Cardiac dysrhythmias

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farevalo2
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119709
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Cardiac dysrhythmias
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2011-11-29 23:06:19
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cardiac dysrhythmias
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  1. excitability
    bility of cell to respond to stimulus
  2. Automaticity
    ability of cell to reach threshold potential and generate impulses without an outside stimulus
  3. SA node is:
    • pacemaker of the heart
    • sets pace and transmits impulses throughout the myocardium
  4. conductivity
    ability of the muscle to move an impulse from cell to cell
  5. what neurotransmitters work within the sympathetic (adrenergic) nervous system?
    • epi
    • norepi
  6. what do epi and norepi do in the body?
    • raise BP
    • increase HR
    • enhance force of myocardial contraction
  7. which NT works with cholinergic parasympathetic nervous system?
    • acetylcholine
    • --decrease HR
    • --lower BP
    • --reduce force of myocardial contraction
  8. rate of AV node?
    40-60
  9. rate of Bundle of His?
    40-60
  10. rate of bundle branches?
    • 20-40
    • purkinjie fibers? 15-40
  11. during resting state what levels are these electrolytes at INSIDE cell?
    • Na+ lower
    • K+ higher
    • Ca+ lower
  12. what happens to K+, Na+, and Ca++ during depolarization in reference to cells?
    • heart contracts due to Na+ and Ca+ moving into cell
    • and K+ moves out
  13. what is action potential?
    depolarization
  14. repolarization?
    return to resting state
  15. what is EKG?
    graphic display of conduction
  16. monophasic action potential?
    depolarization and repolarization of cardiac muscle cells
  17. what are dysrythmias?
    • disorders of the hearts conduction
    • disturbance in rate, rhythm or both
    • ID by analyzing EKG
  18. 5 large blocks =
    1 sec
  19. QRS Complex:
    • ventricular depolarization
    • contraction of the ventricles
  20. P wave?
    • atrial depolarization
    • contraction of the atrium
  21. duration of P wave should be:
    less than 3 small squares OR <.11
  22. QRS should be:
    <.10
  23. T wave:
    ventricular REpolarization
  24. normal PR interval?
    • .12-.20
    • indicates AV conduction time
  25. steps for interpretation of EKG?
    • 1. look for P-QRS-T
    • 2. determine rate..atrial= count P waves, ventricular= count R waves
    • 3. determine A-V rhythms, R-R for regularity
  26. sinus arrhythmias?
    minor regular variations in HR and pulse pressure assoc with resp
  27. sinus brady?
    • <60 BPM, left untreated if asymptomatic
    • Symptomatic: Atropine IV, Dopamine, Epi
  28. sinus tachy?
    • >100 BPM
    • caused by fever, etc
  29. Tx for atrial flutter?
    • anticoagulation, Cardizem, Digoxin
    • if unstable: cardioversion
    • caused by: aging, hypoxia, electrolyte disturbances, increased atrial pressures, tricuspid vavle disease
    • saw-tooth shaped waves, 200-350 threat of clotting
  30. Tx for A fib?
    • Goal: to decrease atrial irritation, decrease rate of ventricular response
    • CHRONIC: anticoagulation, Warfarin (coumadin), Digoxin, Cardizem, cardioversion if meds not effective synchronized
    • threat of clotting
  31. why cardiovert?
    so pt doesnt go into vfib and need defibrillation
  32. First degree heart block?
    • PR = >.20 (prolonged)
    • delayed conduction through the AV junction
  33. unifocal:
    all uniform
  34. multifocal:
    look different
  35. PVC Tx:
    • Amiodarone bolus 150 mg over 10 mins
    • IV flow of 1 mg/minute
    • may need oral antiarrythmic
  36. Cardioversion and defib are synchronized or not?
    • cardioversion- synchronized
    • defibrillation- unsynchronized
  37. Asystole occurs:
    • most commonly following termination of atrial, AV junctional or ventricular tachycardias. this pause is usually insignificant
    • in AMI, CAD asystole may continue: cardiac arrest
    • Tx: CPR, artificial pacing, Epi, atropine
  38. complications of pacemakers use?
    • infection
    • bleeding, hematoma
    • dislocation of lead
    • cardiac tampponade
    • pacemaker malfunction
  39. sympathetic system: fight or flight:
    increase HR, and BP, enhance force of contractions
  40. during resting state, K+ is where?
    inside cell
  41. V Tach Tx?
    • 1. epi
    • 2. amiodarone
    • 3. lidocaine
    • 4. procainamide
    • AICD
  42. V fib tx?
    • defib
    • CPR
    • epi 1 mg
    • vasopressin 40 U
    • AICD
  43. AV node pacemaker, what type of rhythm is there?
    • Junctional- absent or inverted P wave
    • 40-60 bpm
  44. irregular rhythms?
    • A fib
    • V tach can be
    • V fib

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