Study sets, textbooks, questions
Upgrade to remove ads
Critical Care-Rhythms & Interventions
Terms in this set (26)
-Definition: heart rate less than 60 bpm
-If the pt is symptomatic:
*Pacing (aka a pacemaker)
*Atropine (0.5mg q3-5mg given iv injectin quickly) (DRUG OF CHOICE)
*Epinephrine (given if atropine isn't effective)
*Dopamine: (if low BP accompanies bradycardia, give this med via infusion.
Bradycardia: causes, s/s
Sinus Tachycardia: definition, causes, S/S
Definition: HR greater than 100, regular R-R rhythm
*sympathetic nervous system: anxiety, stress, pain, fever, exercise
`thyroid meds (Synthroid),
*compensatory response to decreased CO or BP:
-S/S: fatigue, weaknss, sob, palpitation, chest pain
Sinus Tachycardia: Interventions
-tx the underlying cause
*ex: if the tachycardia is caused by hemorrhage, RN must stop the bleeding and replace the blood & fluid.
-Digoxin (drug of choice)
-Calcium channel blockers
Atrial Flutter: def, intervention
-Definition: "Saw-toothed pattern"!
*regular/irregular: atrial & ventricular rate
-Intervention: a-fib and a-flutter is the same
-Atrial Flutter: Intervention
-If the pt is unstable:
-if the pt is stable:
*meds: diltiazam, digoxin
Atrial Fibrillation: defintion, Risk Factors
*absent: p-wave, atrial rate (P-P)
*irregular: ventricular rate (R-R)
*HTN, Thrombolytic event (ex TIA ,blood clot)
*CAD, Diabetes Mellitus
*HF, Mitral Valve Disease
*CABG post-op pts
Atrial Fibrillation: Intervention
*warfarin (Coumadin) [check PT/INR], Lovenox, Plavix
*digoxin, amioderone, beta blockers
*sedate the pt prior to doing this
*TEE: done prior to cardioversion to look for blood clots
Synchronized Cardioversion: definition
who is it a tx of choice for?
Cardioversion delivers electrical current to the heart to correct the dysthrymia.
*its synchronized to discharge at the peak of the R-wave.
*procedural sedation is administered PRIOR to cardioversion to reduce pt discomfort
*Ventricular tachycardia w/PULSE
-its the tx of choice for symptomatic pts
Defibriallation is the delivery of a unsynchronized, direct countershock to the heart.
defibrillation stops all electrical activity of the heart, allowing the SA node to take over and re-establish a perfusing rhythm.
Do v-fib pts ever have a pulse? ****
v-fib pts NEVER have a pulse!!!!!!!!!!!!!
Premature Ventricular Contraction (PVC)
*absent: p-wave, wide QRS!
*QRS greater than 0.12 seconds
PVC: Intervention, Symptoms
*treat the underlying cause
`ex: Hyokalemia-give diuretics
`ex: Hypokalemia-give Potassium
`ex too much caffeine-give de-caf coffee
*many pts are ASYMPTOMATIC
*many pt are ASYMPTOMATIC
*decreased peripheral pulses during PVC
3 PVC's in a row is called a _________?
Ventricular Tachycardia: def, rate?
what can it cause?
*absent: p-wave (P-P)
*shape: monomorphic, polymorphic, irregular-ventricualr rate
-It can cause cardiac arrest
-significantly decrased CO
V-tach Risk factors
-ischemic heart disease
-valvlar heart disease
what does tx depend on?
-tx depends on whether the pt is stable/unstable & if its monomorphic or polymorphic.
-Most invasive -> lease invasive
*if pts has a pulse: cardiovert
*if pts has no pulse: defibrillate
`ASAP-CODE THE PT (chest compressions, call for help, defibrillate, Epinephrine, assist with intubation)!!
-Meds: Amioderone, Atropine, Dopamine, Digoxin, Lidocaine
-check labs: K, Ca+, Magnesium. if any are low/high, they will cause v-tach.
Will the pt ever have a pulse?
*None: p-wave, QRS
-v-fib will never have a pulse
*initiate CPR: chest compressions, call for help, defibrillate
*meds: epniphrine, amioderone, lidocaine
*asssist with intubation
Can you defibrillate/Cardiovert/Pace the pt?
-Defintion: asystole is ventricular standstill. the pt is completly unresponsive, with no electrical activity in the heart and no cardiac output.
-chest compressions, call for help, epinephrine, assist with intubation
DO NOT defibrillate/Cardiovert/Pace the pt
Pulseless Electrical Activity: interventions
Can you defibrillate/Cardiovert/Pace the pt?
*chest compressions, call for help, epinephrine, assist with intubation
DO NO T defibrillate/Cardiovert/Pace the pt
-This is the dying heart.
3rd Degree Heart Block
-Defitnion: aka "complete heart block"
when the electrical impulse is completly blocked btw the atria and ventricle.
*the atria and ventricles aren't talking, functioing independently of one another.
*temporary pacing wires
Supraventicular Tachycardia (SVT)
*rate: 150-250 bpm
*present: p-wave, QRS-wave
*Vagal stimulation (ex: beardown, cough,
*meds: adenosin (seda
Which 2 rhythms will you NOT DEFIBRILLATE?
-how does defibrillation work? (aka "what does defibrillation attempt to do?)
-Defibrillate is NOT INDICATED when there is no electrical activity present (i.e ASYSTOLE) or when the heart muscle is not contracting despite an organized rhythm (i.e PULSELESS ELECTRICAL ACTIVITY_PEA).
-Defibriallation attempts to convert lethal ventricular dysrhythmias (i.e v-fib & pulseless v-tach) into a organized rhythm by passing an electrical shock through the heart.
*Defibrillation CANNOT CREATE A RHYTHM if there is no electrical activity present.
Sets with similar terms
4801 Adaptive Quizzing Review (Cardiac)
Types of dysrhythmias
Other sets by this creator
COMMON GREEK ROOT & PREFIXES
Arrythmia Day 2_BC
Day 1 Arrythmias_BC
Recommended textbook solutions
Clinical Reasoning Cases in Nursing
Julie S Snyder, Mariann M Harding
The Human Body in Health and Disease
Gary A. Thibodeau, Kevin T. Patton
Medical Terminology: Learning Through Practice
Paula Manuel Bostwick
Mecánica de Materiales
Barry J. Goodno, James M. Gere
Other Quizlet sets
MTAP 2 CC
Machine Learning 2019 Final Exam 25 March 2019
NSG 301 Exam 2 questions