Exam (elaborations)
Med Surg_ Cardiac Test 2 - Ch. 35 Dysrhythmias (1).
- Course
- Institution
Med Surg_ Cardiac Test 2 - Ch. 35 Dysrhythmias (1).
[Show more]
Seller
Follow
modockochieng06
Content preview
Med Surg: Cardiac Test 2 - Ch. 35 DysrhythmiasResult from disorders of impulse formation, conduction of impulses or both - ANS-Dysrhythmias
Autonomic
Parasympathetic (Vagus Nerve) - Decreases rate of SA node, slows impulse conduction of AV
node
Sympathetic - Increases rate of SA node, Increases impulse conduction of AV node, and
Increases cardiac contraction - ANS-Nervous System control of the Heart
60-100 BPM - ANS-Normal Pacemaker
40-60 bpm - ANS-Normal AV node
20-40 bpm - ANS-Normal Purkinje fibers
6 second strips; voltage = x, time = y
Large (5x5) and small squares (1 mV x 0.04s)
300 large squares = 1 min - ANS-ECG Time and Voltage
P-Wave - Atrial Depolarization
P-R Interval - P-wave to beginning of QRS - ANS-ECG Monitoring - Atrium
QRS Complex - Q wave is normally negative deflection after P-wave; R wave is normally first
positive deflection; S wave is normally first negative deflection after R wave; Depolarization of
both ventricles (systole)
S-T Segment is S wave to beginning of T wave - time between ventricular depolarization and
repolarization (diastole); should be isoelectric (flat)
T wave - ventricular repolarization (should be upright) - ANS-ECG Monitoring - Ventricles
Presence of P wave: upright or inverted, one for every QRS or multiple, A-Fib or flutter waves
present
Atrial Rhythm: regular or irregular
Atrial Rate
Duration of P-R interval: normal or prolonged
Ventricular Rhythm: Regular or irregular
Ventricular Rate
Duration of QRS: normal or prolonged
ST Segment: is it isoelectric (flat_, elevated, or depressed
Q-T Interval: normal or prolonged duration
T wave: upright or inverted
Is there a dominant or underlying rhythm and/or dysrhythmia?
, What is the clinical significance of your findings?
What is the treatment for Identified rhythm? - ANS-Questions to ask when evaluating Cardiac
rhythm
Determine HR, Is HR normal?, Is it regular and is R wave equal distance?, What waves are
present?, then analyze - ANS-Steps to interpret 6-Second Strips
Count - Number of QRS complexes in 1 minute, R-R intervals in 6 seconds, and multiply by 10,
Number of small squares between one R-R interval, and divide this number into 1500, Number
of large squares between one R-R interval, and divide this number into 300 - ANS-Calculating
HR
Clip excessive hair, rub skin w/dry gauze, alcohol for oily skin, may need skin protectant if
diaphoretic, then apply electrode pad (with lead attached) - ANS-Patient Prep for ECG
Shows structural changes, conduction disturbances, damage (ischemia or infarction), electrolyte
imbalance, or drug tox.
Place leads according to diagram
Artifact = wrong lead placement - ANS-12-Lead ECG
Observation of HR and rhythm at a different site
Two types - centralized: trained person monitoring at all times; advanced alarm: alerts when
abnormalities, not monitored at all times
Frequently assess all monitored patients - ANS-Telemetry Monitoring
Interpret rhythm and evaluate cardiac status of patient
Is patient hemodynamically stable? (all vitals new or normal)
Determine cause of Dysrhythmia
Treat the patient, NOT the monitor - ANS-Assessment of Cardiac Rhythm
60-100 bpm; normal conduction pattern - ANS-Normal Sinus Rhythm (NSR)
<60 bp, normal conduction pattern
Normal in aerobic athletes and during sleep
Can occur during: PNS - carotid massage, valsalva maneuver, hypothermia, vagal stimulation;
Drugs - B-adrenergic (-olol) and Ca+ Channel Blockers (-pines)
Associated with: Hypothyroidism, Hypoglycemia, Increased Intracranial Pressure, Interior MI
Manifestations: Hypotension, pale/cool skin, weakness, angina, dizziness or syncope, confusion
or disorientation, SOB
Treatment: Atropine, Pacemaker, or stop offending drugs - ANS-Sinus Bradycardia
101-200 bpm, normal conduction pattern
Possible decreased cardiac output due to not enough filling
Caused by: vagal inhibition and sympathetic stimulation
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 modockochieng06. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $7.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now