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NUR 230 > Cardiac Rhythms > Flashcards

Cardiac Rhythms Flashcards

(51 cards)

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1
Q

what is automaticity

A

ability of cardiac cells to initiate electrical impulses- av node

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2
Q

what is excitability

A

ability of non-pacemaker cells to respond to pacemaker cell

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3
Q

what is conductivity

A

transmission of impulses from one cell to the next

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4
Q

electrical conduction

A

SA
between 1 and 2….. intranodal pathway
AV
bundle of his
bundle branches
purkinje fibers

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5
Q

inherent rate of SA node

A

60-100 x per min

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6
Q

what is inherent rate of AV node

A

40-60 bpm

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7
Q

inherent rate of purkinje fibers

A

20-40 bpm

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8
Q

chronotropic properites

A

affect hr itself
slow/increase hr

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9
Q

dromotropic properties

A

speed of conduction through heart

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10
Q

inotropic properites

A

affects contractility
how much the heart is able to squeeze

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11
Q

what are arrhythmias

A

D i s o r d e r s o f f o r m a t i o n o r
c o n d u c t i o n ( o r b o t h ) o f
e l e c t r i c a l i m p u l s e s w i t h i n
h e a r t
* C a n c a u s e d i s t u r b a n c e s o f
* R a t e
* R h y t h m
* B o t h r a t e a n d r h y t h m
* P o t e n t i a l l y c a n a l t e r b l o o d
f l o w a n d c a u s e
h e m o d y n a m i c c h a n g e s
* D i a g n o s e d b y a n a l y s i s o f
e l e c t r o g r a p h i c ( E C G )
w a v e f o r m

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12
Q

causes of arrhythmias

A

Coronary artery disease (CAD)
* Cardiomyopathy
* Hypertension
* MI
* Valve disorders
* Electrolyte imbalances
* Cardiac medications

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13
Q

how to arrhythmias affect perfusion

A

sv
co
preload
contractility
afterload

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14
Q

what is afterload

A

resitance heart is pumping against

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15
Q

diagnostics for arrhythmias

A

12-lead EKG
* CXR
* Labs
* CBC
* Electrolytes
* Thyroid (tachycardias)

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16
Q

what causes action potential

A

electrolytes moving in and out of cell

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17
Q

what is p wave

A

atrial depolarization

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18
Q

hat is qrs

A

ventricular depolarization

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19
Q

t wave

A

ventricular repolarization

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20
Q

repolarization is

A

diastole

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21
Q

depolarization is

22
Q

systemactic approach to rhythm interpretation

Study These Flashcards
A

Measure Heart Rate (slow,
normal, fast?)
* Evaluate Rhythm (regular or
irregular?)
* Is there a P wave before every
QRS?
* Is the QRS narrow or wide?
* Evaluate the ST segment- flat,
depressed, elevated?
* Interpret Rhythm

23
Q

sinus bradycardia

Study These Flashcards
A

the same as sinus rhythm but lower than 60 bpm

24
Q

causes of sinus bradycardia

Study These Flashcards
A

l o w m e t a b o l i c n e e d s , v a g a l s t i m u l a t i o n ,
m e d i c a t i o n s , S A n o d e d y s f u n c t i o n , i n c r e a s e d
I C P , C A D , M I

