This study source was downloaded by 100000829310167 from CourseHero.com on 07-27-2021 07:01:19 GMT -05:00

This study source was downloaded by 100000829310167 from CourseHero.com on 07-27-2021 07:01:19 GMT -05:00 https://www.coursehero.com/file/65067074/Mark-Klimek-Audio-Lecture-3-Cardiacdoc/ Mark Klimek Audio Lecture #3 Cardiac

Calcium Channel Blockers are like Valium for your heart (calms your heart down)

CCB’s are negative inotropics, negative dromotropics, and negative chromotropics.Weaken, slow down, and depress the heart. Cardiac depressant.

They treat: A, A-A, and A-A-A

Anti-hypertensive – relaxes heart and blood vessels – BP goes down Anti-Angina – relaxes the heart – decreases oxygen demand – pain goes away Anti-Atrial-Arrhythmia= it treats everything atrial related = treats supra ventricular tachycardia (supra means above, above the ventricle is the atrial).

Side effects: Headache & Hypotension

Headache (vasodilation in the brain) Hypotension (relaxes the heart and the blood vessels) Monitor BP intermittently. If systolic is <100, hold!

Names of CCB’s:

Names ending in “dipine” (You're dipping in the calcium channel) ⮱ amlodipine, felodipine, isradipine, nicardipine, nifedipine, nisoldipine Verapamil, Diltiazem, Cardizem [Cardizem = Continuous IV drip] ⮱ For drip, monitor BP continuously. If systolic BP is 98 titrate it down.

This study source was downloaded by 100000829310167 from CourseHero.com on 07-27-2021 07:01:19 GMT -05:00 https://www.coursehero.com/file/65067074/Mark-Klimek-Audio-Lecture-3-Cardiacdoc/ Mark Klimek Audio Lecture #3 Cardiac

This study source was downloaded by 100000829310167 from CourseHero.com on 07-27-2021 07:01:19 GMT -05:00 https://www.coursehero.com/file/65067074/Mark-Klimek-Audio-Lecture-3-Cardiacdoc/ Mark Klimek Audio Lecture #3 Cardiac

Cardiac Arrhythmias (#03 – time13:33)

• Normal sinus rhythm - Peaks of p waves are evenly spaced

• V-fib - Chaotic squiggly line. No pattern

• V-tach - Sharp peaks & jags. There's a pattern

• Asystole - Flat line

• Atrial Flutter

• Atrial Fibrillation

• PVCs

This study source was downloaded by 100000829310167 from CourseHero.com on 07-27-2021 07:01:19 GMT -05:00 https://www.coursehero.com/file/65067074/Mark-Klimek-Audio-Lecture-3-Cardiacdoc/ Mark Klimek Audio Lecture #3 Cardiac

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Terminologies (time 19:50)

P wave- Answer will always be atrial Lack of a P wave- is ventricular QRS depolarization- Answer will always be ventricular

Six rhythms most tested on NCLEX

• Asystole – “a lack of QRS” depolarization’s (a straight line); NO ventricular action at all

• Atrial flutter – “SAW TOOTH”

Rapid P-wave depolarization’s in a saw-tooth (flutter)

Fibrillation - always described with the word CHAOTIC

• Atrial fibrillation

⮱ Chaotic P-wave depolarization’s (lacks any discernable pattern)

• Ventricular fibrillation

⮱ Chaotic QRS depolarization

Tachycardia – always describe with the word BIZARRE

• Ventricular tachycardia

⮱ Wide, bizarre QRS’s ⮱ Tachy is always discernable repeating pattern

• Premature ventricular contractions (PVCs)

⮱ Periodic wide, bizarre QRS’s – short run of VTachs ⮱ Generally are low to moderate priority. unless everyone else has a normal rhythm

⮱ Be concerned, if:

• More than 6 PVCs per minute - if there is any change in rhythm Check Pulse and BP
• If there are 6 PVCs in a row
• PVC falls of T-wave of previous beat

Low Priority:

Premature ventricular contraction (PVC) A bunch of PVC’s is like a short run of V-Tach

Moderate Priority:

If more than 6 PVC’s in a minute, or if there are more than 6 PVCs row, or if the PVC falls on the T wave of the previous beat.(R on T phenomenon)

They are NEVER a high priority High Priority

Lethal / Life Threatening: Kills you in 8 mins or less.

Prioritize!! – THERE IS NO CARDIAC OUTPUT Asystole- No pulse V-fib- No pulse

Potentially Life Threatening:

V-Tach- Patient has a pulse – still have cardiac output