Exam (elaborations)
Medsurg Basic cardiac dysrhythmias Part 1 (1)
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Medsurg Basic cardiac dysrhythmias Part 1 (1)
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Medsurg Basic cardiac dysrhythmias Part 1Disorders of formation or conduction (or both) of electrical impulses within heart
Disturbances may be due to:
Rate
Rhythm
Both rate and rhythm
Potentially can alter blood flow and cause hemodynamic changes
Diagnosed by analysis of electrographic waveform
May be benign (sinus arrhythmia) - some acute; some chronic
May be lethal (ventricular fibrillation) - may require emergent intervention - ANS-dysrhythmias
Lack of oxygen
Drugs
Local anesthetics
Beta blockers, Calcium channel blockers
Amiodarone
Epinephrine
Digitalis
Autonomic Nervous System Influences
Sympathetic or Parasympathetic
Health history: include presence of coexisting conditions, indications of previous occurrence
All medications: (prescribed and OTC)
Psychosocial assessment: patient's "perception" of dysrhythmia
Decreased CO!!!!!!!!!!!!!!!!! - ANS-factors contributing to dysrhythmias
Atrial
Premature atrial complex
Atrial flutter
Atrial fibrillation
Ventricular
Premature ventricular complex
Ventricular tachycardia
Ventricular fibrillation
Ventricular asystole
Classified by site of origin and underlying cause
, Ventricular tachycardia means there is a problem in the ventricles causing a rapid heart rate
within the ventricles (inherent rates!)
Atrial fibrillation means there is a problem in the atria causing altered conduction through the
atria
First Degree AV Block means the problem is in the AV junction and electrical impulses are being
blocked - ANS-types of dysrhythmias
Conduction Disturbances
First-degree AV Block
Second-degree AV Block, Type I (Wenckebach)
Second-degree AV Block, Type II
Third-degree AV Block - ANS-dysrhythmia classification
Electrical activity precedes mechanical activity
Electrical activity can occur without mechanical activity
Electrical stimulation - mechanical stimulation - contraction = pulse, CO, BP - ANS-ECG
represents electrical activity
Ability to initiate an electrical impulse - ANS-automaticity
Ability of one cell being stimulated to stimulate adjoining cells and conduct a current -
ANS-conductivity
Ability to be stimulated by an adjoining cell - ANS-excitability
Ability of cell to not respond to stimulation if the impulse cannot be conducted normally -
ANS-refractioriness
Initiate and conduct impulses - ANS-electrical cells
Contract in response to stimulation - ANS-mechanical cells
depolarization and is associated with systole - ANS-electrical stimulation
repolarization and is associated with diastole - ANS-electrical relaxation
Electrical Impulses visible on ECG
Each phase of cardia cycle reflected by specific waveform
Electrodes: clip hair; abrade skin with dry gauze; no alcohol
If not attached correctly - will cause artifact - distorted waveform
Various sites for electrode placement - continuous monitors use 2 - 5 electrodes
Creating imaginary line called a - looks at electrical activity directly in front of it
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