2010cardiac dysrhythmias

8/7/2019 2010Cardiac Dysrhythmias

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Cardiac Dysrhythmias



Dysrthythmias

Some are benign

1. Athletic heart syndrome

2. Sympathetic nervous system

Some are lethal



Cardiac Cell Characteristics

Automaticity

Excitability

Conductivity

Refractoriness

Contractility



Normal Conduction

SA node-

AV node-

NSR-



Supraventricular

Any rhythm that originates above the

ventricles

Includes-1. NSR

2. Sinus node dysrhythmias

3. Supraventricular dysrhythmias4. Junctional dysrhythmias



Sinus Node Dysrhythmias

Sinus arrythmia

Sinus tachycardia

Sinus bradycardia

Sick sinus syndrome



Ectopic Sinus Node Beats

PAC

PSVT



Ectopic Sinus Node Beats

Atrial flutter

Atrial fibrillation



Junctional Dysrhythmias

Junctional escape-

PJC-



Non-supraventriclar Dysrhythmias

The nasty ones

PVC-



Ventricular Dysrhythmias

Ventricular tachycardia

Ventricular fibrillation



V-fibrillation



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



AV conduction blocks

1st degree blocks-

usually benign



Second Degree Blocks

Type 1- Mobitz 1 or Wenkebach



AV Conduction Blocks

3rd degree block

AV dissociation



Diagnostics

ECG-12 lead-

Cardiac monitoring-

1. Continuous bedside-2. Telemetry-

3. Home

Electrophysiology-



Medications

Sodium channel blockers- Class 1

1. Goal-

2. Action-3. Side effects-



Beta Blockers-Class 2

Goal-

Uses-

Side effects-



Potassium Channel Blockers- Class 3

Goal-

Uses-

Side effects



Calcium Channel Blockers- Class 4

Goal-

Uses-

Side effects-



Digoxin

Goal-

Uses-

Side effects-



Treatments

Counter shock

1. Synchronized

cardioversion

2. Defibrillation



Pace Makers

Uses-

Temporary

Permanent



Pace Makers

Terms-

1. Sensing-

2. Capture-3. Demand pacing-



Types of Pace Makers

Single chamber pacing

Dual chamber pacing



Implantable Defibrillator

How it works-

Uses-



Care of Clients with Pacers or

Defibrillators

CXR

Minimize movement

ROM

Monitor ECG

Education

Testing



Cardiac Mapping and Catheter

Ablation

How it works

Uses



Nursing Diagnoses and Interventions

Decreased cardiac output

1. Assessment

2. Monitor ECG3. Assess causes

4. Cardioversion



Sudden Death

Cardiac arrest

Causes

S/S Basic life support

Advanced cardiac life support

2010cardiac dysrhythmias

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