NURSING NR 341 Critical Care Exam II Notes Latest Updated,100% CORRECT
6 views 0 purchase
Course
NURSING NR 341
Institution
NURSING NR 341
NURSING NR341Critical Care Exam II Notes Latest Updated
Chapter 35:Dysrhythmias/ Arrhythmias
+ Autonomic Nervous System
- Parasympathetic . Nervous System (Decreases rate of SA node/Slows impulse conduction of AV node)
- Sympathetic Nervous System
+ Increases rate of SA node
+ Increases imp...
nursing nr341 critical care exam ii notes latest updated
Written for
NURSING NR 341
All documents for this subject (2)
Seller
Follow
paulhans
Reviews received
Content preview
NURSING NR341Critical Care Exam II Notes Latest Updated
Chapter 35:Dysrhythmias/ Arrhythmias
+ Autonomic Nervous System
- Parasympathetic . Nervous System (Decreases rate of SA
node/Slows impulse conduction of AV node)
- Sympathetic Nervous System
+ Increases rate of SA node
+ Increases impulse conduction of AV node
+ Increases cardiac contractility
- SA node is the normal pacemaker of heart (SA node (atrial side) = Switch of
Heart)
+ HR 60-100 BPM (if SA node if functioning properly)
- Secondary Pacemakers
+ AV node (atrial septum) takes charge if SA node is not functioning properly
- HR 40-60 BPM
+ His-Purkinje Fibers/"Tertiary Pacemaker" takes charge if SA & AV node
not working
- HR 20-40 BPM = NEEDS PACEMAKER!
(ECG/EKG) STANDARD DIAGNOSTIC FOR HEART
- ER with angina (chest pain) 12 lead EKG
1. The P-Wave-depolarization (contraction)
+ P-Wave should be round, smooth, small, upright above isoelectric line
- Like a hill
2. The PR Interval is measured from the beginning of the P Wave to the
beginning of the QRS complex. Time it takes impulse to travel from SA node
to AV node
4. The ST Segment-time between ventricular depolarization and repolarization
(diastole).
+ The ST Segment should be isoelectric (flat).
- ST elevation MI!!
- ST depression Cardiac ischemia
1
,5. The T Wave represents the time for ventricular repolarization
+ T Wave should be upright [peaked T wave=hyperkalemia]
+ Inverted T wave=abnormality
6. The QT Interval-time taken for entire electrical depolarization and
repolarization of the ventricles [prolonged=dysrhythmias]
2
,Key Things to Remember:
+ Tiny box = 0.04 seconds
+ Big box = 5 tiny boxes = 0.2 seconds
+ PR Interval = 3-5 tiny boxes (0.12-0.2 seconds)
- PR interval > 5 boxes = 1st degree heart block
+ QRS = 1-3 tiny boxes (0.04-0.12 second)
- QRS > 3 boxes = some type of ventricular problem
+ ST depression = Ischemia
+ ST elevation = MI (worse than ischemia)
+ P wave = Atrial contraction (multiple p waves= a-fib stroke)
+ Increase HR, Decrease BP = Dehydration Can be sinus tachycardia
*** Signs and Symptoms of Decreased Cardiac Output ***
+ Decreased LOC (Confusion, Dizziness, Syncope, Restlessness, Agitation,
Lethargy, Coma)
*** Dysrhythmias Key Points to Remembers ***
+ Dysrhythmias are not treated unless the patients are symptomatic
+ Dysrhythmias can be categorized as either too fast, too slow, or too
ugly
+ Atrial dysrhythmias are fast heart rates with narrow QRS
complexes
+ Atrial dysrhythmias lead to strokes
+ Ventricular dysrhythmias have wide QRS complexes
+ When rhythms are slow, we want to increase HR
+ When rhythms are fast, we want to slow HR
+ When rhythm is pulseless ventricular tachycardia or
ventricular fibrillation, the patient requires
defibrillation in addition to CPR
+ Pulseless electrical activity is when there is a cardiac rhythm, but the
patient
does not have a pulse
+ Asystole cannot be defibrillated
3
, Changes Associated with Myocardial Ischemia
1. ST segment is depressed = Ischemia
- Normal ST line would be at isoelectric line level
2. T wave is inverted = MI (old)
Patients with ischemia may display one or both changes
Changes Associated with Injury
1. Physiologic Q wave- first negative deflection (wave) following the P wave.
It is normally very short and narrow
2. Dramatic ST segment elevation = MI
Normal Sinus Rhythm
+ Sinus node fires 60-100 beats/minute
+ Follows normal conduction pattern
+ P wave upright and uniform & precedes QRS complex
+ PQ interval 3-5 boxes
+ QRS narrow 1-3 boxes and equal distance
- Distance same = Regular rhythm
+ T wave upright and uniform
4
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller paulhans. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $16.99. You're not tied to anything after your purchase.
