EKG basics and Dysrhythmias part 2 Questions With Complete Solutions

types of ventricular dysrhythmias correct answer: -Premature Ventricular Contractions -Ventricular Tachycardia -Ventricular Fibrillation -Asystole Ventricular dysrhythmias are correct answer: more life threatening than atrial dysrhythmias premature ventricular dysrhythmias are also known as correct answer: PVC'S Premature ventricular complexes are a result of correct answer: increased irritability of ventricular cells -early ventricular complexes followed by a pause Treatment for PVC correct answer: eliminate contributing cause -underlying conditions -stress, drug, infections, surgery -K/Mag IF PVC's are frequent they can be treated with a correct answer: beta blocker When do you worry about PVC's correct answer: when they're frequent and cardiac output is affected PVC's look correct answer: wide and bizarre Ventricular tachycardia correct answer: repetitive firing of irritable ventricular ectopic focus usually 140-180 BPM Intermittent ventricular tachycardia correct answer: is non sustained sustained vtach correct answer: lasts 15-30 seconds What does vtach look like correct answer: What do PVC's look like correct answer: VT is a common initial rhythm in correct answer: cardiac arrest Treatment for vtach in a patient who is stable correct answer: cardioversion followed by antidysrhthmic meds to prevent further incidents Treatment for unstable vtach correct answer: (unstable means pulseless) CPR and defibrillation Treatment for persistent vtach correct answer: radiofrequency ablation Causes of vtach correct answer: MI cardiomyopathy hypokalemia hypomagnesemia valvular disease HF drug toxicity hypotension Ventricular fibrillation is fatal within how many minutes correct answer: 3-5 Ventricular fibrillation correct answer: electrical chaos What does the rhythm look like with vfib correct answer: disorganized, no recognisable EKG reflections What causes v-fib correct answer: MI hypokalemia hypomagnesemia hemorrhage drug therapy rapid SVT shock With vfib ventricular contraction cannot occur so correct answer: there's no perfusion What does ventricular fibrillation look like correct answer: Symptoms of vfib correct answer: pt will be faint lose consciousness become pulseless apnic no BP no HR respiratory acidosis metabolic acidosis pupils fixed and dilated skin cold and mottled Interventions for vfib correct answer: *Defib* CPR drug therapy: antidysrhythmic What is the treatment goal for vfib correct answer: convert to an organized rhythm what does torsades de pointes look like correct answer: Torsades de pointes is a type of correct answer: ventricular tachycardia What can cause torsades de pointes correct answer: antidysrhythmics Treatment for torsades de pointes correct answer: magnesium sulfate Asystole correct answer: ventricular standstill complete absence of any ventricular rhythm What causes asystole correct answer: Usually result of advanced cardiac disease, severe conduction disturbance, or end-stage HF Cardiac arrest correct answer: What is your job when your pt goes into cardiac arrest correct answer: give information about the pt rhythm prior to arrest record info family support Treatment for cardiac arrest correct answer: start compressions maintain patent airway ventilate with mouth-mask device Defibrillation correct answer: Asynchronous countershock that depolarizes critical mass of myocardium simultaneously to stop re-entry circuit and allow sinus node to regain control of heart Defibrillation allows for correct answer: a system reset and allows the SA node to kick back in Dont delay defibrillation because it is correct answer: the best chance for survival Automated external defibrillation correct answer: create an opportunity for laypersons to respond to cardiac arrest What is the function of AED's correct answer: analyze the rhythm and shocks are delivered for ventricular fibrillation or pulseless ventricular tachycardia only! Implantable defibrillator correct answer: inserted under subclavian one of more episodes of spontaneous sustained VT or VF not caused my MI leads are implanted Nursing care for implantable defibrillator is correct answer: similar to PPM insertion Normal sinus rhythm assessment correct answer: HR 60-100 regular rhythm Sinus arrhythmia assessment correct answer: HR 60-100 irregular rhythm Sinus arrhythmia causes correct answer: intrathoracic changes during breathing Treatment for sinus arrhythmia correct answer: treat underlying cause Sinus tachycardia assessment correct answer: HR greater than 100 palpitations, chest discomfort, anxiety pale, syncope, signs of hypovolemia( decreased urine output, increased HR and decreased BP) Causes of sinus tachycardia correct answer: MI electrolyte imbalances hypoxia drug toxicity hypovolemia Treatment for sinus tachycardia correct answer: assess apical and radial pulse for 1 min bedrest if BP is low Education for sinus tachycardia correct answer: avoid substances increased fluids rise slowly stress management Sinus bradycardia assessment correct answer: HR less than 60 LOC decreased perfusion weakness Sinus brady can be normal in correct answer: athletes causes of sinus bradycardia correct answer: HTN medications straining stimulation of vagus nerve Treatment for sinus bradycardia correct answer: Atropine transcutaneous or transvenous pacer O2 IV fluids Assessment for PAC's correct answer: usually no symptoms may have palpitations premature p-wave my be masked by previous t-wave Causes of PAC correct answer: Stress Fatigue Caffeine Tobacco Alcohol Hypoxia Electrolyte imbalance ischemia inflammation Treatment for PAC's correct answer: treat cause education meds What meds are used in treatment for PAC's correct answer: anticoagulants antidysrhythmics SVT Assessment correct answer: HR 100-280 CP Palpitations May have no p-waves Causes of SVT correct answer: stress illicit drugs ETOH Caffeine thyroid disorder congenital Who is most likely to have SVT correct answer: young people especially women Treatment for SVT correct answer: vagal maneuvers cardioversion (adenosine) RFA AFib assessment correct answer: asymptomatic irregular HR fatigue SOB weakness Causes of afib correct answer: HTN previous MI HF diabetes TIA CKD alcohol Treatment for afib correct answer: antidysrhythmics beta blockers anticoagulants PVC's assessment correct answer: decreased cardiac output decreased perfusion decreased LOC SOB Causes of PVC"s correct answer: age MI HF COPD anemia stress drugs infection surgery Treatment for PVC's correct answer: treat underlying cause K/Mag beta blocker