifocal?
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the shape looks different, from a different spot in the ventricle, one regular qrs, one inverted
-more serious b/c overall ventricle has more irritable spots that can cause chaos for the system |
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what is ventricular tachycardia?
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-three or more PVCs in a row due to irritability
-no atrial rhythm and ventricular rhythm is rapid (100-250) |
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common causes of ventricular tachycardia is?
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-MI
-CAD -valvular dysfunction -CHF -electrolyte imbalances -drug toxicity |
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s/s of V tach
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can be stable with a pulse or unstable with hyptoension and no detectable pulse
-shock -chf -mi |
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treatment of Vtach
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-monitor
-treat underlying cause - give drugs & start Cpr/ defibrillate |
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What is ventricular fibrillation?
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-chaotic electrical pattern of electrical activity in the ventricles where impulses arise from different foci
-there is no effective cardiac contraction & no CO - there is no way to measure ecg, all fib-waves without a pattern |
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what causes ventricular fibrillation ?
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-MI
-ischemia -untreated VT -CHD -acid-base imbalances -electrical shock -hypothermia |
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how do you treat ventricular fibrillation/
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advanced cardiac life support- cpr, meds, etc.
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What is asystole?
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-ventricular standstill
- no electrical activity nor CO -a flat line |
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what are causes of asystole?
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-anything that causes inadequate blood flow to the heart
-pulmonary embolism -hypoxia -electrolyte disturbances -MI -electrical shock -drug abuse -od of tricyclic antidepressants |
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s/s of asystole
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patient is unresponsive without a rhythm & bp
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Treatment of asystole is?
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CPR with ACLS protos are only possible treatment
-intubate -verify by 2 leads |
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what is pulseless electrical activity (PEA)?
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-electrical firings of heart continue but there is not mechanical contraction of the muscle
-low or no bp, no pulse |
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what does pulseless electrical activity result in/
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cardiac arrest
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what causes pulseless electrical activity?
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-hypovolemia
-hypoxia -hypothermia -hyperkalemia -tension pneumothorax -Pulmonary embolism -MI -OD on tricyclic antidepressants |
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how do you treat PEA?
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Cpr with epinemphrine (to stimulate mech contraction of heart)
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What is suddent cardiac death?
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death by any dysrhythmia such as V fib, PEA, or aortic rupture
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