review 3rd semester

Last update by Joe on 11/30/2010
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Signs and symptoms of dysrhythmias

irregular rate and rhythm
low or high blood pressure
low O2 sats
chest, arm, neck, back, shoulder, jaw pain
extreme restlessness
feelings of impending doom
numbness or tingling
weak and fatigue
cold, clammy

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Related Quiz Content
  • tpr27
    normal sinus rhythm
    rate - 60-100
    rhythm - regular
    P wave, PR interval, QRS complex are normal
  • tpr27

    sinus bradycardia

    rate is slower than 60 beats/min
    may be normal in athletes

    chest pain (may not be enough oxygen to heart)

    Treatment -atropine
  • tpr27
    sinus tachycardia

    rate > 100 beats per minute
    normal in infants and children

    caused by stressors such as pain, fever, hypovolemia, hypoxia, etc.
    Treatment - treat symptoms
    if pain - manage pain
    if hypovolemia - fluids
    Adenosine - prolongs repolarization
    lopressor - reduces heart rate and myocaridal oxygen consumption

  • tpr27
    Premature atrial contraction (PAC)

    hidden P wave, irregular rhythm
    can be caused by stress, fatigue, caffeine, tobacco, alcohol

    if heart is healthy, isolated PACS are not significant
    withdrawal source of stimulants
    Beta-adrenergic blockers

  • tpr27
    Paroxysmal supraventricular tachycardia (PSVT)
    rate >100
    P wave may be hidden
    occurs sometimes - abrupt onset and termination
    associated with overexertion, emotional stress, stimulants

    Treat underlying cause
    adenosine - first drug of choice to convert PSVT into normal sinus
    beta-adrenergic blocker
    amiodarone (cordarone)
  • tpr27
    Atrial flutter

    QRS normal, but atrial response sawtooth from 1 irritable foci

    warfarin (coumadin) to prevent stroke when flutter is greater than 48 hr
    primary goal - slow the atrial response by increasing AV block
    Calcium channel blockers and Beta-adrenergic Blockers
    electrical cardioversion
    Antidysrhythmic drugs convert flutter to sinus - admiodarone
    EPS - ablate irritable foci

    risk for stroke

  • tpr27
    Atrial fibrillation
    most common dysrhythmia
    multiple ectopic foci - loss of effective atrial contraction
    Atrial - 350-600 beats/minute
    random appearance

    Risk for stroke - thrombi may develop
    atria doesn't fully eject blood each contraction

    If chronic, sustained - Priority med - coumadin, 81 mg aspirin
    calcium channel blockers - diltiazem
    B-adrenergic blockers - metoprolol (lopressor)
  • tpr27
    junctional dysrhythmias
    SA node fails to fire or the signal has been blocked
    AV node becomes pacemaker
    HR 40-60 beats/minute
    P wave inverted or higgen

    Atropine to increase atrial activity
    DC conversion should not be used
    rate control - B-adrenergic blockers, calcium channel blockers
  • tpr27
    1st degree AV block
    Prolonged PR (greater than 0.2 sec.)
    no treatment
    modifications to causative medications
    continue to monitor
  • tpr27
    2nd degree AV block Type I
    not all P waves are followed by QRS

    atropine to increase HR
    may need pacemaker
  • tpr27
    2nd degree AV Type II
    P wave is nonconducted for a certain number of impulses 2:1 or 3:1
    permanent pacemaker needed

review 3rd semester
review 3rd semester
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