Cardiac - Arrhythmias

Question 1

Rhythm where sinus node creates impulse at slower rate than normal

Answer 1

Sinus Brady

Question 2

What are the treatments for sinus brady?

Answer 2

Treat the cause
Assess for manifestations for decreased CO
Atropine IVP is VERY low

Question 3

Rhythm where sinus node creates an impluse at a faster rate than normal

Answer 3

Sinus Tachy

Question 4

What is the number 1 golden rule for treating sinus tachycardia?

Answer 4

TREAT THE CAUSE

Question 5

When and why is sinus tach bad?

Answer 5

• Decreases Cardiac Output
• Increases Cardiac Workload
• May lead to ischemia/HYPOtension

Question 6

Rhythm that occurs as extra and abnormal electrical activity ABOVE ventricles and AV node

Answer 6

Supraventricular Tachycardia (SVT)

Question 7

What are some causes of SVT?
- High levels of ______
- ___________ imbalance

Answer 7

stress
Electrolyte

Question 8

What is occurring during SVT?

Answer 8

Reentering of electrical signals FROM vents to atria

THIS IS NOT SUPPOSED TO HAPPEN
- Imagine: impulses are turning around on a one-way street and reentering the atria

Question 9

What are the treatment options for SVT?

Answer 9

(SVT)
Start w/
Vagal
Treatment

If non-pharm interventions do not work: (ABCDs of SVT)
Adenosine
Beta-blocker
Cardiac Ablation
Digoxin

If unstable: Synchronized Cardioversion

Question 10

Rhythm where electrical impulses start in the atria but not the SA node. A premature impulse before the SA fires

Answer 10

Premature Atrial Contraction (PAC)

Question 11

What are some causes of PACs?

Answer 11

-Caffeine, nicotine, alcohol
- Hypervolemia
- Anxiety
- Hypokalemia

Question 12

What are the treatments of PACs?

Answer 12

Treatment is not normally needed

Question 13

Rhythm where heart’s electrical signals through the atria, which are beating too quickly though at a regular rhythm

Answer 13

Atrial flutter

Question 14

What are some causes of atrial flutter?

Answer 14

Hypertension
CAD
Valvular Disease
Pulmonary Embolism
Cardiomyopathy

Question 15

What is one of the biggest risks for a pt with atrial flutter?

Answer 15

Risk for clotting

Question 16

What is the treatment for a new atrial flutter?

Answer 16

Adenosine
Cardioversion

Question 17

What is the treatment for an old atrial flutter?

Answer 17

Anticoagulants
Cardioversion
Antiarrhythmic (amiodarone)

Question 18

Rhythm that has uncoordinated electrical activity in the atria that causes rapid and disorganized “fibbing” of muscles in the atrium. Atria are quivering instead of contracting

Answer 18

Atrial Fibrillation

Question 19

What are pts with afib at risk for?

Answer 19

Clots - blood is not pumped effectively and begin to pool in the ventricles

Question 20

What are the common treatments for atrial fibrillation?

Answer 20

Cardioversion
Antiarrhythmic (amiodarone)
Anticoagulants
Short–> Heparin gtt
Long –> Coumadin, Eliquis, Rivaroxaban

Question 21

Rhythm where there is early/premature conduction of the QRS complex

Impulse starts in the ventricle before next normal beat fires from the SA

Answer 21

Premature ventricular Contraction (PVC)

Question 22

What are some causes of PVCs

Answer 22

Caffeine, tobacco, nicotine
Cardiac ischemia
Hypoxia
Tachycardia
Acidosis
Dig. Toxicity
Heart Failure
Electrolyte Imbalance

Question 23

What is the treatment of PVCs?

Answer 23

Find the cause and treat it

Question 24

This rhythm’s signal starts in the AV node, not the SA.

AV is now acting as the pacemaker of the heart instead of the SA

Answer 24

Junctional Rhythms

Question 25

What is the treatment of junctional rhythms?

Answer 25

If symptomatic, treat like Brady

Question 26

Where can the p wave be located in a junctional rhythm

Answer 26

- inverted in front of QRS - Buried w/ in QRS - Inverted behind QRS

Question 27

Rhythm where the waveform is irregular, coarse, and of different shapes. Ventricles are QUIVERING. No Cardiac Output CAN BE FATAL

Answer 27

Ventricular Tachycardia

Question 28

What are the top 3 treatments of Vtach?

Answer 28

1. Amiodarone 2. Lidocaine 3. Magnesium if the rhythm is Torsade's If none of these things work -- CARDIOVERSION

Question 29

If pt has no pulse, what is the immediate treatment?

Answer 29

Call code and start CPR

Question 30

What rhythm is rapid, disorganized pattern of electrical activity in the ventricle in which electrical impulses arise from different foci

Answer 30

Ventricular Fibrillation (Vfib)

Question 31

What is the treatment for ventricular fibrillation?

Answer 31

DEFIB THE VFIB **No pulse, so start CPR

Question 32

What rhythm shows that a patient is dying/ or is about to.

Answer 32

Idioventricular rhythm ** If NO pulse, tx like asystole ** If DO have pulse --> Epp, vasopressors, trans. pacing

Question 33

This rhythm can look like any arrhythmia, but there is no heart rate/ pulse

Answer 33

Pulseless Electrical Activity

Question 34

What are the "H's"

Answer 34

Hypovolemia Hypoxia Hydrogen Ions (acidosis) Hypo/Hyper kalemia Hypoglycemia Hypothermia

Question 35

What are the "T's"

Answer 35

Toxins Tamponade Thrombosis Tension Pneumo Trauma