Dysrhythmias (Including EKG Strips)

Dysrhythmias (Including EKG Strips) (nclex) ScienceMedicineCardiology dane_schultz Save EKG Strips 35 terms jferkfer410Preview ACLS Pre-Course Self-Assessment 60 terms dad2jamesPreview CLC Exam 193 terms jrwalker93Preview Dysrhy 17 terms Tor Normal Sinus Rhythm Refers to a rhythm that originates in the SA node @ a rate of 60-100 BPM and follows normal conduction pattern of the cardiac cycle.Sinus Bradycardia The conduction pathway is the same as that in sinus rhythm but the SA node fires @ a rate of less than 60 BPM. May be normal in athletes.Pale, cool skin, hypotension, wekness, angina, dizziness or syncope, confusion or disorientation, and shortness of breath.Symptomatic Sinus Bradycadia S/S (P/HYPOHTN/W/A/D/S episodes/C/Dist/SOB Admin of atropine, or pacemaker therapy. If due to drugs; must be held, discontinued, or dosages reduced.Symptomatic Sinus Bradycardia Tx

Sinus Tachycardia The conduction pathway is the same as that in sinus rhythm. The discharge rate from the sinus node increases because of vagal inhibition or sympathetic stimulation. the sinus rate is 101-200 BPM.Dizziness, dyspnea, and hypotension due to decreased CO. Increased O2 consumption due to increased HR. Angina or an increase in infarction size may accompany this disorder in pts with CAD or AMI Sinus Tachycardia S/S (D/Dsp/HYPOHTN due to decreased ?/ Increased ? consumption due to increased heart ?/A/Increase in size of ?The underlying cause determines treatment, eg.) pain management if d/t pain. In stable pts vagal manuevers can be attempted. Beta-adrenergic blockers Sinus Tachycardia Tx (Managment of ?/BB/ ? manuevers Atrial Flutter An atrial tachydysrhythmia identified by recurring, regular, sawtooth-shaped flutter waves that originate from a single ectopic focus in the right atrium, less commonly, can occur in left atrium. Atrial Rate is 240-250. Av node blocks most of the impulses so ventricles contract somewhat normally.High venticular rate; loss of atrial 'kick'. Decreased CO, HF: esp in pts with underlying heart disease, and increased risk of stroke.Atrial Flutter S/S (HVR/Loss of atrial ?/ decreased ?/HF/ risk of ?Coumadin, slow ventricular response by increasing AV block, calcium channel blockers, beta-adrenergic blockers, electrical cardioversion, antidysrhythmia meds, and radiofrequency catheter ablation.Atrial Flutter Tx (Slow ? response by ? AV block/ C/ CCB/ BB/Anti-? meds/EC/RCA Atrial Fibrillation Characterized by a total disorganization of atrial electrical activity due to multiple ectopic foci resulting in loss of effective atrial contraction. No identafiable or misshaped P-wave.Usually occur with underlying heart disease. Decreased CO, thrombi form in atria due to blood stasis, causes 20% of all strokes.Atrial Fibrillation S/S ( Decreased ?/ (T) in atria from stasis)

Goals include decreased ventricular repsonse (<100>

Ventricular Trigeminy When every third beat is a PVC Couplet Two consecutive PVCs Ventricular Tachycardia A run of 3 or more PVCs. It occurs when an ectopic focus or foci fire repetively and the ventricle takes control as the pacemaker.Stable- pt has pulse. Unstable- pt has no pulse. Severe decreased CO, loss of atrial contraction, hypotension, pulmoary edema, decreased cerebral blood flow, and cardiopulmonary arrest. Patient will not stay asymptomtic and both will require electrical therapy.Ventricular Tachycardia S/S (Stable pt has ? unstable has no ?/ severe decrease in ?/ loss of ? contraction/ HYPOHTN/E/Decreased ? blood flow/ CPA/ Requires ? therapy.Precipitating causes must be treated and identified. If pt is monomorphic & hemodynamically stable and has preserved left ventricular function: IV procainamide, sotalol, amiodarone, or lidocaine. If hemodynamically unstable ro poor left ventricualr function: IV amiodarone or lidocaine and cardioversion.Monomorphic Ventricular Tachycardia Tx ( ? meds to preserve ? ventricle function) With a normal baseline QT interval: Beta-adrenergic blockers, lidocaine, amiodarone, procainamide, or sotalol. Cardioversion if drug therapy is innefective. Prolonged QT intervals: IV magnesium, isopoterenol, phenytoin, lidocaine, or antitachycardia pacing.Polymorphic VT Tx (All these need normal ? interval/ BB/Lid/CV drug therapy if ineffective) Monomorphic Ventricular Tachycardia QRS complexes that are the same shape, size, and direction.