MED-SURG---Cardiac Rhythm & Dysrhythmias Flashcards Preview

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Flashcards in MED-SURG---Cardiac Rhythm & Dysrhythmias Deck (64)
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31

Name "3" types of Ventricular Dysrhythmias

*Premature Ventricular Contractions (PVC)

*V-Tachycardia

*V-Fibrillation

32

Which dysrhythmia can be classified by ventricular rate?

ATRIAL FIBBRILATION

Controlled-ventricular rate--<100 bpm

Uncontrolled(RAPID)ventricular rate--> 100 bpm

33

With PVC's...when the ventricular impulse arises from one ectopic site all the PVC's look the same (monomorphic) and are called ___________

UNIFOCAL

34

Electrical "picture" of what is happening in the conduction system

ECG
Electrocardiogram

35

Normal Magnesium Lab Values

1.5 - 2.5

36

Delivery of a direct countershock to the heart synchronized to the QRS complex

Cardioversion

37

Time when a cell cannot accept another impulse and be stimulated

ABSOLUTE REFRACTORY PERIOD

38

how does a tachydysrhythmia affect the patient

Excessive Heart rate >100. (TOO FAST)
----->short diastolic (relaxation / filling) time----->decreased Cardiac Output

THIS MEANS THERE ISNT VERY GOOD VENTRICULAR FILLING---->resting/filling time is cut short and the ATRIA can not work properly to fill the ventricles which provides for good cardiac output

INCREASED WORKLOAD OF THE HEART & INCREASED MYOCARDIAL O2 DEMAND

39

(3) Nursing administration for Calcium Channel Blockers

1) Check HR--if <50 call provider for order

2) change position slowly- (orthostatic hypotension)

3) avoid activities that require alertness until effects are known

40

The life threatening effects of dysrhythmias are generally related to ______________ and ____________.

Decreased cardiac output

ineffective tissue perfusion

41

Norma Potassium Lab Values

3.5 - 5

42

implementation of Beta Blockers

Metoprolol \ Propranolol
GIVE IV DOSE OVER 2 MINUTES TO PATIENT WHILE ON CARDIAC MONITOR

Sotalol
-GIVEN OVER 5 HOURS
-PT MUST BE HOSPITALIZED FOR UP TO 3 DAYS

43

How does a Bradydysrhythmias affect the patient

SLOW HEART RATE <60--negatively affects perfusion because the HR is too slow to provide for adequate output for perfusion to entire body

44

Dysrhythmias treatment is based on the cardiac rhythm, which can require any of the following (4) forms of treatment

Cardioversion
Defibrillation
Pacemaker insertion
Medication

45

Dysrhythmias have a disturbance in impulse from _____________ or ______________

FORMATION---where the signal begins

PROPAGATION---how the impulse travels

46

A PVC that follows every normal beat

Ventricular Bigeminy

47

If a change is notated on EKG (from the baseline) you should_______

Consider a 12 lead EKG

48

HOW TO BETA BLOCKERS WORK (ACTION?) WHICH ENDS UP RESULTING IN …(3) THINGS

ACTION: block beta 1 receptor in the heart

OUTCOME: < Heart Rate

49

Time when a cell needs a "greater than normal" impulse to be stimulated

RELATIVE REFRACTORY PERIOD

50

5 steps involved in administered adenosine

1) administer at IVP at a site closest to the heart (central line or AC)--only has half life of 10 seconds

2) rapid push with 20 ml of NSS Flush immediately after

3) Raise arm following push

4) Have code cart in room just in case

5) patient must be on monitor

51

Some potential Causes for AV BLOCK / Heart Blocks

Beta Blockers
Calcium channel blockers Digoxin
Ischemia
Necrosis
Myocardial Infarction

52

Name two Calcium Channel Blockers

Diltiazem (Cardizem)
Verapamil

53

The "3" steps of "THE ACTION POTENTIAL"

1) RESTING POTENTIAL (unexcited)
**cells are polarized and ready to accept impulse
**Mainly (-) inside the cell and (+) outside cell

2) DEPOLARIZATION
**cells receive and respond to electrical stimulus
**Movement of charged particles making inside more (+)

3) REPOLARIZATION
**Cells return to negative state by moving (+) ions out

54

(TRUE / FALSE)

If HR is elevated it doesn't permit for proper ventricular filling---which leads to a decrease in cardiac output

TRUE

55

DEFINE PRELOAD

AMOUNT OF BLOOD LEFT IN VENTRICLES JUST PRIOR TO CONTRACTION
HOW FULL IS THE VENTRICLE BEFORE IT SQUEEZES?

56

Name "3" Beta Blockers

Metoprolol
Propranolol
Sotalol

57

uncontrolled (or RAPID) ventricular rate is AKA ___________

RVR
Rapid Ventricular Rate

58

Side effects of Calcium Channel Blocker (5)

Bradycardia

Constipation

Hypotension

Heart Failure

Peripheral Edema

59

an extremely rapid, chaotic ventricular depolarization that causes the ventricles to quiver and cease contracting; the heart DOES NOT Pump

Ventricular Fibrillation (AKA: Cardiac Arrest)

60

"5" Characteristic features of Ventricular Dysrhythmias?

*Wide / Bizarre QRS Complex----- >0.12

*No relationship between the QRS complex and P Wave

*Increased amplitude of QRS complex

*Abnormal ST Segment

*T-Wave deflected in the opposite direction from the QRS complex.