Ventricular Arrhythmias

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Author:
NurseFaith
ID:
283561
Filename:
Ventricular Arrhythmias
Updated:
2014-09-19 22:38:51
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Cardio Day Six
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Cardio Day Six
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  1. EKG differences for Ventricular Arrhythmias
    T waves are always bigger and wider than P wave

    P waves come from atrial muscle

    QRS will tend to be wider when there is BBB
  2. When there is an irritable spot in the right ventricle, the ____ side will be stimulated first
    Right
  3. The beat of a PVC goes in what direction?
    • Opposite direction from a normal beat 
    • (wide, fat, ugly beat that interupts rhythm > premature ventricular contraction)
  4. No PR interval, Wide and bizarre QRS, Opposite direction of T wave
    Premature Ventricular Contraction
  5. Pt assessment on someone that has a PVC (premature ventricular contraction)
    • No pulse that you can feel-- NO cardiac output
    • (people can feel these)
  6. What is unique about a beat after a PVC
    • It comes right on (normal) time
    • Compensatory Pause
  7. Most common cause of irritability of heart muscle
    Hypoxia
  8. Number one treatment for patient with PVC (or any heart irratibility)
    OXYGEN! (number one cause of irritability is hypoxia)

    • *check oxygen nasal canula
    • *tell pt to cough
  9. Unifocal PVCs
    come from the  same place in the heart
  10. Multifocal PVCs
    Come from different points on the heart muscle (more dangerous than unifocal) > V Fib!
  11. Treament for Multifocal PVCs
    • Oxygen is priority
    • Amiodarone 150mg IV over 10-15 min
    • Procainamide (Lidocaine/Novacaine) numbing
  12. effect of lidocaine/novacaine on the heart
    Numbing agent and prolongs ventricular resting periods
  13. When two PVCs happen in a row, they are considered to
    "Couplet"
  14. 3 or more PVCs in a row (that have fired rapidly) =
    Short Run of Ventricular Tachycardia
  15. Patterns of Irregular Beats:
    Ventricular Bigeminy (one normal, one irregular...more serious) Trigeminy (normal, normal, PVC) or Quadrigeminy (normal, normal, normal, PVC)
  16. Normal PR interval
    .12-.20
  17. Cause of Ventricular Tachycardia
    Severe irritability of ventricular muscle (hypoxia) as well as acid-base imbalances (lactic acid released in response to blocked artery)
  18. If someone is in Ventricular Tachycardia, there are signs/symp of low cardiac output...what is treatment?
    • Oxygen
    • Cardiovert (synchronized)
    • Push Amiodarone, Procainamide, Lidocaine, and Magnesium
  19. Warning about Treatment during Ventricular Tachycardia:
    pt may become unresponsive and without breathing at any time! (don't treat monitors, ALWAYS assess your patient!)
  20. If person is in V tach with no s/s of life (no pulse) what is treatment?
    CPR, Defibrilator/AED
  21. Rate of 150-250 bpm, No PRI, Wide Short and Fat QRS
    Ventricular Tachycardia
  22. Complication of very low blood temperature
    Ventricular Fibrillation
  23. Totally chaotic EKG with no discernible waves or complexes
    Ventricular Fibrillation
  24. If pt has a "fine" V Fib EKG, giving what will help make it more "corse" and shockable?
    IV epinephrine
  25. Treatment for unresponsive V Fib patient
    • CPR
    • Shock
    • Medications
    • CPR
  26. Treatment order for pt in  V Fib with pulse
    • Oxygen
    • IV access
    • Lidocaine 1 mg
    • Lidocaine .5mg every 8 min (up to 3)
    • Procainamide 20 mg (up to 1000 mg)
    • Cardiovert as in unstable patients
  27. Straight line on EKG, absense of any electrical activity
    Asystole
  28. Only treatment for Asystole
    • Check pt before calling code
    • CPR
    • Epinephrine
    • (shocking will not work because there is no electrical activity)
  29. Things that lead to Asystole
    Pulseless Electrical Activity (PEA) -- assess your pt!

    • Hypovolemia
    • Hypoxia
    • Hydrogen Ion Excess (Acidosis)
    • Hypo/erkalemia
    • Hypothermia
    • Tension Pneumothorax, Tamponade, Toxins, Thrombosis Pulmonary

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