Chapter 27- dysrhythmias

Question 1

what are the four intervals in the heart

Answer 1

-stimulation for the electrical impulse
-transmission to adjacent tissue
-contraction of atria then ventricles
-relaxation of atria then ventricles

Question 2

what does automaticity mean

Answer 2

ability for the heart to generate electrical impulses

Question 3

what does conductivity mean

Answer 3

ability of tissues to transmit electrical impulses

Question 4

what is the pacemaker of the heart

Answer 4

SA node

Question 5

what is an action potential

Answer 5

contraction of myocytes, controlled by voltage

Question 6

what do sarcomeres, troponin, and Ca part of

Answer 6

neurons will stimulate muscle cells, which stimulate contraction

Question 7

what is a sarcomere

Answer 7

contraction unit

Question 8

what is troponin

Answer 8

binds to calcium, opening sites and causing contraction

Question 9

what does calcium do

Answer 9

react to troponin

Question 10

what electrolytes is the SA node dependent on

Answer 10

Na and K

Question 11

what is automaticity

Answer 11

allows any part of the conduction system to start an impulse

Question 12

what is the absolute refractory period

Answer 12

the cells can not respond to a new stimulus

Question 13

what causes arrhythmias

Answer 13

irregular electrical impulse and or conduction

Question 14

ectopic focus/ectopic beat and causes

Answer 14

impulse started by something other than SA
-hypoxia, ischemia, hypokalemia

Question 15

what is an atria flutter

Answer 15

the atria is beating faster than the ventricles
-lub, lub, lub

Question 16

what is atria fibrillation?

Answer 16

AV cannot keep up with SA – no p wave

Question 17

what is a heart block

Answer 17

signal between atria and ventricles is messed up or blocked, emergency intervention is needed

Question 18

the main concern when starting antidysrthmias

Answer 18

making the dysrhythmia worse or creating a new one

Question 19

what is cardioversion

Answer 19

shock to the heart

Question 20

what is defibrillation

Answer 20

emergency situation, VTAC and VFIB can be shocked

Question 21

pacemaker

Answer 21

for tachy and brady arrhythmias to keep heart pace WNL
-some can do both if needed

Question 21

what is ablation

Answer 21

Burnout problem areas

Question 22

MOA of antidysrhythmic drugs

Answer 22

-reduce automaticity
-slow conduction impulses
-prolong the refractory period

Question 23

when are antidysrhythmic drugs used

Answer 23

-treatment of atrial fibrillation or flutter
-maintaining NSR after ablation
-suppressing fast/irregular ventricle rate – isn’t filling with enough blood
-dysrhythmias that could be fatal — A fib causing clots

Question 24

how do sodium channel blockers work

Answer 24

blocks the opening of sodium channels

Question 25

what can sodium channel blockers treat

Answer 25

atrial dysthymia, supraventricular tachycardia -- bursts of high rapid HR which are normally idiopathic

Question 26

side effects of sodium channel blockers

Answer 26

arrhythmias, bradycardia, hypotension -respiratory depression, dizziness, syncope, drowsiness, fatigue, confusion, anticholinergic

Question 27

nursing concern for sodium channel blockers

Answer 27

interacts with anticoagulants and A fib pts need them

Question 28

common sodium channel blockers

Answer 28

quinidine, lidocaine

Question 29

how do beta blockers work

Answer 29

decrease conduction through the SA/AV node -decreases cardiac excitability, workload, and oxygen consumption

Question 30

what are beta blockers used to treat

Answer 30

-dysrhythmia from SNS stimulation, a fib, and flutter, post-MI and CHF to prevent v-fib

Question 31

side effects of beta blockers

Answer 31

BRADYCARDIA, HYPOTENSION, DIZZY, SYNCOPE -Av block, bronchospasm, dyspnea, drowsiness, fatigue, ED

Question 32

nursing considerations of beta blockers

Answer 32

-taper off -when taken with Ca blocker can increase risk of heart block

Question 33

common beta blockers

Answer 33

METOPEROL and ETGENELOL -propranolol, acebutolol, esmolo

Question 34

what does potassium do for the heart

Answer 34

control contractility

Question 35

what should potassium levels be

Answer 35

3.5-5

Question 36

hypokalemia signs

Answer 36

ventricular dysrhythmias, muscle weakness, decreased deep tendon reflexes, weak peripheral pulses

Question 37

issues with IV potassium

Answer 37

can burn, should be given in a Central line

Question 38

hyperkalemia signs

Answer 38

dysrhythmias, v-fib, HB, cardiac arrest, muscle twitching, numbness in hands, feet and mouth

Question 39

what can quickly bring down potassium levels

Answer 39

insulin/dextrose

Question 40

how do potassium channel blockers work

Answer 40

prolongs action potential, slows repolarization, and prolongs the refractory period

Question 41

when are potassium channel blockers used

Answer 41

given IV for life-threatening tacy dysrhythmias given PO for tachycardia, V/A fib, and A flutter

Question 42

side effects of potassium channel blockers

Answer 42

bradycardia, hypotension, weakness, dizziness, worsened/new dysrhythmias, PULMONARY TOXICITY, HEPATOTOXICITY, blurred vision

Question 43

who should not take potassium channel blockers

Answer 43

AV block, shock, hypotension, respiratory depression, and renal/hepatic impairment

Question 44

common potassium channel blockers

Answer 44

AMIODARONE -dofetilide, ibutilide, sotalol

Question 45

how do calcium channel blockers work

Answer 45

reduce automaticity of SA node and slow conduction of AV node

Question 46

what can calcium channel blockers treat

Answer 46

supraventricular dysrhythmias (SA and AV) and tachycardia -emergency for A-fib, SVT

Question 47

side effects of calcium channel blockers

Answer 47

BRADYCARDIA, HYPOTENSION, -flushed skin, MI, hepatotoxicity, peripheral edema

Question 48

who shouldn't take calcium channel blockers

Answer 48

HB, sick sinus, HF, hypotension, renal/hepatic, PREGNANCY

Question 49

nursing considerations with calcium channel blockers

Answer 49

grapefruit, monitor with beta-blockers and digoxin

Question 50

what is sick sinus

Answer 50

irregular heart rhythm

Question 51

how does adenosine work and when is it used

Answer 51

depression of conduction at the AV node, causing NSR -EMERGENCY MED

Question 52

can digoxin treat dysrthmias

Answer 52

YES