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Ch. 36 Dysrhythmia Care
Terms in this set (20)
What does the p wave represent?
What are t cells (transitional cells) for in the heart?
They cause impulses to slow down or be delayed in the av node before proceeding to ventricles. This gives time for atrial kick
State the flow of electricity in the heart
SA node -->AV node -->; Bundle of His --> Left and right bundle branches -->Purkinje fibers
What does the PR segment represent?
The delay in the AV node, thus showing how long it takes for the impulse to travel through the av node
True or false. Electrode placement is different for women than for men?
What is the baseline called for an ecg?
The isoelectric line
If electrical current is flowing toward a positive electrode, which way will the deflection go?
If electircal current is flowing away from positive pole, which way will deflection go?
In a standard bipolar limb lead, what is the charge for the right arm, left leg, and left arm?
Right arm always negative
Left leg always positive
Left arm can be either positive or negative
True or false. A sinus arrhythmia is normal?
What is a sinus arrhythmia?
Just like normal sinus rhythm except the Heart Rate increases slightly during inspiration and decreases slightly during exhalation. Irregular
Can digitalis cause a sinus arrhythmia?
Can morphine cause a sinus arrhythmia?
For who are you most concerned for with tachydysrhythmias?
Those who have coronary artery disease (CAD). U decrease diastolic time so there is less blood flow to the coromary arteries
With bradydysrhythmias, when should u really be concerned?
If BP starts dropping or pt is symptomatic
What are benefits to bradydysrhythmias?
Less o2 demand on heart
Good coronary perfusion time
What is the negative to bradydysrhytmias?
Coronary perfusion decreases if HR too slow to provide adequate cardiac output
A pt is being transported from the floor to the ICU. He is at risk for bradydysrhythmia. What would be your intervention before letting him be transported?
Noninvasive temporary pacing, set to kick in if HR drops during transport.
Where should you place the pacing electrodes if you have a female pt?
Below breast on the apex side
Describe what you would do to pace a patient?
1) Wash skin with soap and water
2) Apply electrodes per package instructions
3) Turn pacer on, set rate as ordered and establish a stimulation threshold (lowest current that achieves capture).
4) While pacing, palpate RIGHT radial or carotid pulse, and BP to assure perfusion. Vitals cannot be taken on left side because they may not be accurate with the voltage.
5) Observe for discomfort (muscle stimulation, skin irritation, excessive sweating).
6) Give analgesics or sedatives as prescribed for comfort.
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