Module 6 Ch 23

Question 1

What is an arrhythmia

Answer 1

Disorder of formation or conduction of electrical impulses within heart

Question 2

What can arrhythmias mess with

Answer 2

rate, rhythm and then both together

Question 3

Is depolorization systole or diastole

Answer 3

systole

Question 4

Is redepolorization systole or diastole

Answer 4

diastole

Question 5

What is the path of normal electrical conduction

Answer 5

SA node
AV node
Conduction
Bundle of his
Bundle branches
Purkinje fibers

Question 6

What is the rate of normal sinus rhythm

Answer 6

60-100

Question 7

What does normal sinus rhythm look like

Answer 7

normal QRS, P wave normal and consistant in front of QRS

Question 8

What is the rate of sinus bradycardia

Answer 8

less then 60 bmp

Question 9

What does sinus bradycardia look like

Answer 9

• Normal QRS
• P wave for every QRS
• Just slower then normal

Question 10

How do you manage sinus bradycardia

Answer 10

• Resolve the cause
• Atropine if instable
  -Can then do trancutaneous pacing or epi

Question 11

What is the rate for sinus tachycardia

Answer 11

OVer 100 bpm

Question 12

What does sinus tachycardia look like

Answer 12

• QRS is normal
• P wave for every QRS
• Just faster then normal

Question 13

How can you manage sinus tachycardia

Answer 13

• Vagal maneuvers (carotid massage, bear down with bowels, forceful coughing, cold stimulus to face)
• Adenosine to interrupt heart rate
• Cardioversion as last resort

Question 14

What is the rate of sinus arrhythmia

Answer 14

60-100bpm

Question 15

What does sinus arrhythmia look like

Answer 15

Irregular, QRS is normal, P waves are in front of QRS

Question 16

How can you manage sinus arrhythmia

Answer 16

Typically don’t, as it does not cause any significant issues

Question 17

What is the rate of premature atrial complex (PAC)

Answer 17

Depends on the underlying rhythm (tachy, brady)

Question 18

What does premature atrial complex (PAC) look like

Answer 18

• Irregualr rhythm
• QRS is normal if its post P wave
• P wave is early and different, can be hidden in T wave

Question 19

How can you manage premature atrial complex (PAC)

Answer 19

• Patients may say “heart skipped a beat”
• Infrequent= no treatment
• Frequent= other condition (A fib)
• Management is based on underlying condition

Question 20

What is the rate of atrial fibrillation

Answer 20

Atrial: 300-600 bpm (atria is quivering)
Ventricular: 120-200 (goes fast but not atria fast)

Question 21

What does atrial fibrillation look like

Answer 21

QRS: normal
P waves: none, irregular

Question 22

What is the management of atrial fibrillation

Answer 22

• Depends on cause and pattern and duration with the presence of structural or valvular heart disease and other cardiac conditions
• Preventing embolic events such as stroke with anticoagulant meds
• May not convert back

Question 23

What are some issues that occur with A fib

Answer 23

Cardiac arrest
Heart failure
Thrombolytic event

Question 24

What medications can be used for A fib

Answer 24

• Antithrombotic drugs
• Oral antithrombolytic therapy
• Warfarin
  -IV heprin

Question 25

What is electrical cardioversion

Answer 25

- For patients with hemodynamically unstable A fib - Goal is to convert the heart from a fib to normal sinus

Question 26

What is the rate for atrial flutter

Answer 26

Atria: 250-400bpm Ventricle: 75-150 bpm

Question 27

What does atrial flutter look like

Answer 27

- QRS can be normal or absent or irregular - P wave: sawtooth shaped

Question 28

How can you manage Atrial flutter

Answer 28

Vagal maneuvers Adenosine Antithrombotic therapy Cardioversion

Question 29

What symptoms can atrial flutter cause

Answer 29

chest pain SOB low BP

Question 30

How can you administer adenosine

Answer 30

Rapidly via IV, followed by a 20 ml flush and elevation of IV arm to promote circulation

Question 31

How can you assess cardiac output and oxygenation

Answer 31

cap refill vital signs cyanosis

Question 32

What is assessment for a patient with arrhythmias

Answer 32

- Health Hx (previous issues/causes) - Medications - Psychosocial assessment - Physical assessment (skin, fluid retention, rate, rhythm of apical, pulses, heart sounds, BP and pulse pressure)

Question 33

What are some goals for someone with an arrythmia

Answer 33

- decreasing occurrence to maintain cardiac output - Minimize anxiety - Acquiring knowledge about it and its treatments

Question 34

What are some nursing interventions for a person with arrhythmia

Answer 34

- MOnitor and manage it - Reduce anxiety - Promote home and community care - Educate about self care - Continuing care (followups)

Question 35

What are some nursing interventions to monitor an arrhythmia

Answer 35

- Assess vitals - Assess for dizzy, light headed ness, fainting - 12 lead ECG - Antiarryhthmic meds- 6 min walk test

Question 36

What are some evaluation of arrhythmias

Answer 36

- Maintain cardiac output - Reduce anxity - Express understanding

Question 37

What is a pacemaker

Answer 37

- electronic device that provides electrical stimuli to heart muscle

Question 38

What are the two types of pacemakers

Answer 38

permanent and temporary

Question 39

What are some complications of pacemakers

Answer 39

- Infection - Bleeding - Dislocation of lead - Skeletal muscle or phrenic nerve stimulation - Cardiac tamponade - Pacemakers malfunction