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26 Cards in this Set
- Front
- Back
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What occurs in Sinus Arrhythmia
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1. SA node initiates impulse
2. Impulses are irregular 3. HR increases when pt inhales 4. HR decreases when pt exhales 5. it is normal in the young and elderly |
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What is the treatment for asymptomatic Sinus Arrhythmia?
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NOTHING
Monitor |
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What is a possible EKG change associated with Sinus Arrhythmia?
How do you treat it? |
1.Sinus Bradycardia with symptoms can occur during exhalation:
2. Same as Sinus Bradycardia with symptoms (ADE) Atropine 0.5mg up to3mg Dopamine 2-10mcg/kg/min CI Epi 2-10mcg/kg/min CI Pacing (need to speed up the heart or hit the gas pedal |
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Sinus Sick Syndrome occurs when you see the EKG having
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Bradycardia with intermittent Tachydysrhythmias
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Causes of Sick Sinus Syndrome
Complications of Sick Sinus Syndrome |
Causes:
1. Ischemia 2. degeneration of the SA node Complications: 1. Heart Failure 2 Thromboembolism (CVA) 3. Decreased cerebral blood flow |
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Treatment of Sick sinus syndrome
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1. Permanent pacemaker
2. Digoxin or Beta Blockers |
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What happens during a Premature Atrial Contraction (PAC)
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1. The irritable atria fires prematurely
2. It produces a single ectopic (extra) beat 3. The conduction through the ventricles are normal 4. P wave may look funky 5. Ekg may show a pause to compensate for the extra beat |
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Causes of PAC
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1. Stress &Caffeine
2. Tobacco & Hypoxia 3 Atrial enlargement 4. Infection/inflammation 5. Myocardial ischemia |
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You arrive at your clients room and notice on the EKG monitor they are having PAC's. Your instructor tells you that PAC's are warning signs for what?
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1. PAC's may be a warning sign for impending Atrial Tachycardia (SVT) and Atrial Fibrillation
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Atrial Tachycardia (SVT) RRPPQ
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R: Rhythm is constant and regular
R: Rate is 150-250 P: there is a P wave for every QRS, but may be hidden P: PRI less than 1/2 R to R QRS: tall skinny and at least 15 |
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Atrial Tachy (SVT) Causes
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1. Rheumatic heart disease
2. Pulmonary disorders 3. Stress and Hypoxia 4. Caffeine and Marijuana 5. Sympathomimmetic drugs (EPI, and Ephedrine) |
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Treatment for Atrial Tachycardia (SVT)
Asymptomatic: Symptomatic: |
Asymptomatic:
None if only short burst are present Symptomatic: 1. Cardioversion 2. Vagal stimulation 3. Adenosine 4. Calcium channel blockers 5. Beta blockers 6. Digoxin 7. *Cordarone* |
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Atrial Flutter
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Irritated atria initiates electrical impulse
Flutter waves on EKG (F WAVES) AV node blocks some of the impulses to protect the ventricles from a High HR * 3 squiggles per QRS* * Has a high risk for a thrombus* |
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Cause of Atrial flutter
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1. CAD
2. PE 3. Mitral valve disease 4. Thoracic surgery 5. COPD |
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Atrial flutter treatment
Symptomatic: |
1. Cardioversion, however your patient needs to be in A flutter less than 48 hours due to complications.
2. When in doubt do not cardiovert treat them as asymptomatic |
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Atrial flutter treatment
Asymptomatic |
1. Cardizem 10-20mg IV over 2 mins
2. Adenosine 6mg IV 3 Adenosine 12mg IV 4. Adenosine 12 mg IV |
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Atrial fibrillation
"Jelly in the jar" |
1.Atria loose the ability to pump blood effectively.
2. multiple atrial depolarization before ventricular depolarization 3. NO P WAVES PRESENT 4. QRS are irregularly, irregular |
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Treatment for Atrial Fibrillation
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Same as Atrial Flutter
1. Cardiovert 2. Cardizem 10-20mg iv over 2 mins 3. Adenosine 6 mg IV 4. Adenosine 12mg IV 5. Adenosine 12mg IV |
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Junctional Rhythms
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Impulse comes from the AV node
Impulse is multidirectional Causes the P wave to be upsidedown P wave can be before, during or after the QRS QRS is normal |
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What is the rate of a Junctional Rhythm?
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40-60 beats a min
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Premature Junctional Contraction
(PJC) |
The Junction of the AV node fires prematurely and produces an extra beat(s)
R: Rate is underlying based on strip P: Short PRI or no P wave Q: conduction through the ventricles is normal |
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Causes of PJC
Non Drug related causes |
1. Ischemia and Hypoxia
2. Pain and fever 3. anxiety 4. nicotine and caffeine 5. Electrolyte imbalces |
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what is the main drug associated with PJC's
How would you assess the effect of this drug? |
Digoxin overdose
Monitor s/s of overdose along with therapeutic level of digoxin |
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What electrolyte imbalances are common with PJC
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1. MAGNESIUM!!!!
2. Calicum, Potassium * remember the relationship calcium and magnesium have with each other* |
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How would you treat PJC's
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You would treat the cause of the PJC
1. if it is ischemia give them oxygen 2. if it is pain give them relief 3. if it is anxiety provide a sedative per md order 5. advise against smoking and caffeine 6. Monitor F/E\ *** need to be able to identify lab values, ABGs, and VS associated with each sign and symptom |
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Junctional Escape
START HERE |
Start here
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