Summary ACUTE FINAL STUDY GUIDE SP'17 -

ACUTE FINAL STUDY GUIDE SP’17 –

EXAM #2 – DYSRHYTHMIAS
 Electrophysiology
o SA  60-100bpm
o AV  40-60bpm
o BOH  40-60bpm
o Perkinje fibers  20-40bpm
 What Affects the HR?
o Autonomic nervous system
 Parasympathetic
 Decreases
 Sympathetic
 Increases
o Baroreceptors
 Dysrhythmias
o Heartbeat disturbances
 Formation, conduction, or myocardial response
o Causes
 MI
 Hypocia
 Acid base imbalances
 Drug alcohol abuse
 Hypovolemia
 Shock
 Cardiovascular diseases
 Electrolyte imbalances
 Atrial Problems
o Normal sinus rhythm vs. Afib




o Reading Tele-strips
 Regular or irregular
 Count the rate
 Are there P waves for each QRS? And do they look the same?
 Are the ST segments at baseline?
o Atrial Fibrillation (A-Fib)

, o Atrial Flutter (A-flutter)




o Nursing Interventions with Atrial Problems
 Meds
 Anticoagulation
o Heparin, Coumadin, Xarelto
 Betablockers
 CCB
 Digoxin
 Amiodarone
 Verapamil
 Adenosine
 Cardioversion
 Controlled setting
 Ablation
 Ventricular Problems
o Ventricular Tachycardia (V-Tach)




o Ventricular Fibrillation (V-Fib)

, o Problems with Ventricular Arrhythmias
 CPR
 Death
o Nursing interventions with Ventricular problems
 Defibrillate
 CPR
 Meds
 Amiodarone
 Lidocaine
 Epinephrine
 Asystole




o Problems with Asystole
 Death
 Pacemakers
o Permanent
 Chronic or recurrent dysrhythmias
 Fixed  always paces at a constant rate
 Demand  detects at a preset rate only if HR is bellowing a certain level
o Temporary  emergency situations
 External
 Epicardial
 Endocardial
o Nursing Interventions
 CXR
 Bleeding and infection
 Arm sling
 Counting pulse
 No MRI
 Carry ID card
 Electronics carried on opposite side
 AICD (Automatic Internal Cardiac Defibrillator)
o Can be inserted for defibrillator use
 Post MI
 Severe heart failure