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Medical Surgical Nursing_ Chapter 25_ Nursing Care of Patients with Cardiac Dysrhythmias (1
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Medical Surgical Nursing_ Chapter 25_ Nursing Care of Patients with Cardiac Dysrhythmias (1

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  • August 7, 2024
  • 5
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • medical surgical nursing chapter 25 nursing care

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Medical Surgical Nursing: Chapter 25: Nursing Care
of Patients with Cardiac Dysrhythmias
Via a cardiac monitor or ECG/EKG - ANS-How does one view electrical activity of the heart?

Total of 60-100/min - ANS-SA nodes fires how many times/min?

AV node - ANS-The ventricles contract due to electrical stimulations from which node?

This begins with one heart beat and goes until the beginning of the next heart beat. - ANS-What
is a cardiac cycle

Abnormal or disordered heart rhythm. - ANS-What is dysrhythmia(s) or Arrhythmia(s)?

An extra or skipped heart beat. - ANS-What is an ectopic heart beat?

Any part of the myocardium - ANS-Ectopic beats come from _________ ?

When the SA node completes a full cycle (60-100 bpm) - ANS-What is normal sinus rhythm?

This is when the atria contract at a rate of 250-350/min, BUT not every impulse gets through the
AV node (HR<250/min)
- no P wave, so no PR
- associated with CAD, HTN, chronic lung disease, PES, cardiomyopathy, hyperthyroidsim
- F waves march out - ANS-What is an atrial flutter?

- decreased CO, may lead to HF, increased risk of stroke - ANS-Clinical manifestations of atrial
flutter

- slow the ventricular response
- meds: CCB, beta blockers, cardioversion - ANS-Treatment for atrial flutter

This is when the atria rate is 300-600/min, BUT not every impulse gets through the AV node
(NOTE: no P-wave is seen)
- most common dysrhythmias
- chronic or intermittent - ANS-What is atrial fibrillation?

- decreased CO, rapid ventricular response
- medications: beta blockers, CCB
- cardioversion
- anticoagulation - ANS-Clinical significance and treatment of afib

, - used to convert a fib to NSR
- if in afib for more than 48 hrs, anticoagulant therapy is required for 3-4 weeks before the
procedure
-transesophageal echo may be used to r/o clots
- thrombin inhibitors not approved for cardioversion (ie Argatroban,
Dabigatran) - ANS-cardioversion

Ventricle because they pump 5x as much blood with greater strength. - ANS-Which type of
dysrhythmias are worse: Atrial or Ventrical and why?

This is when the ventricles are irritable and fire before the SA node resulting in a wide and
bizarre QRS complex on an ECG. Caffeine can play a role. - ANS-What is a Premature
Ventricular Contraction ("PVC")

This is when the ventricle quivers and is unable to initiate a contraction. This occurs when many
ectopic ventricular foci fire at the same time. DEATH IS IMMINENT IF NOT TRATED
IMMEDIATELY. - ANS-What is ventricular fibrillation?

aka: cardiac arrest (flat line) - ANS-What is asystole also known as?

Electrical cardioversion - ANS-When atrial fibrillation or flutter doesn't respond to medications a
patient may elect to have ________ performed to convert their rhythm?

- First wave of the cardiac cycle and represents atrial depolarization (contraction)
- When the SA node fires the electrical impulse spreads from the right to left atrium. -
ANS-Define P wave

- This represents the time it takes the electrical impulse to travel from the SA node to the AV
node.
- This begins at the P wave and ends at the beginning of the QRS complex - ANS-Define PR
Interval (PRI)

- Represents ventricular depolarization (contraction)
- It's composed of three waves: Q,R and S
- Q wave is the first downward deflection after the P wave
- R wave is the first upward deflection after the p wave
- S wave is the first negative deflection after the R wave - ANS-Define the QRS Complex.

- The interval represents the time it takes for the electrical impulse to travel from the AV node
rapidly through the ventricles. - ANS-Define QRS Interval

This represents ventricular repolarization (resting). When the ventricles are filling with blood and
preparing to receive the next impulse. In most leads, the T wave is an upward (positive)

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