.png){kind=logo}
This study source was downloaded by 100000820363976 from CourseHero.com on 07-29-2021 20:27:04 GMT -05:00
https://www.coursehero.com/file/30072914/Mark-Klimek-Lecturesdocx/
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
2
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
3
pulse)
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, • Atrial fibrillation • Atrial flutter
• PVC
In order of
4
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?
- Chest tube is not bubbling
- Chest tube drained 800 mL in first 10 hours
- Chest tube is not draining (because it is not doing what it is supposed to do)
- 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?
- Clamp it (FIRST)
- Cut broken device off of tube
- Put the end of the tube in NS
- Unclamp it (because you’ve reestablished the water seal)
BEST thing to do is put in
.png)