JANUARY 24, 2018 - Calcium channel blockers are like valium for...

MARK KLIMEK

LECTURE #3

JANUARY 24, 2018

CALCIUM CHANNEL BLOCKERS

Calcium channel blockers are like valium for your heart. Calms the heart down. Indicators – tachycardia, tacharythmias Negative intropic, chronotropic, dromotropic (relax your heart, calm it down) They treat – A (antihypertensives), AA (antianginal), AAA (anti-atrial arythmia) they treat atrial dysrhythmias and supraventricular contractions (SVT) Names – majority end in -dipine (amlodipine, nifedipine) & verapamil, cardizem (can be given as a continuous IV drip) Side effects – headache & HYPOtension (take BP before administering, hold if systolic is <100)

CARDIAC ARRYTHMIAS

QRS refers to – Ventricular P refers to – Atrial

ATRIAL FLUTTER

Rapid P wave repolarizations in a saw tooth pattern This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 21:04:50 GMT -05:00

https://www.coursehero.com/file/30072914/Mark-Klimek-Lecturesdocx/

ATRIAL FIBRILLATION

chaotic QRS depolarizations, heart rate is irregular

TX: HEPARIN first, then ABCD

VENTRICULAR FIBRILLATION

Chaotic QRS depolarizations

TX: defibrillation (shock them)

VENTRICULAR TACHYCARDIA

Wide bizarre QRS’s

TX: Lidocaine & amiodarone

• This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 21:04:50 GMT -05:00

https://www.coursehero.com/file/30072914/Mark-Klimek-Lecturesdocx/

ASYSTOLE

a lack of QRS repolarizations

TX: epinehphrine & atropine

PVC Periodic wide, bizarre QRS’S. If there are more than 6 PVCs in a minute, or 6 in a row, you elevate the priority to moderate. PVC are not priority. NOT necessary to contact HCP.

TX: lidocaine & amiodorone

LETHAL ARRYTHMIAS

Asystole Ventricular fibrillation

POTENTIALLY LIFE THREATENING

Ventricular tachycardia (have a cardiac output, pulse) Atrial fibrillation Atrial flutter

PVC

3 In order of This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 21:04:50 GMT -05:00

https://www.coursehero.com/file/30072914/Mark-Klimek-Lecturesdocx/

HOW DO YOU TREAT SUPRAVENTRICULAR (ATRIAL) ARRYTHMIAS?

Adenocard (adenosine – push in less than 8 seconds, fast and don’t worry about asystole) Beta blockers (-lol) Calcium channel blocker Digitalis (lanoxin, digoxin)

CHEST TUBES

Purpose  re-establish negative pressure in the pleural space (negative is good in pleural space, makes things stick together) In a pneumothorax, chest tube removes  air In a hemothorax, chest tube removes  blood You have a patient with a chest tube in for a hemothorax, what would you report to HCP?

1.Chest tube is not bubbling 2.Chest tube drained 800 mL in first 10 hours 3.Chest tube is not draining (because it is not doing what it is supposed to do) 4.Chest tube is intermittently bubbling

LOCATION OF CHEST TUBES

Apical chest tube  way up high, removes air because air rises (A for Apical) Basilar chest tube  bottom of the lungs, removes blood (B for Blood)

WHAT DO YOU DO IF A WATER SEAL BREAKS?

1.Clamp it (FIRST) 2.Cut broken device off of tube 3.Put the end of the tube in NS 4.Unclamp it (because you’ve reestablished the water seal) 4 BEST thing to do is put in This study source was downloaded by 100000857336479 from CourseHero.com on 03-13-2023 21:04:50 GMT -05:00

https://www.coursehero.com/file/30072914/Mark-Klimek-Lecturesdocx/