Dysrhythmias

Question 1

automacity function

Answer 1

Ability to generate electrical impulse

Question 2

Excitability function

Answer 2

Ability to respond to outside impulse

Question 3

conductivity function

Answer 3

Ability to receive electrical impulse and conduct it

Question 4

contractility function

Answer 4

Ability of myocardial cells to shorten in response to an impulse

Question 5

when does a P-wave occur?

Answer 5

During atrial depolarization

Question 6

when does QRS complex occur?

Answer 6

During ventricular depolarization

Question 7

when does T-wave occur?

Answer 7

During ventricular repolarization

Question 8

which node initiates atrial depolarization?

Answer 8

SA node

Question 9

T/F, the AV node initiates ventricular depolarization

Answer 9

True

Question 10

normal heart rate

Answer 10

60 to 100 per minute

Question 11

normal P-wave occurrence

Answer 11

Upright and rounded
One before every QRS complex
Even regular rhythm

Question 12

Normal PR interval time

Answer 12

12 to 20 seconds

Question 13

normal QRS time

Answer 13

less than 12 seconds
Narrow

Question 14

what do normal rate, rhythm, P-wave, PR interval, QRS indicate

Answer 14

Sinus rhythm

Question 15

sinus arrhythmia

Answer 15

Fluctuation in rate and initiation
Variability in heart rate

Question 16

is sinus arrhythmia still normal?

Answer 16

Yes, no changes to cardiac output

Question 17

Who is sinus arrhythmia more common in?

Answer 17

Younger people
Associated with respiratory and autonomic nervous system fluctuations

Question 18

dysrhythmia

Answer 18

Abnnormal cardiac rhythm
Problem with impulse generation or conduction

Question 19

do dysrhythmias alter cardiac output?

Answer 19

Yes

Question 20

Inappropriate automaticity cause of dysrhythmia

Answer 20

Cell initiates action potential when it is not supposed to

Question 21

Triggered activity cause of dysrhythmia

Answer 21

Extra impulses generated during/right after repolarization

Question 22

reentry cause of dysrhythmia

Answer 22

Cardiac impulse in one part of heart continues to depolarize after main impulse is finished

Question 23

sinus-

Answer 23

Triggered in/around SA node

Question 24

sinus bradycardia

Answer 24

Slow heart rate <60 BPM

Question 25

is sinus bradycardia still normal?

Answer 25

Yes – regular rhythm, PR, QRS

Question 26

causes of sinus bradycardia

Answer 26

Hyperkalemia – slows depolarization Vagal response Digoxin toxicity late hypoxia meds – beta blockers, CCB MI – ischemia

Question 27

s/sx sinus bradycardia

Answer 27

lightheaded, dizziness Easily fatigued Syncope Dyspnea Chest pain/discomfort Confusion

Question 28

treatment for sinus bradycardia

Answer 28

Assess for symptoms first If symptomatic: atropine If atropine, not effective – pacemaker

Question 29

sinus tachycardia

Answer 29

Fast HR 100-150 bpm

Question 30

is sinus tachycardia still normal?

Answer 30

Yes, but P waves may be partially hidden PR, QRS, rhythm still normal

Question 31

causes of sinus tachycardia

Answer 31

Exercise Pain Strong emotions Fluid volume deficit Fever – increased metabolic rate Meds – Epi, albuterol caffeine, nicotine, cocaine Early hypoxia

Question 32

treatment for sinus tachycardia

Answer 32

based on cause hypovolemia – fluids Fever – antipyretics Pain– analgesics Beta blockers to lower heart rate and myocardial oxygen consumption

Question 33

paroxysmal supraventricular tachycardia

Answer 33

HR 150 to 200 BPM “ feeling like my heart is racing”

Question 34

is PSVT normal?

Answer 34

Usually no P waves, if present is abnormal QRS – normal

Question 35

T/FPSVT usually begins and ends slowly

Answer 35

False, suddenly

Question 36

causes of PSVT

Answer 36

Overexertion Emotional stress Stimulants Digoxin toxicity Rheumatic, heart disease, CAD, R HF Wolf Parkinson, white syndrome

Question 37

s/sx PSVT

Answer 37

Palpitations Chest pain Fatigue Lightheaded, dizzy Dyspnea

Question 38

where does PSVT originate?

Answer 38

Above ventricles, AV node

Question 39

where do sinus bradycardia and tachycardia originate?

Answer 39

SA node

Question 40

which sinus rhythm is caused by early hypoxia?

Answer 40

Sinus tachycardia

Question 41

Which sinus rhythm is caused by late hypoxia?

Answer 41

Sinus bradycardia

Question 42

premature atrial contractions

Answer 42

Early P waves that have morphological changes

Question 43

what should you check with premature atrial contractions?

Answer 43

Electrolytes May need oxygen

Question 44

T/F premature atrial contractions are fatal

Answer 44

false, usually no consequences If frequent, puts patient at more risk for other dysrhythmias

Question 45

does premature atrial contractions have a normal PR and QRS interval?

Answer 45

Yes

Question 46

atrial flutter

Answer 46

Reentry impulse, repetitive and cyclic rate >250, still regular QRS is slower P-wave looks like shark tooth

Question 47

where does atrial flutter originate?

Answer 47

AV node Overrides SA node

Question 48

causes of atrial flutter

Answer 48

CAD, cardiomyopathy Heart valve disease Congenital, heart disease Inflammation of heart – myocarditis HTN Lung disease/overactive thyroid Electrolyte imbalance Heart surgery

Question 49

atrial fibrillation

Answer 49

Multiple irritable spots in atria Irregularly irregular HR 100-175 no identifiable P-wave Fibrillation waves

Question 50

T/F atrial fibrillation is more symptomatic than atrial flutter

Answer 50

True

Question 51

s/sx a fib

Answer 51

palpitations Heart racing Fatigue Dizziness Chest discomfort SOB Can be asymptomatic**

Question 52

causes of a fib

Answer 52

Electrolytes imbalance Hypoxia CBD

Question 53

complications of a fib

Answer 53

Decreased cardiac output Heart failure Embolus – stroke risk

Question 54

what is the most common type of treated dysrhythmia?

Answer 54

Afib

Question 55

treatment for a fib

Answer 55

Control the rate – BB, CCB, digitalis, amiodarone Stroke prevention – anticoagulates antiplatelets

Question 56

Non-medication treatment for a fib

Answer 56

ablation Cardioversion

Question 57

Premature ventricular contractions

Answer 57

ventricular dysrhythmia Contraction coming from ectopic focus in ventricles Comes earlier than QRS complex should Not a normal rhythm or P wave

Question 58

what does the QRS complex look like in PVC?

Answer 58

Wide and distorted shape

Question 59

causes of PVC

Answer 59

Stimulants Electrolytes Hypoxia Exercise Stress Fever CVD

Question 60

ventricular tachycardia

Answer 60

Three or more PVCs together Ectopic focus within ventricles takes control and fires repeatedly rate 150-200 bpm

Question 61

differences with ventricular tachycardia

Answer 61

No atrial contractions No P-wave PR interval not measurable

Question 62

causes of ventricular tachycardia

Answer 62

MI CAD ABNORMAL ELECTROLYTES HEART FAILURE Drug toxicity

Question 63

what is an immediate intervention for ventricular tachycardia and fibrillation?

Answer 63

Check for a pulse

Question 64

ventricular fibrillation

Answer 64

Irregular waveforms of varying shapes and sizes Ventricles are quivering No effective contractions equals no cardiac output