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100
Care of a patient who just underwent radiofrequecy catheter ablation is similar to that of a patient who just underwent ____
What is cardiac cath
100
Recurring, regular saw tooth-shaped waves
Concerning symptoms: Can cause HF in pts with underlying heart disease, increased risk of stroke. Pts often on Coumadin to prevent clots
Name this rhythm and the tx
What is atrial flutter
Tx (if symptomatic):
1. CCB
2. BB
3. Surgical ablation
4. Electrical cardioversion for emergencies
100
Respiratory symptoms, labs requiring rapid response from nurse, and rapid notification of doc (3)
What are:
1. Low PaO2
2. Extreme acidosis or alkalosis
3. All the late signs of IWOB (discussed on another tab)
100
Calculate the MAP (mean arterial pressure):
BP = 83/50
What is SBP + 2(DBP) / 3
83 + 50(2) / 3
83 + 100 / 3
183/3
MAP = 61 mmHg
100
This is a type of VTach
Name this rhythm and the tx:
What is Torsades de pointes
Tx:
Treat like VTach, but also must give mag sulfate 4 gm
200
This is what defibrillation treats (2)
What are:
1. VFib
2. Pulseless VTach
200
Define defibrillation and how to perform (2)
What is:
1. Attempt to repolarize the heart and have the SA node resume the pacemaker role
2. Apply shock pads and ECG leads, turn OFF the sync button
200
This is used to treat adenosine OD (3)
What are:
1. Defibrillation
2. Vasopressor for hypotension
3. Theophylline
200
Non-pharmacologic tx of choice for atrial dysrhythmias resulting in rapid vent. rates and AV node reentrant tachy refractory to drug tpy. This destroys or ablates accessory pathways or ectopic sites in the atria, AV node and ventricles
What is radiofrequency catheter ablation
300
Adenosine has drug interactions with these (5)
What are:
1. Caffeine
2. Carbamazepine
3. Dipyridamole
4. Guarana
5. Theophylline
300
Antiarrhythmic; used in PSVT; slows conduction thru the AV node and can interrupt reentry pathways thru AV node; decreases cardiac O2 demand, which decreases hypoxia
What is adenosine
300
Teach patients to report these symptoms when given adenosine (5; these symptoms are usually transient)
What are:
1. Facial flushing
2. Dizziness
3. Sweating
4. Palpitations
5. Chest pain
300
These are common side effects that are NOT emergent when given adenosine
What are:
1. Headache
2. Nausea
3. Vomiting
4. Tingling in arms
5. Numbness
300
No impulse from SA to AV node, complete heart block; both nodes contracting independently
Name this rhythm and the tx:
What is 3rd degree AV block
Tx:
1. Pacemaker
2. Dopamine
3. Epi
400
HR 150-220, normal or abnormal rhythm.
Symptons: Prolonged HR > 180 causes decreased CO, hypotension, palpitations, dyspnea, angina
What is SVT
Tx:
1. Valsalva maneuver
2. Carotid massage
3. Coughing
4. Adenosine (regular rhythm)
5. If irregular, adenosine unsuccessful, or hemodynamically unstable, synchronized cardioversion
6. BB
7. CCB
400
Prolonged signal from SA to AV node; gradual lengthening of PR interval followed by a dropped QRS complex; P waves are normal; associated with ischemia; generally transient and well-tolerated
Name this rhythm and tx
2nd degree AV block type I (Mobitz I or Wenckebach)
Tx (if pt symptomatic):
1. Atropine to increase HR
2. Temp pacemaker
400
Conduction from SA to AV node is prolonged; prolonged PR (> 0.20)
Name this rhythm and the tx
What is 1st degree AV block
Tx: None needed, just observe
400
Most common clinically significant dysrhythmia, not a medical emrg. Total disorgan. of atrial electrical activity because of multiple ectopic foci resulting in loss of effective atrial contraction. P waves barely discernible. Atrial = wavy or coarse baseline
Name the rhythm and the tx
What is AFib
Tx:
1. Coumadin to reduce clot risk
2. CCBs
3. BBs
4. Dig to control rate
5. Dronaderone
6. If symptomatic but not responding to therapy - ablation
400
Dropped QRS complex WITHOUT PR lengthening; block in bundle branches; P waves are normal
Name the rhythm and the tx:
What is 2nd degree AV block, type II
Tx: Pacemaker
500
3 or more PVCs; ventricle takes control as pacer; life-threatening dysrhythmia
Name these rhythms and the txs:
What is VTach:
1. Monomorphic
2. Polymorphic
Tx:
1. WITH a pulse = amiodarone and cardioversion
2. Pulseless = CPR and defibrillation
500
These are the late signs of IWOB (5)
What are:
1. Pursed-lip breathing
2. Pt. only able to speak 2-3 words, needing to take a breath (signs of dyspnea)
3. Chest retractions (inward moving of the intercostal spaces or supraclavicular area and accessory muscle use)
4. Paradoxical breathing indicates severe distress
5. If pt. has to sit up to breathe
500
HR < 60, normal rhythm
Symptoms of fatigue, dizziness, chest pain, syncope, pale/cool skin, hypotension, weakness, confusion, disorientation
Name the rhythm and the tx
What is sinus brady; what is:
Tx:
1. Atropine
2. Pacemaker
3. Medication evaluation/discontinuation
500
HR > 100, normal rhythm
Symptoms include dizziness, dyspnea, hypotension (decreased CO), angina
Name this rhythm and the tx
What is sinus tach
1. Treat cause
2. Vagal maneuvers
3. BBs
4. CCs
5. Adenosine
6. If clinically unstable use synchronized cardioversion
500
Distorted P wave, irregular rhythm, contraction starts from ectopic focus in atrium causing it to fire a 2nd time
Symptoms: Palpitations
Name this rhythm and tx
What are PACs
Palpitations - Isolated PACs are not concerning; repeated PACs could be problematic
Tx:
1. Withdrawal of stimulation source (caffeine, sympathomimetic drugs)
2. If severe, administer BB to decrease PACs