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JM Dysrhythmias

Dysrhythmias

QuestionAnswer
What is a dysrhythmias? Disturbance in heart rate or heart rhythm.
What are dysrhythmias caused by? A disturbance in the electrical conduction of the heart, NOT by abnormal heart structure.
Discuss some nursing assessments for dysrhythmias. OFTEN ASYMPTOMATIC TIl CO ALTERED; tachycardia >100bpm,bradycardia<60bpm, irregular rhythm, pulselessness, ecg changes, complaints of : palpitations,syncope, pain, dyspnea,diaphoresis,hypotension, electrolyte imbalance.
Discuss two nursing diagnoses for dysrhythmias. Ineffective tissue perfusion r/t; Activity intolerance r/t.
What is atrial fibrillation? Chaotic activity in the AV node;no true P waves visible; irregular ventricular rhythm.
Assessment and treatment for Atrial fibrillation? Anticoagulant therapy due to risk for stroke,antidysrhythmic drugs, cardioversion.
Describe atrial flutter. Saw-toothed waveform, fluttering in chest, ventricular rhythm states REGULAR.
What are the assessments and treatment for atrial flutter? Cardioversion to treat atrial dysrhythmia, antidysrhythmic drugs, radiofrequency catheter ablation.
Describe ventricular tachycardia. Wide, bizarre QRS.
What is the assessment and treatment for ventricular tachycardia? Pulse, IMPAIRED CARDIAC OUTPUT, TX: synchronized cardioversion if pulse present (if no pulse, treat as V. Fib.), antidysrhythmic drugs.
Describe ventricular fibrillation. CARDIAC EMERGENCY. Think “V”-VERY BAD!!Irregular undulations of varying amplitudes, from coarse to fine, NO CARDIAC OUTPUT!!
What are some common causes of dysrhythmias? Drugs (e.g.,digoxin,quinidine,caffeine, nicotine,alcohol),acid-base and electrolyte imbalances(K+,Ca+, Mg+),marked thermal changes, disease,trauma,and stress.
What is the basic assessment and treatment for dysrhythmias. CPR, defibrillation as quickly as possible, antidysrhythmic drugs.
Discuss nursing plans/interventions for dysrhythmias. Determine meds client is currently taking,serum drug levels, esp digitalis, serum electrolyte levels, esp K+ and Mg++,obtain ECG reading on admission,monitor CONTINUOUSLY!!
What teaching should the RN do for pt with Holter monitor? Keep a record of: med times/doses,chest pain episodes:type and duration,valsalva maneuver,sexual activity, exercise and other activities.
What should RN’s approach be with pt w/dysrhythmia? What should the RN monitor about pt’s activity? approach calm, reassuring manner,monitor client’s activity,observe for any symptoms occurring during activity.
What should the RN be prepared for with dysrhythmia pt? For emergency measures, such as cardoiversion or defibrillation, be prepared for pacemaker insertion.
Describe a temporary pacemaker and it’s use. Used temporarily in emergency. Pacing wire threaded into rt.ventricle via superior vena cav, or an epicardial wire put thru chest incision during cardiac surgery.
What is cardioversion? The delivery of synchronized electrical shocks to the myocardium.
Describe a permanent internal pacemaker. With pulse generator implanted in the abdomen or shoulder;may be single-or dual-chambered.programmable pacemakers can be reprogrammed by placing a magnetic device over generator.
What teaching should be done concerning pacemaker? Toreport pulse rate lower than the set rate of pacemaker, avoid leaning over car w/engine running,stand 4-5 ft from microwave,radar detectors that are operating,avoid MRI.
What is the difference in synchronous and asynchronous pacemakers? : Synchronous, or demand: Synchronous, or demand pacemaker: fires only when the client’s heart rate falls below a rate set on the generator.Asynchronous, or fixed:pacemaker fires at a constant rate
What tends to be a precursor to ventricular tachycardia and ventricular fibrillation? Premature ventricular contractions (PVCs)-recognize and treat pas prescribed. A PVC is a contraction originating in an ectopic focus in the ventricles. It is the premature occurrence of a QRS complex that is wide and distorted in shape.
What is a PVC? Contraction originating in an ectopic focus inventricles. The premature occurrence of a QRS complex that is wide and distorted in shape: if they occur more often than 1X10beats,groups of two or three, near the T wave,take on multiple configurations.
Created by: 100000255019352
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