Dysrhythmias (arrhythmias):
Most common complication post MI
Disturbance of rate, rhythm or conduction of electrical impulses within the heart
Prompt assessment of dysrhythmias and the patient’s response to the rhythm is critical
Classifications of arrhythmias:
Sites:
o SA node (sinus rhythm)
o Atrial (atrial rhythms)
o AV node (nodal or junctional rhythm)
o Ventricles (ventricular rhythms)
Type:
o Flutter
o Fibrillation
o Block
Prognosis:
Minor – no immediate concern
Major – reduction of efficiency of the heart
Lethal – requires immediate treatment or resuscitation, death producing
Dysrhythmias symptoms:
Some dysrhythmias no symptoms
Some dysrhythmias life threatening (sudden collapse, death)
Typical symptoms:
o Dizziness
o Weakness
o Decreased exercise tolerance
o Shortness of breath
o Fainting
o Palpitations or “heart has skipped a beat”
Common causes of dysrhythmias:
Cardiac causes
o Accessory pathways, conduction defects
o Cardiomyopathy, heart failure
o Myocardial cell degeneration (ischemia, injury, infarction)
o Valve disease
Other conditions
o Acid-base imbalances
o Electrolyte disturbances
o Caffeine, tobacco, alcohol
o Drug effects (antidysrhythmia, stimulants, beta-blockers)
o Emotional crisis, herbal supplements, connective tissue disorders
o Hypoxia, shock
o Metabolic conditions (thyroid dysfunction)
, lOMoARcPSD|20734855
2
o Near-drowning, poisoning
Sinus Bradycardia
Identifying EKG characteristics:
▪ Rate: < 60 beats a minute
▪ Rhythm: Regular
▪ P waves: Normal and precede each QRS
▪ PR interval: Normal range (0.12 – 0.20)
▪ QRS: Normal (< 0.12)
Etiology:
▪ May be normal in physically conditioned adults and during sleep
▪ Increased vagal tone (Valsalva maneuver, endotracheal suctioning, vomiting, gagging)
▪ Medication effect (narcotics, cardiac glycoside, beta blockers, calcium channel blockers)
▪ Pathology (hypothermia, hypothyroidism, increased intracranial pressure, obstructive jaundice,
MI--- inferior wall MI involves right coronary artery). Ischemia of sinus node slows rate.
Clinical significance:
▪ May be asymptomatic.
▪ Symptoms are associated with decreased cardiac output:
o Hypotension, dizziness, syncope
o Pale, cool skin
o Weakness
o Confusion or disorientation
o Shortness of breath
o Angina
o Decreased urinary output
Treatment:
▪ Treat only is symptomatic
▪ Atropine IVP (0.5 – 1 mg)
▪ If due to medication discontinue or reduce dose
▪ Pacemaker may be required
Nursing implications:
▪ Assess for signs and symptoms of decreased cardiac output
▪ Observe for premature ventricular contractions (PVCs) or other ectopic beats
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 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 HIGHSCORE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for £6.55. You're not tied to anything after your purchase.
