Dysrhythmias (Part 2) Test Questions with 100% Complete Answers, A+

Dysrhythmia - cORRECT sOLUTION Any disorder of the heart beat or heart rhythm. Cardiac output is impaired. Cellular oxygenation is then also impaired Electrical problem will definitely effect the mechanical but a mechanical problem may not effect the electrical. Explaining dysrhythmias - cORRECT sOLUTION -Classified to their site of origin -SA node atrial tissue, AV node, junctional tissue (tissue around AV node), and ventricular tissue -Caused by a disturbance in impulse formation or by conduction delays or blocks Tachydysrhythmias - cORRECT sOLUTION -HR 100 -Shorten diastolic time (filling of vent. so not enough to push out) and coronary perfusion time. -Increase work of heart, increase myocardial O2 demand Bradydysrhythmias - cORRECT sOLUTION -Heart rate 60 -Rate too slow to provide adequate cardiac output. (Doesn't give body what it needs fast enough) Premature complexes - cORRECT sOLUTION -Occurs when a cell OTHER THAN THE SA NODE becomes irritable and fires an impulse before the next sinus complex -Can be atrial, junctional, ventricular -If frequent can cause decrease CO Paroxysmal - cORRECT sOLUTION -Rhythm is intermittent (self limiting and ends on it's own - can be A.Fib) -Initiated be a premature beat (i.e. PAC, PVC) -Resolves without intervention (self limiting) ***Symptoms commonly seen with dysrhythmias*** - cORRECT sOLUTION -Hypotension* -Dizziness/Syncope -SOB -Chest pain -Palpitations -Weakness and fatigue -Anxiety or restlessness -Diaphoresis -Pale, cool skin -Delayed cap refill -Decreased urine output Can be very vague like just feeling tired/fatigued A sign of decreased perfusion is a symptom of dys. normal sinus rhythm - cORRECT sOLUTION refer to notes for helpful chart Sinus bradycardia - cORRECT sOLUTION -All the characteristics of NSR except heart rate is LESS than 60BPM (Can be normal in a conditioned athlete or long term BB/anxiety drug use) -Causes: Vagal stimulation (cough/strain w/ BM) temporary Beta Blockers Antianxiety meds Conditioned athlete -Treat ONLY if the patient is symptomatic Atropine (anticholinergic - Increases HR by working on the nervous system) Sinus tachycardia - cORRECT sOLUTION -All of the characteristics of NSR except a heart rate GREATER than 100 bpm -Causes: Anxiety, fright, stress Exercise Pain, fever Alcohol ingestion (even if just sitting on couch) Hypovolemia Hypoxemia Meds: caffeine, catecholamines, atropine, nicotine, thyroid meds, dopamine -Treat ONLY if patient is symptomatic -Treat the CAUSE! (ie. anxiety=antianxiety med, pain=pain meds) Keep assessing b/c something is going on even if you don't see it yet Atrial dysrhythmias - types - cORRECT sOLUTION -Four types you need to know 1. Premature Atrial Contraction (PAC) 2. Superventricular Tachycardia (SVT) 3. Atrial fibrillation 4. Atrial flutter Atrial dysrhythmia causes - cORRECT sOLUTION -Hypoxia -Stress -Anxiety -Electrolyte imbalance -Myocardial Ischemia -Infection -Fatigue -Drugs: stimulants, anesthesia, digoxin -Caffeine, alcohol, nicotine (biggest causes) Premature atrial contractions (PAC's) - cORRECT sOLUTION -Ectopic foci in the atrial tissue - a cell in the atria that does not normally create an impulse, becomes irritable and creates an electrical impulse -NSR and beat that comes early -NOT life threatening Treatment of PAC - cORRECT sOLUTION -If asymptomatic, none -O2 (if becomes more freq.) -Electrolyte replacement (look at K and MG) -If frequent antidysrhythmics -Amiodarone, metoprolol, digoxin