lecture 3 – cardio + ECG readings Flashcards
1
Q
definition
sinus
A
conduction began in SA node
2
Q
HR for sinus rhythm
A
60-100 bpm
3
Q
it is possible to have a waveform on the ECG while the patient does have a pulse
A
true
4
Q
definition
arrhythmia
A
conduction cycle does not begin in the SA node
5
Q
what is the regularity for sinus rhythm?
A
regular
6
Q
what is the PRI for sinus rhythm?
A
0.12 - 0.20
7
Q
how many seconds is each box on an EKG strip?
A
0.04
8
Q
how long is the QRS wave on a sinus rhythm?
A
less than or equal to 0.12 seconds
9
Q
what is the QTI of a sinus rhythm?
A
less than 0.40 seconds
10
Q
sinus rhythm
A
11
Q
what are the nursing actions for sinus rhythm?
A
none
12
Q
what is the HR for sinus brady?
A
< 60 bpm
13
Q
every other data besides HR for sinus rhythm is the same for sinus brady & sinus tachy
A
true
14
Q
what causes sinus brady?
A
- B-blockers
- Ca+ channel blockers
- post-cath lab procedures
15
Q
what are the nursing actions for sinus brady?
A
- assess BP, for syncope and SOB
- prevent falls
- administer Atropine
16
Q
the patient has AMS & visible signs of hypoxia, their ECG shows sinus brady. what is the nursing action?
pt is SYMPTOMATIC
A
administer Atropine
17
Q
what is the MOA of Atropine?
A
elevates heart rate
indicated for sinus brady
18
Q
sinus brady
A
19
Q
what is the HR for sinus tachy?
A
100 -150 bpm
20
Q
nursing actions for sinus tachy
A
- check BP, for syncope and SOB
- prevent falls
- possibly administer B-blockers & Ca+ channel blockers
21
Q
sinus tachy
A
22
Q
what is the PRI of A-fib?
A
none
23
Q
what is the rate & regularity of A-fib?
A
none; it has irregular rhythm
24
Q
what is it called when an A-fib has more than 100bpm?
A
rapid ventricular response
25
what causes A-fib?
* MI
* rheumatic heart disease
* COPD
* CHF
* ischemia
* CAD
26
what does the nurse need to check for a patient with *A-fib*?
INR
27
how does a patient with *A-fib* present?
* CP
* hypoxia
* hypotension
* SOB
* decreased cardiac output
28
what is the QTI of A-fib?
less than 0.40 seconds
29
how long is the QRS wave of A-fib?
less than 0.12 seconds
30
what causes atria to quiver and lead to A-fib?
chaotic ectopic current activity
31
what are possible treatments for A-fib?
* cardioversion
* B-blockers
* Ca+ channel blockers
* Digoxin
* possibly anticoagulant *(hemostasis)*
32
A-fib
33
what is the HR of atrial flutter?
250 - 350 bpm
34
P waves are absent in atrial flutter
true
35
how long is the QRS complex in atrial flutter?
less than or equal to 0.12 seconds
36
what are the causes for atrial flutter?
* RHF
* pericarditis
* valve disorder
* hyperthyroidism
37
atrial flutter
38
what is the HR for V-tach?
100 - 250 bpm
39
what is the characteristic of the QRS complex in V-tach?
wide and bizarre
40
P waves are often buried in the QRS complex in V-tach due to rapid rhythm
true
41
what is the rhythm for V-tach?
regular
42
how is V-tach defined?
3 or more consecutive PVCs occur at a rate of 100 bpm
43
what causes V-tach?
* low Mg
* low K+
* CNS stimulants
* digoxicity
* AMI
44
what are the *priority* nursing actions for V-tach?
* check for pulse
* check BP
45
potential treatments for stable V-tach
| pulse present
* oxygen
* 12-lead EKG
* **Amiodarone**
* check K+ & Mg
* prepare for cardioversion *(may turn unstable)*
46
potential treatments for unstable V-tach
| pulse present
* cardioversion
* administer Amiodarone bolus + infusion
47
what are the nursing actions for pulseless V-tach?
* defib + CPR
* activate code (ACLS certified)
48
V-tach
49
what is V-fib?
irritable ventricles send out rapid electrical stimuli
50
how do ventricles act during V-fib?
they do not contract because they never depolarize
51
conduction bypasses SA & AV node in V-tach
true
52
how does the patient with V-fib present?
* pulseless
* no BP
* no cardiac output
* apneic
* unresponsive
53
what causes V-fib?
* CAD
* AMI
* hypoxia
* acidosis
* cardiac catheterization
* cardioversion
* accidental electrocution
* extreme hypothermia
54
nursing priorities for V-fib
* check ABC
* begin CPR
* defib
* epinephrine
55
V-fib
56
what is the HR for *supraventricular tachycardia*?
