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classical 2nd degree heart block
- Rhythm reg
- rate usually brady
- PRI > 0.20 and is constant for conducted beats.
- 2 or more P-Waves for every QRS
hallmark for Classical 2nd degree
PRI is constant for conducted beats and that there is 2 or ore P-Waves for every QRS complex
Interventions for Classical 2nd Degree Heart Block
- observe pt close for S/S of low cardiac output
- usually symptomatic
- encourage rest, limit visitors decrease activity
- have crash cart and external pacemaker near room
- ATROPINE 0.5 - 1mg at bedside (if severely brady)
3rd degree heart block
- rhythm is regular
- rate dependent upon the escaped rhythm. if junctional rate will be 40-60, if ventricular escape rate will be 20-40
- P-Waves are not associated with QRS complexes
- MEDICAL EMERGENCY!!
Hallmark 3rd degree heart block
- there is no constant PRI
- P-Waves and QRS complexes are regular but there is no relationship between the two
interventions for 3rd degree heart block
- Atropine 0.5-1mg at bedside
- Assess freq. notify Physician
- admin O2
- light activity with strict bedrest
- Crash Cart and external defib must be near the pt (pacer pads on standby)
in care of 3rd degree they will need
- a pacemaker, so you need to make sure temp external is on standby in case it is needed
- NO relationship between P-wave and QRS!!
- Asycronized pacing!! (set pacemaker to fire constantly regardless of underlying rhythm.