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33 Cards in this Set
- Front
- Back
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dysrhythmia |
abnormal rhythm of the heart's electrical system |
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Causes of dysrhythmias |
-CAD -electrolyte imbalance -changes in oxygenation -drug toxicity -hypoxia -MI ...and others |
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Heart conduction pathway |
SA node--> |
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Pacemaker of the heart |
SA node (60-100 bpm) |
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AV node initiate electrical impulses at how many beats per minute? |
40-60
(backup pacemaker) |
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If the SA and AV node do not initiate heart beat, which system takes over? |
Bundle branch system (20-40 beats/min) |
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Where are leads placed for ECG? |
-limbs -chest |
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ST Segment |
early ventricular repolarization |
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U Wave |
late ventricular repolarization |
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QT Segment |
Total time of ventricular depolarization and ventricular repolarization |
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PR Interval length? |
0.12-0.2 seconds (5 small boxes) |
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QRS duration? |
0.04-0.12 seconds (<3 small boxes) |
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Big box method |
300/number of big boxes |
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Small box method |
1500/number of small boxes |
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When do you use the 6-second strip method? |
when heartbeat is irregular |
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ECG Rhythm analysis steps |
1. determine HR 2. determine heart rhythm (reg/irreg) 3. analyze P waves 4. measure PR interval 5. measure the QRS duration
if everything is within norms, you can say this is a normal sinus rhythm |
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Normal sinus rhythm |
-HR 60-100 -Rhythm: Regular -P wave before each QRS, identical -PR interval .12-.2 seconds -QRS <1.2 seconds |
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Sinus Arrhythmia |
-HR 60-100 -Irregular rhythm -P wave before each QRS, identical -PR interval .12-.2 seconds -QRS <.12 seconds
Normal...can be caused by taking a deep breath, holding your breath, etc. |
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Tachy-dysrhythmias classification |
when the rate of the SA node discharge exceeds 100 bpm |
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Clinical manifestations of tachycardia |
-SOB -Diaphoresis - |
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Rules for Sinus Tachycardia |
Regularity: R-R intervals are regular, overall rhythm is regular Rate: over 100 bpm but usually less than 170 P WAVE: one Pwave in front of every QRS. Pwaves appear uniform. PRInterval: measures between 0.12 and 0.2 seconds in duration. PRI is consistent QRS: Measures less than 0.12 seconds |
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Sinus Tachycardia treatment |
-treat the cause -stable or unstable? -O2, IV therapy, rest, antipyretics, beta-adrenergic agents -Drugs (diltiazem, adenosine) -synchronized cardioversion |
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Rules for Sinus Bradycardia |
Regularity: R-R intervals are regular, overall rhythm is regular Rate: less than 60 bpm, usually more than 40 P Wave: One Pwave in front of every QRS, waves appear uniform PRI: 0.12-0.2, PRI is consistent QRS: measures less than 0.12 seconds |
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Sinus Bradycardia Interventions |
Assess patient to see if they are symptomatic
If symptomatic, treat as an emergency -oxygen -atropine (may cause tachycardia, don't use in pats with closed-angle glaucoma) -Isuprel -replace volume -external pacemaker -no straining/bearing down--could drop BP even more
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Sinus Bradycardia manifestations |
-syncope -dizziness/weakness -confusion -hypotension -diaphoresis -SOB -anginal pain |
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Premature Atrial Contraction (PAC) |
-can be caused by drinking too much caffeine -ectopic focus of atrial tissue fires an impulse before the next sinus impulse is due -most often benign, no intervention needed |
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Supraventricular Tachycardia (SVT) |
-rapid stimulation of atrial tissue occurs at a rate of 100-280 bpm with a mean of 170 bpm in adults -no P WAVE in front of the QRS complex |
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Paroxysmal supraventricular tachycardia (PSVT) |
rhythm is intermittent and terminated suddenly with or without intervention |
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SVT Manifestations |
-dependent upon rate and duration -chest pain, weakness, SOB, fatigue, nervousness, hypotension, anxiety, syncope -sustained SVT may result in heart failure, cardiogenic shock or angina |
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SVT Interventions |
-Treat the cause -oxygen -anty-dysrhythmic drugs--Adenosine, Cardiazem, Beta blocker -synchronized cardioversion, if patient is unstable -radiofrequency ablation--recurrent SVT -carotid massage can only be performed by the MD -have them bear down as if to have a bowel movement |
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Atrial Flutter Rules (sawtooth pattern) |
-atrial rhythm regular, ventricular rhythm regular or irregular -HR--ventricular rate varies -PWAVES- flutter or F wave with "sawtooth" pattern -PR interval-none measurable -QRS complex-0.06-0.1 seconds |
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Atrial Flutter Interventions |
same as for SVT beta blockers calcium channel blockers antiarrhythmic drugs, or amiodarone |
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Atrial Flutter |
HR: 220-430 bpm Rhythm: Regular or variable PWAVE: sawtoothed appearance PR Interval: none QRS: <0.12 seconds |