25
how to treat sinus bradycardia
atropine transcutaneous pacemaker
26
sinus tachycardia
regular rhythm higher than 100 bpm
27
causes of sinus tachy
ph y s i c a l / p s y c h o l o g i c a l s t r e s s , m e d i c a t i o n s , i l l i c i t d r u g s , a u t o n o m i c d y s f u n c t i o n ( P O T S ) TREAT UNDERLYING CAUSE
28
treatment for sinus tachy
iv fluids blood transfusion antipyretics analgesics vagal maneuvers iv beta blockers calcium channel blockers (verapamil)
29
premature ventricular contraction (PVC)
could be sinus/tachy/brady p waves sometimes absent not conducted normally Rate: 60-100 bpm (could vary depending on underlying) * Rhythm/ Regularity: Irregular due to early beat * P Waves: upright, round, 1:1- PVC’s P wave often absent * QRS Complexes: normal beats narrow, PVCs wide * ST Segment: without elevations
30
causes pvc
stimulants etoh mi heart failure digitalis toxiicty hypoxia acidosis electrolyte imbalances
31
amiodarne side effects
sun sensitivity dizziness/syncope wt gain edema blurry vision thyroid toxicity and other toxicities
32
determine is\f pvcs are....
PERFUSING check pulse while auscultating heart or watch monitor and correlate findings
33
afib
Characteristics: * Rate: Atrial rate 300-600 bpm; Ventricular rate varies * Regularity: Irregular * P Waves: fibrillatory waves * QRS Complexes: narrow * C o m m o n a r r h y t h m i a a s s o c i a t e d w i t h i n c r e a s e d a g e a n d r i s k f a c t o r s d i s c u s s e d i n e a r l i e r s l i d e
34
treatment for a fib
* A n t i t h r o m b o t i c s - l o n g t e r m - w a r f a r i n , F a c t o r X a i n h i b i t o r s ( a p i x a b a n , e t c . ) ; s h o r t t e r m - h e p a r i n , e n o x a p a r i n * H e a r t r a t e c o n t r o l - ( m a i n t a i n H R < 8 0 ) - b e t a b l o c k e r , c a l c i u m c h a n n e l b l o c k e r * M e d i c a t i o n s t o C o n v e r t - s o d i u m c h a n n e l b l o c k e r ( f l e c a i n i d e ) , p o t a s s i u m c h a n n e l b l o c k e r ( a m i o d a r o n e , d o f e t i l i d e ) * C a t h e t e r a b l a t i o n - d e s t r o y s s p e c i f i c c e l l s t h a t a r e t h e c a u s e o f a t a c h y a r r h y t h m i a * E l e c t r i c a l c a r d i o v e r s i o n - i f h e m o d y n a m i c a l l y u n s t a b l e * T i m e d e l e c t r i c a l c u r r e n t * S y n c h r o n i z e d w i t h E C G o n c a r d i a c m o n i t o r t h a t p r e v e n t s s h o c k f r o m o c c u r r i n g d u r i n g r e p o l a r i z a t i o n * M e d i c a t e c l i e n t w i t h s e d a t i v e & a n a l g e s i c , o r d o n e u n d e r a n e s t h e s i a
35
what is r on t phenomenon
Can cause ventricular tachycardia or ventricular fibrillation
36
v tach
Rate: 120-200 bpm * Regularity: May be regular or irregular * P Waves: Will not see * QRS Complexes: Wide, abnormal shape
37
increased risk in vtach
p r o l o n g e d Q T , M I , h e a r t f a i l u r e
38
treatment for vtach
S t a b l e - A s s e s s m e n t a n d m o n i t o r 1 2 - l e a d E K G * U n s t a b l e w i t h p u l s e - s o d i u m o r p o t a s s i u m c h a n n e l b l o c k e r s ( a m i o d a r o n e , l i d o c a i n e , p r o c a i n a m i d e ) ; c a r d i o v e r s i o n no pulse- CPR and defib (unsynchronized shock)
39
vfib
Rate: Unable to determine, no pulse * Regularity: Irregular * P Waves: Will not see * QRS Complexes: Unable to determine, irregular waves, changing amplitudes CALL A CODE
40
causes of vfib
M I c a u s e d b y C A D , u n t r e a t e d V T , v a l v u l a r h e a r t d i s e a s e , c a r d i o m y o p a t h y , m e d i c a t i o n s , a c i d - b a s e / e l e c t r o l y t e a b n o r m a l i t i e s , e l e c t r i c a l s h o c k
41
treatment for vfib
defibrilation cpr amiodarone epi
42
asystole
Rate: Unable to determine, no pulse * Regularity: Unable to determine * P Waves: Unable to determine * QRS Complexes: Unable to determine CALL A CODE
43
management asystole
cpr epi identify and treat possible underlying cause
44
nsg interventions
* Assess vital signs on an ongoing basis * Assess for lightheadedness, dizziness, fainting * If hospitalized * Obtain 12-lead ECG * Continuous monitoring * Monitor rhythm strips periodically * Antiarrhythmic medications * Minimize anxiety of client
45
indications for pacemakers
lower than normal impulse formation, symptomatic AV or ventricular conduction disturbance
46
types of pacemakers
permanent temp: ex is transcutaneous * On-demand vs. Fixed/asynchronous * Implantable Cardioverter Defibrillator (ICD) * Provides additional ability to cardiovert or defibrillate VT or VFib
47
pacemaker complications
Infection Bleeding or hematoma formation Dislocation of lead Skeletal muscle or phrenic nerve stimulation Cardiac tamponade Pacemaker malfunction
48
restrict what with pacemaker insertion
arm movement do not raise above head for 2 weeks
49
pacemaker discharge education
carry id avoid electromagnetic interference mri precautions pulse diary
50
icd discharge ed
log of icd discharges know rate cut off avoid activities that raise hr near cut off notify ems no airport want security screenings, request hand search no driving
51

NUR 230 (16 decks)

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