Cardiac Disorders
Atrial Dysrhythmias
Heart Blocks
Ventricular Dysrhythmias
ATI/ in class questions
100

A disorder that is brought on by a weakening of the arterial walls causing a local area of bulging or dilation, creating an out pouch that is susceptible to rupture

what is ANEURYSM

100

A heart rate of 101-150 with a normal pr/qrs interval.

Can be cause by hypovolemia, fever, anxiety, pain, hypoxia, electrolyte imbalances.

treatment: treat cause, may use an antiarrhythmic (beta blocker)

sinus tachycardia

100

dropped QRS, changing PR interval

Second degree type 1 block

100

wide and bizarre QRS periodically, QRS in opposite direction of P waves

can be present in couplets, triplets, or as a bigeminy

decrease in cardiac output

Premature ventricular contraction

100

An older pt hospitalized with chest trauma following an MVA who is not intubated has a R femoral arterial line. Because the pt has been thrashing about in bed, a physician writes an order for wrist restraints to be applied. Based on this, which action by a nurse is correct?

A) chemically restrain the patient, B) place a 4 point restraint on the patient, C) request and order for a right ankle restraint


C

200

A cardiac disorder that is often caused by atherosclerosis and results in the destruction of heart muscle from lack of oxygen

what is MYOCARDIAL INFARCTION

200

heart rate less than 60 with normal pr/qrs interval

causes: MI, electrolyte disturbances, med toxicity, respiratory, increased vagal tone

treatment: atropine, transcutaneous pacing, epi/dopamine infusion

sinus bradycardia

200

Prolonged PR interval, generally no treatment required

First degree AV block

200

many tall waves, 3 premature ventricular contractions in a row

pith a pulse: antiarrhythmic drugs

unstable with a pulse: cardioversion

without pulse: treat with CPR, defib, epi

ventricular tachycardia

200

The nurse is caring for a pt with a PA catheter. The nurse understands that the SVO2 will most likely be which of the following if the pt is in cardiogenic shock?

A) decreased, B)increased, C) the same as usual

A

300

A cardiac disorder that is caused by capillaries becoming highly permeable allowing proteins/ fibrinogens to leave the blood stream and enter pericardial cavity, resulting in inflammation. There are five categories: inflammatory, neoplastic, degenerative, vascular and idiopathic.

What is PERICARDITIS
300

pacemaker cells fire earlier than expected. QRS is normal, interval between r waves change

causes: hypoxia, caffeine, medications, enlarged atria

no treatment needed

premature atrial contraction

300

present in someone that has had an MI in the past

QRS wide and has rabbit ears

bundle branch block

300

flat line 

may have idioventricular beats: when SA and AV are failing and there is still some minimal activity

treat with CPR and epi, DO NOT defibrillate

asystole

300

A nurse is caring for a 12 kg child following cardiac surgery. The chest tube drainage total is 200ml for the past hour. What is the best action?

A) empty the drainage tube, B) Notify the provider, C) increase the suction to the chest tube

B

rationale: drainage should be 1ml/kg/hour. this could be indicative of bleeding

400
A cardiac disorder that is characterized by the heart being unable to pump adequate cardiac output to maintain adequate tissue perfusion, normally goes hand in hand with an MI

what is CARDIOGENIC SHOCK

400

SA node fails and the AV node takes over the pacing (40-60 bpm). p waves are not present or they are buries within the QRS

causes; ischemia, hypoxia, drug toxicity

treatment: transcutaneous pacemaker

junctional escape rhythm

400

atrial rate and ventricular rate but no connection. ventricular rate as low as 20-40

p waves fall in the middle of the qrs

EMERGENCY

causes: MI, ischemia, medication

treatment: pacing, epi/dop infusion

third degree heart block

400

many small waves, no atrial or ventricular contraction, no pulse, no BP

immediate CPR and defibrillation

ventricular fibrilation

400
  1. A nurse is orienting a new nurse on care of a pt who is having a line placed for hemodynamic monitoring. Which of the following by the new nurse indicates understanding?

    1. Air should be instilled into the monitoring system prior to the procedure

    2. The pt should be positioned on the L side during the procedure

    3. The transducer should be level with the 2nd intercostal space after the line is placed

    4. A chest x-ray is needed to verify placement after the procedure

4

500

a cardiac disorder characterized by heart muscles becoming weak, enlarges, tick, or rigid and may develop structural changes. The ejection fraction decreases and symptoms are present when it becomes less than 30%

what is Cardiomyopathy

500

any dysrhythmia with a rate over 150 and originates above the ventricle. QRS in normal limits, one loopy wave between QRS complex

treatment: symptomatic=cardioversion, asymptomatic= vasovagal maneuvers, adenosine, then a beta blocker or calcium channel blocker

causes: hypoxia, cardiac disorders, electrolyte imbalances, drug toxicities, thyrotoxicosis

supraventricular tachycardia

500
dropped QRS, pr interval is constant


causes: ischemia

treatment: atropine, transcutaneous pacing, IM epi

second degree type 2 heart block

500

type of v tach where depolarization is occuring in concentric manner around the ventricle

V tach waves with increasing and decreasing amplitude

stable: treat with magnesium push

unstable: use defibrilation

torsades de pointes

500
  1. A nurse on a cardiac unit is caring for a group of pts. The nurse should recognize which of the following pts as being at risk for the dev. of dysrhythmia? (SELECT ALL THAT APPLY)

    1. A pt who has metabolic alkalosis

    2. A pt who has a blood K of 4.3

    3. A pt who has an SaO2 of 96%

    4. A pt who has COPD

    5. A pt who underwent stent replacement in a coronary artery

1,4,5

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