150-250 bpm
57
what does the *QRS complex* look on *supraventricular tachycardia*?
narrow; < 0.12 seconds
58
what is the rhythm of *supraventricular tachycardia*?
regular
59
what are the causes of *supraventricular tachycardia*?
* stimulants
* sepsis
* stress
* alcohol
60
SVT
61
what are the treatments for *SVT*?
* vasovagal maneuver
* baring down
* carotid massage
* Adenosine
* Verapamil
* ablation
* cardioversion
* anticoagulant for stroke prevention
62
what is an *angioplasty*?
a procedure in which a balloon is inserted & inflated within a narrow or blocked artery
63
what is *CABG*?
| coronary artery bypass grafting
surgeon takes one piece of a blood vessel in other parts of the body & use it to reroute blood from a blocked artery
64
what is the sequence for *cardiac conduction*?
1. SA node
2. AV node
3. Bundle of His
4. Purkinje fibers
65
which node generates impulses?
SA node
66
what are the causes of ST elevation?
* low oxygen from CAD
* elevated Potassium
* blocked coronary arteries
67
what are the major treatments for STEMI?
* reperfusion
* angioplasty
* possible CABG
68
how does STEMI manifest in the heart?
constant contraction of ventricles
69
what are the s/s of *STEMI*?
* hyperkalemia
* diaphoresis
* CP
* elevated *troponin*
70
what are the minor treatments for *STEMI*?
* nitroglycerin
* O2
* Morphine
* Aspirin
71
what is another word for *contraction*?
depolarization
72
what is another word for *relaxation* (of myocardium)?
repolarization
73
what does the *P wave* represent?
atrial depolarization
| atria squeeze blood into the ventricles
74
what is *cardiac ablation*?
cauterization of erratic cells
75
what does the *QRS complex* represent?
ventricle depolarization
| ventricles squeeze blood into the aorta or pulmonary artery
76
what does the *T wave* represent?
ventricle repolarization
77
what is the most common lead to monitor?
Lead II
| aligns w/ RA to apex of heart
78
why is the presence of a *P wave* pertinent?
indicate the conduction started in the SA node as it should
79
the width of the *QRS complex* is determined by the amount of time it takes for ventricles to *repolarize*
true
80
what does an elevated *ST segment* indicate?
myocardium infarction
81
what does the *T wave* represent?
* the end of the conduction cycle
* ventricle repolarization
82
what does a *peaked T wave* indicate?
electrolyte imbalances
| particularly K+
83
5 lead ECG
* clouds over grass
* smoke over fire
* **V**hite on right
84
what is the anatomical landmark for a *V1 lead*?
4th intercostal space
85
# indications
defibrillation
* V-fib
* pulseless V-tach
* accompanied w/ CPR
* only for EMERGENCY
86
what is the *priority* nursing action for delivering shocks to a patient?
ensure absence of clots
87
# indications
cardioversion
* V-tach w/ pulse
* SVT
* to reset ***SA NODE***
* low-energy shock only
* do NOT deliver during ***T wave***
88
what is the MOA of *Adenosine*?
suppresses automaticity of pacemakers
| leading to FLATLINE
89
how is *Adenosine* administered?
* fast & hard
* followed by saline flush
90
what are the nursing actions for *asystole*?
* CPR
* ET tube insertion
* ACLS
* ***Epinephrine***
* ***Vasopressin***
91
*asystole* is a shockable rhythm
false
92
what does *Amiodarone* do for the heart?
slows cardiac conduction
93
waveform interpretation
94
what are the s/s of *AV heart block*?
* CP
* low SpO2
* hypotension
* lethargy
* anxiety
* palpitations
* SOB
* elevated HR
* syncope
| in other words, COLLAPSED
95
what are first line of treatments for *AV heart block*?
* B-blockers
* Ca+ channel blockers
* Digoxin
96
what is the goal of treating an *AV heart block*?
restore AV node function
97
what type of drug is *Digoxin*?
inotropic antiarrythmic
98
what are second line of treatments for *AV heart block*?
* Atropine
* Dopamine
* Epinephrine
| also classified as VASOPRESSORS
99
what is the third line of treatments for *AV heart block*?
pacemaker
100
post-op care for *pacemakers*
* immoblize arm
* prevent infection
* advise to avoid soaking, powders, & creams on the area
* check pulse daily
101
what are patients allowed to do when they have had *pacemakers* for about 2 weeks?
* swim
* drive
* report dyspnea & dizziness
102
why do patients with a *pacemaker* need an ID card?
it contains important information such as the make of their pacemaker, their doctor, or other precautions for events contraindicated with a pacemaker
103
what do patients need to avoid when they wear a *pacemaker*?
* MRI
* metal detectors
* stereos
* earphones
104
why do patients with *pacemakers* need to avoid contact sports and tight clothing?
avoid displacement of wires
