Basic Dysrhhythmia
In order, name the conduction pathway.
SA node, AV node, Bundle of His, R/L bundle branch, Purkinje Fibers
FACES
Fatigue
limitation of Activities
Chest congestion/cough
Edema
SOB
What are the 2 most common complications of pericarditis?
Pericardial effusion- can compress nearby structures (lungs, phrenic nerve -->hiccups)
Cardiac tamponade- effusion compressing the heart (CP, anxiety, restless)
What are s/s of aortic stenosis
DOE, chest pain, fatigue, syncope, orthopnea
Heart block saying
If the R is far from P, then you have a First Degree.
Longer, longer, longer, drop! Then you have a Wenkebach. (type 1)
if some P's don't get through, then you have Mobitz II. (type 2)
If P's and Q's don't agree, then you have a Third Degree.
What does the PR interval represent
Conduction through AV node
Longer = slower conduction
Shorter = faster conduction
How is systolic failure measured in LSHF?
Left ventricular ejection fraction- percentage of blood is being pumped out of the heart into the aorta (normal is 55-60%)
What are the 3 pathophysiology phases of endocarditis?
Bacteremia --> adhesion --> vegetation
What are the 2 types of valve disease?
Stenotic- valve doesn't open all the way --> not enough blood passing
regurgitation- valve doesn't close all the way -->backflow
Sinus is 60-100
brady- <60
tachy >100
What is the difference between Afib and aflutter visually on an EKG
Aflutter- pwaves, atrial rate 250-350
Afib- atrial rate 350-400, no pwaves
Name 2 heart failure medications
Diuretic
ACE/ARB
beta blocker
How is endocarditis diagnosed?
Blood cultures, CBC, C reactive protein (inflammation)
Echo
Chest xray
EKG
What are 3 teaching points related to valve repair
medication regimen (anticoagulation therapy)
Good oral hygiene (avoid endocarditis)
Avoid heavy lifting/driving
Monitor for s/s of infection
Medic alert bracelet
Atrial rhythms
Atrial rhythm >ventricular rhythm- conduction gets caught and is firing from somewhere other than the SA node
What are the 3 types of junctional rhythms and what is each rate
Junctional escape- 40-60
Accelerated junctional rhythm- 61-100
Junctional tachycardia >100
P WAVE!!! INVERTED!! Starts at the AV node, P wave (atria) fires randomly or not at all
What is afterload?
The resistance the left ventricle has to overcome in order to pump blood
increased afterload = increased cardiac workload
What are 3 causes of pericarditis?
Infection
MI
Cancer
Trauma
Renal Failure
What is the antibiotic prophylaxis for dental work
2 hours before- amoxicillin 2g --> clindamycin 600mg if allergic to PCN
Junctional rhythms
Originate from AV node
Junctional 40-60
accelerated 61-100
tachy >100
tachy is always >100, the between numbers is accelerated
What are 2 causes of idioventricular rhythm, and what is the rate of ventricular rhythms?
MI, conduction disease; 20-40 BPM
Name 4 patient teaching componenets to heart failure
Daily weights, S/S, Diet (low sodium!), fluid restriction, activity intolerance, medication side effects/regimen
In what disorder is friction rub most often heard, and where is the best place to listen for it?
Pericarditis- L sternal border, patient leaning forward
What history might cause a person to qualify for antibiotic prophylaxis before dental work
Prosthetic valves, previous IE, cardiac transplant
Ventricular rhythms
Originate in the ventricle- ventricles beat so fast that atrial rate cannot be seen on EKG