Warren Shared "Cardiac + Dysrhythmias" - 22 Picmonics
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Cardiac + Dysrhythmias
EKG Findings - Treatments
- Atrial Fibrilation
- Rate Control (Beta-blockers, Ca-Blockers or Digoxin)
- Warfarin before Cardioversion
- Atrial Flutter
- Tx same as A-Fib
- Multifocal Atrial Tachycardia
- Verapamil
- SVT
- Vagal Maneuvers
- Adenosine (Adenocard)
- Ventricular Tachycardia
- Amiodarone or Lidocaine
- Ventricular Fibrilation
- Cardioversion then Epinephrine
- Torsades de Pointes
- Magnesium
Parts of an ECG
- PQRST
- P Wave
- Atrial Depolarization
- QRS Complex
- Ventricular Depolarization
- T Wave
- Ventricular Repolarization
2 mins
ECG Interpretation
- Rate
- Rhythm
- P Waves
- Upright, Rounded, Before Every QRS
- PR Interval (< 0.20 seconds)
- Normal QRS (< 0.12 seconds)
2 mins
ECG: Sinus Bradycardia
- Rate
- < 60 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Atropine
1 min
ECG: Sinus Tachycardia
- Rate
- > 100 bpm
- Rhythm
- Regular
- P Wave
- