Cardiac YOU GOT THIS! Flashcards
(52 cards)
permanent ventricular pacemaker
pts with permanent pacemaker should be assessed for both electrical capture and mechanical capture best method for mechanical capture is either auscultation of apical or palpation of femoral… assess for pulse deficit
atrial pacing
pacer spikes precede P waves
ventricular pacing
pacer spikes precede QRS complexes
IV potassium
NEVER ADMINISTERED BY GRAVITY D/T risk for lethal arrhythmias if administered too quickly
triple-lumen peripherally inserted central catheter
indicated for administration of noxious meds (parenteral nutrition, chemotherapy), long-term IV therapy or in clients with poor venous access
- dresing change every 48 HOURS with a gauze dress or 7 days with a transparent semipermeable dressing (biopatch) or immediately if dressing is loose/torn, soiled or damp
- all infusing meds (EXCEPT VASOPRESSORS) must be paused before drawing blood
- scrub hub 10-15 seconds
- dressings that no longer occlude the insertion site must be changed immediately, loose corners reinforced by tape
Thoracic aortic aneurysm
can put pressure on the esophagus and cause dysphagia this may indicate aneurysm has increased in size
atropine uses
“death rattle” noisy rattling with breathing in dying client, can help manage airway secretions
decreased cardiac output
decreased perfusion to the body decreased LOC wet lung sounds SOB cold and clammy decr UOP weak peripheral pulses
widened QRS wave
often seen in PVCs, electrolyte imbalances and drug toxicity
treatment for sinus brady
correct underlying cause
may be d/t CCB, beta blockers, amiodarone
vagal stim
lower metabolic needs
causes of sinus tachy
stress some meds like epi, illicit drugs, stimulants heart failure cardiac tamponade hyperthyroidism
causes and treatment of v-tach
causes myocardial ischemia/infarction electrolyte imbalances digoxin toxicity stimulats
treatment:
stable w a pulse: o2, antidysrhythmias (amiodarone), synchronized cardioversion
unstable without a pulse: cpr, possible intubation, drug therapy (epinephrine, vasopressin, amiodarone)
causes and treatment for vfib
causes
cardiac injury, medication toxicity, electrolyte imbalances, untreated ventricular tachy
treatment
CPR, o2, defib, possible intubation, drug therapy (vasoconstrictors like epi, antiarrhythmic like amoidaraon, lidocaine and then possibly magnesium)
a fib causes and treatment
causes
open heart surgery, heart failure, copd, htn, ischemic heart disease
tx of stable pt: o2, drug therapy (neta blockers, ccb, digoxin, amiodarone, anticoagulant therapy)
tx of unstable pt: o2, cardioversion
QRS depolarization
ventricular
p wave
atrial
p waves in the form of a saw tooth wave
atrial flutter
chaotic p wave patterns
a-fib
chaotic QRS complexes
v-fib
bizarre QRS complexes
v-tach
periodic wide bizarre QRS complexes
PVCs
PVCs
typically low priority moderate priority when: 6 or more PVCs in a minute more than 6 PVCs in a row R on T phenomenon (PVC falls on a T wave)
**PVCs after MI is common, low priority
lethal arrhythmias
HIGH PRIORITY
- asystole
- v-fib
- both either low or no CO… little to no brain perfusion –> confusion and death
potentially lethal cardiac arrhythmia
v-tach
HAS CO! means they have a pulse
