Describe treatment of dysrhythmias correct answer: To determine if treatment is necessary, assess the patient. Then ask the following questions:
Is he or she experiencing signs and symptoms of decreased cardiac output?
Is the dysrhythmia potentially life threatening?
If the answer to either of ...
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Cardiac Dysrhythmias Part 2 Questions
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Describe treatment of dysrhythmias correct answer: To determine if treatment is necessary, assess the patient. Then ask the following questions:
Is he or she experiencing signs and symptoms of decreased cardiac output?
Is the dysrhythmia potentially life threatening?
If the answer to either of these questions is yes, the patient will need to treatment for the dysrhythmia.
***WE WILL DISCUSS TREATMENTS OF DYSRHYTHMIAS BASED UPON CURRENT ACLS TREATMENT ALGORITHMS
CLINICAL MANIFESTATIONS OF DECREASED CARDIAC
OUTPUT INCLUDE CHEST PAIN, DYSPNEA, DECREASED LEVEL OF CONSCIOUSNESS, HYPOTENSION, HEART FAILURE
IF PATIENT IS NOT SHOWING SIGNS OF DECREASED CO THEN SEARCH FOR CONTRIBUTING CAUSES AND SEEK EXPERT CONSULTATION
POTENTIALLY LIFE THREATENING DYSRHYTHMIAS: SECOND DEGREE AV BLOCK TYPE II, COMPLETE HEART BLOCK, VENTRICULAR TACHYCARDIA, VENTRICULAR FIBRILLATION What are the Hs and Ts (potential causes of rhythm issues)? correct answer: Hypovolemia
Hydrogen ions (acidosis)
Hyper/hypokalemia
Hypoxia
Hypothermia Hypervagal
Hypoglycemia
Malignant Hyperthermia
Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis (cardiac)
Thrombosis/embolus (pulmonary)
Trauma
QT prolongation
Pulmonary hypertension
What categories can dysrhythmias be divided into for determining treatment? correct answer: Bradycardias
Tachycardias
Pulseless arrest
**AS A GENERAL RULE, IF A DYSRHYTHMIA IS CAUSING A DROP IN CARDIAC OUTPUT AND IT IS TOO FAST, YOU SLOW IT DOWN; IF IT IS TOO SLOW, YOU SPEED IT UP.
IF ECTOPICS ARE PRESENT, YOU SUPPRESS THEM BY DECREASING THE IRRITABILITY. IF CARDIAC ARREST IS PRESENT, YOU GENERATE A MORE VIABLE RHYTHM.
What are the steps for treatment of dysrhythmias in general? correct answer: Identify and treat underlying cause (might need to treat emergently if the patient has manifestations of decreased
cardiac output)
Maintain airway
Give O2
IV access
12 Lead ECG (but should not delay treatment)
How do you treat bradycardia dysrhythmias? correct answer: If a patient is experiencing altered mental status, chest pain, dyspnea, lightheadedness, hypotension, or ventricular ectopy, treatment should be instituted:
Give O2; give fluids (to normalize BP)
Atropine 0.5 mg IV (drug of choice) (maximum dose 3 mg) (while awaiting pacemaker) Transcutaneous pacing (if available) Prepare for transvenous pacing
Dopamine (2-10 mcg/kg/min), or Epinephrine (0.05-0.1 mcg/kg/min) (if a transcutaneous pacemaker is unavailable and patient not responsive to atropine)
**THE TREATMENT OF BRADYCARDIAS DEPENDS UPON THE PATIENT'S ABILITY TO TOLERATE THE DYSRHYTHMIA.
CAN ALSO USE TRANSVENOUS TEMPORARY PACEMAKING
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