Week 1 (exam 2) Flashcards by Millie Setmeyer

Sinus Brady causes

Meds such as Beta blockers
Vagal stimulation
Runners
Sleep

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Tx for sinus Brady (only if pt is symptomatic)

Possibly a pace maker
Atropine
Dopamine

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Causes of sinus tachycardia

Exercise, anxiety, hypovolemia, shock, caffeine, nicotine, Tylenol

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Tx of sinus tachycardia

eliminate cause, BB, CCB (calcium channel blocker), exercise.

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Supraventricular Tachycardia is when the…
Tx is…

P&T wave are together
BB, adenosine, vagal stimulation

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Premature Atrial Contraction (PAC) is….
Causes are…

Skipped or extra heartbeat that occurs when the atria contract to early, frequent PACs lead to AFIB
Caused by stimulants, stretched atrium

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Atrial Fibrillation (afib) cause

post open heart surgery, valve disease, HF, cardiomyopathy, CAD, HTN R/F – CVA,

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AFIB clinical manifestations

decreased BP, SOB, fatigue, Loose atrial kick. Left atrial appendage (blood pools in there, clots form)

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AFIB Tx Meds

Cardizem/dilt, digoxin, amiodarone, tikosyn, BB, anticoagulant
ACE/ARBs decrease incidence of afib

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AFIB non medication Tx

Vagal stimulation, adenosine (chemical cardioversion), ablation
Cardioversion if unstable
In afib > 48 hrs concern for clot. Do TEE

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Ablation:

scars the electrical impulse in R atrium to try and redirect flow of electricity

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Atrial flutter

saw tooth appearance
3 atrial beats to 1 ventricular beat

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PEA

pt has no pulse
tx: CPR and EPI

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Asystole

flat line
tx: CPR, EPI

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PVC (premature ventricular contractions)
_____ or more in a row is considered _____________

PVC is due to _________________, _______________, or _______________

3; a run of VT
This is due to electrolytes being abnormal, may be seen in HF pts or pts with decreased ejection fraction

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VT (Ventricular Tachycardia) causes

HF, EF < 35%, MI

pt may or may not have a pulse
no pulse treat as a code

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Tx of Ventricular Tachycardia

Amiodarone, lidocaine
cardioversion, defibrillators

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Ventricular fibrillation (VF/vfib) tx

CPR, EPI, Defib
if no pulse code pt

Cardioversion Elective

client is awake and fully sedated
synchronized with QRS
50- 200 Joules
pt must sign consent form
on EKG monitor

Cardioversion Emergency

Done with V-fib or V-tach
- no cardiac output
- begin with 200 joules and go up to 360
- client is unconscious
- on EKG monitor

The heart block poem

If the R is far from P you have first degree

Longer longer longer drop! then you have a Wenkebach

If some Ps don’t get through then you have a Mobitz II

If Ps and Qs don’t agree then you have a third degree

Transvenous Pace maker

Invasive
temporary
run pacemaker to RA or RV
goes trough the jugular, subclavian, or femoral vein

Transcutaneous pace maker

Non invasive
hooked to defibrillator pads, gives them a little jolt 60 times per min

Epicardial pacemaker

Invasive
post open heart

Permanent pace maker where is it inserted

typically left upper chest, assess incision site, get EKG to make sure pacer is working properly, don't want arm moving above their head, assess breathing for possible pneumothorax if pt have a pacemaker they should carry a card with them

difference between pace maker and ICD

pace maker produces a pulse ICD will defibrillate a pt

What are the only two shockable rhythms?

V-tach and V-fib

If your pt has V-tach and a pulse you should...

give amiodarone and lidocaine and cardioversion

If your pt has V-Tach and NO pulse you should...

defibrilate

systole is the closure of

tricuspid and mitral valves

diastole is the closure of

pulmonic and aortic valves

Things that affect HR

nerves, and hormones

things that affect stroke volume

blood volume, and vascular resistance

Preload is increased with

hypervolemia regurgitation of cardiac valves heart failure

after load is increased with

hypertension and vasoconstriction

ejection fraction is

the amount of blood pumped out of the ventricle divided by the total amount of blood in the ventricle

Transducer goes in the

phlebostatic axis

Arterial line (pressure measurement)

Continuous invasive blood pressure measurement Placed in artery (radial, femoral, brachial) Map > 65

Systolic HF

problem w the contraction of the heart. Pt will have low ejection fraction (normal is 60%-65%)

BNP levels should be

<100 BNP tells us the stretch of the heart used to help dx HF

Diagnostics for MI

troponin: <0.1 CKMB: <240 Myoglobin: <90 EKG

Angina types

Stable: arteries can't increase blood supply- goes away w rest Unstable: can occur at rest and shows worsening CAD; pt is at risk for damage Variant: Arterial spasms that come at the same time and last the same amt of time, no damage