Relias Assessments Assistance Material DYSRHYTHMIAS

Relias Assessments Assistance Material DYSRHYTHMIAS EKG interpretation - Answer-One of the most useful and commonly used diagnostic tools is electrocardiography (EKG) which measures the heart's electrical activity as waveforms. An EKG uses electrodes attached to the skin to detect electric current moving through the heart. These signals are transmitted to produce a record of cardiac activity. Arrhythmia or dysrhythmia are disturbances in the normal cardiac rhythm of the heart which occurs as a result of alterations within the conduction of electrical impulses. These impulses stimulate and coordinate atrial and ventricular myocardial contractions that provide cardiac output. Sinus Tachycardia - Answer-Sinus tachycardia is a heart rate greater than 100 beats per minute that originated from the sinus node. Rate: 100 to 180 beats per minute P Waves precede each QRS complex PR interval is normal QRS complex is normal Conduction is normal Rhythm is regular Causes of sinus tachycardia may include exercise, anxiety, fever, drugs, anemia, heart failure, hypovolemia and shock. Sinus tachycardia is often asymptomatic. Management however is directed at the treatment of the primary cause. Carotid sinus pressure (carotid massage) or a beta blocker may be used to reduce heart rate. Sinus Bradycardia - Answer-Sinus bradycardia is a heart rate less than 60 beats per minute and originates from the sinus node (as the term "sinus" refers to sinoatrial node). It has the following characteristics Rate is less than 60 beats per minute P Waves precede each QRS complex PR interval is normal QRS complex is normal Conduction is normal Rhythm is regular Causes may include drugs, vagal stimulation, hypoendocrine states, hypothermia, or sinus node involvement in MI. This arrhythmia may be normal in athletes as they have quality stroke volume. It is often asymptomatic but manifestations may include: syncope, fatigue, dizziness. Management includes treating the underlying cause and administering anticholinergic drugs like atropine sulfate as prescribed. Premature Atrial Contraction - Answer-Premature Atrial Contraction are ectopic beats that originates from the atria and they are not rhythms. Cells in the heart starts to fire or go off before the normal heartbeat is supposed to occur. These are called heart palpitations and has the following characteristics: Premature and abnormal-looking P waves that differ in configuration from normal P waves QRS complex after P waves except in very early or blocked PACs P waves often buried in the preceding T wave or identified in the preceding T wave. Causes includes coronary or valvular heart diseases, atrial ischemia, coronary artery atherosclerosis, heart failure, COPD, electrolyte imbalance and hypoxia. Usually there is no treatment needed but may include procainamide and quinidine administration (antidysrhythmic drugs) and carotid sinus massage. Atrial Flutter - Answer-Atrial flutter is an abnormal rhythm that occurs in the atria of the heart. Atrial flutter has an atrial rhythm that is regular but has an atrial rate of 250 to 400 beats/minute. It has sawtooth appearance. QRS complexes are uniform in shape but often irregular in rate. Normal atrial rhythm Abnormal atrial rate: 250 to 400 beats/minute