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8/7/2019 2010Cardiac Dysrhythmias
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Cardiac Dysrhythmias
8/7/2019 2010Cardiac Dysrhythmias
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Dysrthythmias
Some are benign
1. Athletic heart syndrome
2. Sympathetic nervous system
Some are lethal
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Cardiac Cell Characteristics
Automaticity
Excitability
Conductivity
Refractoriness
Contractility
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Normal Conduction
SA node-
AV node-
NSR-
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Supraventricular
Any rhythm that originates above the
ventricles
Includes-1. NSR
2. Sinus node dysrhythmias
3. Supraventricular dysrhythmias4. Junctional dysrhythmias
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Sinus Node Dysrhythmias
Sinus arrythmia
Sinus tachycardia
Sinus bradycardia
Sick sinus syndrome
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Ectopic Sinus Node Beats
PAC
PSVT
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Ectopic Sinus Node Beats
Atrial flutter
Atrial fibrillation
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Junctional Dysrhythmias
Junctional escape-
PJC-
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Non-supraventriclar Dysrhythmias
The nasty ones
PVC-
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Ventricular Dysrhythmias
Ventricular tachycardia
Ventricular fibrillation
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V-fibrillation
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Atrioventricular Conduction Blocks
Delay of transmission from sinus node
through AV node
Types-1. 1st degree block
2. 2nd degree block- type 1 and type 2
3. 3rd
degree block- complete heart block4. AV dissociation
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AV conduction blocks
1st degree blocks-
usually benign
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Second Degree Blocks
Type 1- Mobitz 1 or Wenkebach
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AV Conduction Blocks
3rd degree block
AV dissociation
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Diagnostics
ECG-12 lead-
Cardiac monitoring-
1. Continuous bedside-2. Telemetry-
3. Home
Electrophysiology-
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Medications
Sodium channel blockers- Class 1
1. Goal-
2. Action-3. Side effects-
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Beta Blockers-Class 2
Goal-
Uses-
Side effects-
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Potassium Channel Blockers- Class 3
Goal-
Uses-
Side effects
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Calcium Channel Blockers- Class 4
Goal-
Uses-
Side effects-
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Digoxin
Goal-
Uses-
Side effects-
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Treatments
Counter shock
1. Synchronized
cardioversion
2. Defibrillation
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Pace Makers
Uses-
Temporary
Permanent
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Pace Makers
Terms-
1. Sensing-
2. Capture-3. Demand pacing-
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Types of Pace Makers
Single chamber pacing
Dual chamber pacing
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Implantable Defibrillator
How it works-
Uses-
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Care of Clients with Pacers or
Defibrillators
CXR
Minimize movement
ROM
Monitor ECG
Education
Testing
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Cardiac Mapping and Catheter
Ablation
How it works
Uses
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Nursing Diagnoses and Interventions
Decreased cardiac output
1. Assessment
2. Monitor ECG3. Assess causes
4. Cardioversion