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Med_Surg Exam -1_ Dysrhythmias part 2 (1)
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Med_Surg Exam -1_ Dysrhythmias part 2 (1)
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Med/Surg Exam #1: Dysrhythmias part 2- premature atrial contractions (PACs)
- atrial fibrillation
- atrial flutter
- paroxysmal atrial tachycardia
- supraventricular tachycardia
- supraventricular tachycardia
- wandering atrial pacemaker - ANS-Atrial dysrhythmias
- a premature, ectopic electrical impulse discharges in the atrium before the next normal impulse
of the SA node
- p-wave complex comes in early - ANS-Premature Atrial Contraction (PAC)
a pacemaker site outside of the SA node - ANS-ectopic beat
- rhythm: regular except where the premature beat occurs
- rate: is the rate of the underlying rhythm (60-100 bpm)
- atrial conduction: p-wave before the ectopic beat is different from the p waves of the underlying
rhythm - ANS-PAC criteria
- caffeine
- alcohol
- nicotine
- stretched atrial myocardium
- HR
- anxiety
- hypokalemia
- hyper-metabolic states
- atrial ischemia
- medications
- can be normal is healthy hearts - ANS-causes of PAC
- no treatment is generally needed
- assess the patient
- remove causing agent - ANS-treatment of PAC
- ANS-PAC
- atria are depolarized at rates of 250-400 times per minute
- caused by a reentry circuit
, - not all the atrial impulses are conducted into the ventricle, causing a therapeutic block at the
AV node - ANS-atrial flutter
- atrial rate is between 250-400
- ventricular rate is variable
- atrial rhythm can be either regular or irregular, depending on the conduction pattern
- p-waves produce a saw-tooth pattern called flutter waves - ANS-atrial flutter criteria
what is the atrial rate of atrial flutter? - ANS-250-400
- usually associated with underlying cardiac disease
- long standing hypertension
- cardiomyopathy
- CAD
- hypoxia
- heart failure
- valvular disease
- SA node damage
- post open heart surgery
- digitalis toxicity - ANS-causes of atrial flutter
may cause blood stasis and thromboembolisms due to lack of atrial contraction; stroke! -
ANS-atrial flutter
- control heart rate: diltiazem, beta blockers, digitalis
- convert to NSR: amiodarone, cardioversion
- vagal maneuvers: carotid sinus massage, cough
- anticoagulation - ANS-treatment of atrial flutter
what 5 types of drugs should be given to treat atrial flutter? - ANS-diltiazem (CCB), beta
blockers, digoxin, amiodarone, and anticoagulants
- ANS-atrial flutter
- uncoordinated atrial electrical activation from multiple areas in the atria
- results in a rapid, disorganized, quivering fibrillating atria
- ventricular rate is dependent on the ability of the AV node to conduct the atrial impulses
- lack of atrial contraction increases the risk of thromboembolism formation - ANS-atrial
fibrillation
what type of p waves does atrial flutter have? - ANS-flutter
- ANS-atrial fibrillation
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