Cardiac Dysrhythmias Part 2
Questions with Complete
Solutions
Describe treatment of dysrhythmias - Answer - : To determine if treatment
is necessary, assess the patient. Then ask the following questions:
Is he or she experiencing signs and symptoms of decreased
cardiac output?
Is the dysrhythmia potentially life threatening?
If the answer to either of these questions is yes, the patient will
need to treatment for the dysrhythmia.
What are the Hs and Ts (potential causes of rhythm issues)? - Answer - :
Hypovolemia
Hydrogen ions (acidosis)
Hyper/hypokalemia
Hypoxia
Hypothermia
Hypervagal
Hypoglycemia
Malignant Hyperthermia
Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis (cardiac)
Thrombosis/embolus (pulmonary)
Trauma
QT prolongation
Pulmonary hypertension
What categories can dysrhythmias be divided into for determining treatment? -
Answer - : Bradycardias
, Tachycardias
Pulseless arrest
What are the steps for treatment of dysrhythmias in general? - Answer - :
Identify and treat underlying cause (might need to treat
emergently if the patient has manifestations of decreased cardiac
output)
Maintain airway
Give O2
IV access
12 Lead ECG (but should not delay treatment)
How do you treat bradycardia dysrhythmias? - Answer - : If a patient is
experiencing altered mental status, chest pain, dyspnea,
lightheadedness, hypotension, or ventricular ectopy, treatment
should be instituted:
Give O2; give fluids (to normalize BP)
Atropine 0.5 mg IV (drug of choice) (maximum dose 3 mg) (while
awaiting pacemaker)
Transcutaneous pacing (if available)
Prepare for transvenous pacing
Dopamine (2-10 mcg/kg/min), or Epinephrine (0.05-0.1
mcg/kg/min) (if a transcutaneous pacemaker is unavailable and
patient not responsive to atropine)
How do you treat tachycardia dysrhythmias (with a pulse)? - Answer - :
Tachycardic dysrhythmias are divided into unstable & stable; and
if stable, narrow QRS & wide QRS
If stable, measure QRS
Tachycardia may be related to
Patient being to "light" after anesthesia (if pupils pinpoint=not
"light")
Hypovolemic
Hyperthermic
Early hypoxia or hypercapnia
Questions with Complete
Solutions
Describe treatment of dysrhythmias - Answer - : To determine if treatment
is necessary, assess the patient. Then ask the following questions:
Is he or she experiencing signs and symptoms of decreased
cardiac output?
Is the dysrhythmia potentially life threatening?
If the answer to either of these questions is yes, the patient will
need to treatment for the dysrhythmia.
What are the Hs and Ts (potential causes of rhythm issues)? - Answer - :
Hypovolemia
Hydrogen ions (acidosis)
Hyper/hypokalemia
Hypoxia
Hypothermia
Hypervagal
Hypoglycemia
Malignant Hyperthermia
Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis (cardiac)
Thrombosis/embolus (pulmonary)
Trauma
QT prolongation
Pulmonary hypertension
What categories can dysrhythmias be divided into for determining treatment? -
Answer - : Bradycardias
, Tachycardias
Pulseless arrest
What are the steps for treatment of dysrhythmias in general? - Answer - :
Identify and treat underlying cause (might need to treat
emergently if the patient has manifestations of decreased cardiac
output)
Maintain airway
Give O2
IV access
12 Lead ECG (but should not delay treatment)
How do you treat bradycardia dysrhythmias? - Answer - : If a patient is
experiencing altered mental status, chest pain, dyspnea,
lightheadedness, hypotension, or ventricular ectopy, treatment
should be instituted:
Give O2; give fluids (to normalize BP)
Atropine 0.5 mg IV (drug of choice) (maximum dose 3 mg) (while
awaiting pacemaker)
Transcutaneous pacing (if available)
Prepare for transvenous pacing
Dopamine (2-10 mcg/kg/min), or Epinephrine (0.05-0.1
mcg/kg/min) (if a transcutaneous pacemaker is unavailable and
patient not responsive to atropine)
How do you treat tachycardia dysrhythmias (with a pulse)? - Answer - :
Tachycardic dysrhythmias are divided into unstable & stable; and
if stable, narrow QRS & wide QRS
If stable, measure QRS
Tachycardia may be related to
Patient being to "light" after anesthesia (if pupils pinpoint=not
"light")
Hypovolemic
Hyperthermic
Early hypoxia or hypercapnia
