Describe cardiac dysrhythmia. What is another word for this?
any cardiac rhythm that deviates from normal sinus rhythm. Also called
... [Show More] arrhythmia
Normal Sinus rhythm originates from where? (THINK HEARTS PACEMAKER)
SA node
Describe Normal Sinus Rhythm
Rate: 60-100 bpm
P waves: precede QRS
P-R interval: between atrial and ventricular repolarization
QRS: ventricular depolarization
T wave: Ventricular repolarization
Rhythm: Regular
Think - normal EKG, normal heart rate, etc
Sinus Bradycardia
slow rhythm - originating in the SA node
1. pulse less than 60 bpm
*Can be life threatening if cause is not found
Sinus Tachycardia
rapid, regular rhythm originating in the SA node
1. heartbeat 100-150 bpm or more
*Considered a normal rhythm and usually not caused by cardiac problem
bradycardia can be caused by what?
1. obstructive sleep apnea
2. vomiting
3. intracranial tumors
4. MI
5. medications
6. carotid sinus massage
7. vagal stimulation
8. endocrine disturbances
9. increased intracranial pressure
10. hypothermia
When do you typically see clinical manifestations with patients with bradycardia? What are some of these manifestations?
when heart rate falls below 50.
fatigue, lightheadedness, syncope
A patient's sinus bradycardia was found to be caused by SA node dysfunction? How will this patient typically be treated?
Artificial pacemaker
Management for bradycardia is determined by the cause. For example:
If it is caused by:
1. vagal stimulation (bearing down toilet/straining)(vomiting) = administer stool softener or antiemetics
2. Drug related? = blood drawn, drug withheld
Altropine (Atreza) does what?
increases heart rate
Ventricular tachycardia (VT)
occurs when 3 or more PVCs occur. Can be deadly, heart rate greater than 100 bpm (140-240 bpm)
What do procainamide and aminodarone do?
depress cardiac muscle and slow conduction in the atria, bundle of His, ventricles
If pharmacologic interventions are unsuccessful in treating VT, what is another treatment option?
cardioversion
Repeated and prolonged episodes of VT after MI may be a warning of what? What does this condition require?
ventricular fibrillation.
Requires aggressive evaluation and treatment
Premature Ventricular Contractions (PVCs)
also called extra systole.
- abnormal heartbeats that arise from R/L ventricles.
Clinical Manifestation PVCs
*depend on frequency of PVCs
*some pt. asymptomatic and others -
*palpations, weakness, lightheadedness, decreased cardiac output
Medical Management for PVCs
*focus on treating the underlying heart condition
symptomatic PVC treated with:
- beta-adrenergic blockers (carvedilol),
- antiangials
- propranolo
- antidysthrymics (procainamde, amiodarone, or lidocaine)
PVC can be single event or happen several times. PVCs that last long enough can result in what?
death
Ventricular Fibrillation
!! Medical Emergency !!
occurs when ventricles of the heart are quivering. Rapid and disorganized ventricle pulsation
Cause of Ventricle Fibrillation
myocardial ischemia or infarction
untreated VT
electrolyte imbalances
digitalis or quinidine toxicity
hypothermia
Clinical Manifestation Ventricle Fibrillation
no cardiac output
loss of consciousness
lack of pulse
decrease BP & respirations
possible seizures
death if untreated
Medical Management Ventricle Fibrillation
CPR
Defibrillation * most effective performed 15-20 seconds of onset to avoid brain damage
medications like: lidocaine or procainamide
Assessment Cardiac Dysrhythmia S/S
Palpitations, skipped beats, nausea, lightheadedness, fatigue, anxiety, vertigo, dyspnea, chest discomfort, ECG monitor indicates dysrhythmia, syncope, irregular pulse, tachycardia, tachypnea, [Show Less]