Interventions Flashcards

1
Q

Interventions for Sinus Brady:

causes:

A

Oxygen, establish IV access, 12 lead EKG, aTropine

Hypoxia, OSA, beta blockers, hyperkalemia, hypothermia, hypothyroidism

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2
Q

Interventions for Sinus Tachycardia:

causes:

A

Correct underlying cause-fluid replacement, relief of pain, reduce fear or anxiety
(HR above 100 but less than 150)
(Acute MI, caffeine, dehydration, hypovolemia, drugs, exercise, fear, infection, pain, shock, pulmonary embolism)

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3
Q

Interventions for Sinus Arrhythmia:

causes:

A

No treatment unless it is accompanied by a slow rate with symptoms
(Heart rate increases with inspiration, decreases with expiration)

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4
Q

Abnormalities associated with Sinus Pause/Escape:

A

One missing QRS complex

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5
Q

Interventions for Sinus Pause/Sinus Escape:

causes:

A

Monitor for frequent episodes accompanied by slow rate

Hypoxia, Myocarditis, Acute MI

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6
Q

Abnormalities associated with Sinus Arrest:

causes:

A

More than one QRS complex is missing, no escape beat (lasts longer than 3 seconds)
(Damage to SA node, CAD, acute MI, OSA)

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7
Q

Interventions for Sinus Arrest:

A

Monitor for signs of hemodynamic compromise. If yes- give IV atropine, temporary pacing

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8
Q

Abnormalities associated with PAC

** Escape beat

A

P wave appears before it should

P wave is biphasic, pointed, or flattened

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9
Q

Interventions for PACs:

causes:

A

Continue to monitor, if frequent, correct underlying cause. Electrolyte imbalance, reduce stress, stimulants, treat heart failure
(Common in older adults, electrolyte imbalance, emotional stress, ACS, hyperthyroid, stimulants, heart failure)

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10
Q

Abnormalities associated with Multifocal Atrial Tachycardia:

A

Ventricular rate is above 100, wandering atrial pacemaker. P waves are visible but vary in size, shape, and direction

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11
Q

Interventions for Multifocal Atrial Tachycardia:

causes:

A

If symptomatic, call cardiologist.
Vagal maneuvers, IV adenoSine
(Severe COPD, ACS, Hypokalemia, Precursor for a. fib)

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12
Q

Abnormalities associated with Atrial Tachycardia/SVT:

A

Ventricular rate is above 150, P waves hopes differ, P waves may be lost in T waves

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13
Q

Interventions for Atrial Tachycardia/SVT:

causes:

A

If sustained and symptomatic, give oxygen, IV access, 12 lead EKG, adenoSine (not in severe asthma), synchronized cardioversion
(Digitalis toxicity, electrolyte imbalance, heart disease, infection, pulmonary embolism)

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14
Q

Abnormalities associated with Atrial Flutter:

A

Atrial waveforms are produced that resemble “sawtooth” pattern, rhythm is regular

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15
Q

Interventions for Atrial Flutter:

causes:

A

Consult cardiologist. Beta blockers, diltiazem, cardioversion (for severe signs and symptoms
(AV node is bypassed, pulmonary embolism, cardiac surgery, cardiomyopathy, myocarditis)

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16
Q

Abnormalities for Atrial Fibrillation:

A

Ventricular rhythm is irregular. No discernible P waves, erratic waves

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17
Q

Interventions for Atrial Fibrillation:

causes:

A

Diltiazem or beta blockers to control heart rate (avoid beta blockers for severe heart failure or pulmonary disease
(Cardiac conditions, non-cardiac conditions (DM, PE, Obesity))

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18
Q

Abnormalities associated with Premature Junctional Contractions (PJC)
** Escape beat

A

P waves may/may not be present, could be inverted

causes: heart failure, digitalis toxicity, electrolyte imbalance, stimulants

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19
Q

Interventions for Premature Junctional Contractions (PJC)

A

remove stimulus or dig toxicity (could be feeling lightheaded)

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20
Q

Abnormalities associated with Junctional Escape Beat:

A

usually no p wave, QRS comes after a pause and is narrow

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21
Q

Abnormalities associated with accelerated junctional rhythm:

A

QRS is usually narrow, pacing rate is 40-60 ppm, no p wave or inverted p wave

22
Q

Interventions associated with Accelerated Junctional Rhythm:

A

Monitor closely, remove digoxin if it’s the cause

23
Q

Abnormalities associated with Junctional Tachycardia:

A

Pacing rate is over 100, no P wave/inverted p wave

causes: acute coronary syndrome, dig toxicity, heart failure

24
Q

Interventions for Junctional Tachycardia:

A

Oxygen, 12 lead, vitals, adenoSine

25
Q

Abnormalities associated with PVC

*escape beat

A

Width is typically 0.12 seconds or greater, QRS comes early

26
Q

Interventions for PVCs

A

Oxygen, relief of pain, remove nicotine, decrease emotional stress

27
Q

Abnormalities associated with Ventricular Escape beat

A

QRS comes late, after a pause QRS is wide

28
Q

Interventions for Ventricular Escape Beat

A

Oxygen, IV access, 12 lead EKG, IV aTropine, transcutaneous pacing, dopamine drip

29
Q

Abnormalities associated with V. tach (mono or poly)

A

3 or more PVCs in a row, No P waves, vent rate 150-300

30
Q

Interventions for V. tach”

A

oxygen, IV access, CPR, defibrillation, **epinephrine, amiodarone, vasopressin

31
Q

Abnormalities associated with V fib:

A

Chaotic rhythm, rate p waves, QRS waves are not discernible

32
Q

Interventions for V. Fib:

A

CPR defibrillation, epinephrine, vasopressin, amiodarone, lidocaine

33
Q

Interventions for systole:

A

CPR, epinephrine

34
Q

Abnormalities associated with First Degree AV block:

A

PR interval constant and longer than 0.20 seconds

35
Q

Interventions for First Degree AV block:

A

Monitor closely

36
Q

Abnormalities associated with Second Degree AV block type I:

A

PR interval NOT constant, PR interval prolongs until dropped QRS

37
Q

Interventions for Second Degree AV block type I:

A

Atropine, oxygen, vitals, 12 lead EKG

38
Q

Abnormalities for Second Degree AV block type II:

A

PR interval is constant, too many Ps for one QRS

39
Q

Interventions for Second Degree AV block type II:

A

Atropine, oxygen, vitals, 12 lead EKG

40
Q

Abnormalities for Third Degree AV block:

A

PR interval is not constant, QRS rhythm is regular

41
Q

Interventions for Third Degree AV block:

A

Atropine, oxygen, vitals, 12 lead EKG, permanent pacemaker

42
Q

Which rhythms can you cardiovert?

A

SVTs (tachys) and unstable atrial rhythms

43
Q

Inverted p waves means..?

A

junctional rhythm

44
Q

What do you do for symptomatic brady rhythms?

A

aTropine, transcutaneous pacing, epic or dopamine

45
Q

What do you do for unstable tachy (greater than 150)

A

cardiovert

46
Q

What are the shockable rhythms?

A

V. fib and V. tach (even pulseless V. tach)

47
Q

Meds for V. Fib and V. tach?

A

epinephrine, amiodorone (antiarrythmic), lidocaine (antiarrhythmic)

48
Q

Interventions for systole?

A

CPR and give epinephrine

49
Q

Edison for pulseless V. tach? V tach with a pulse?

A

pulseless v tach= defib!

with a pulse=cardiovert!

50
Q

What interventions do you do for torsades?

A

defib (pulse or no pulse)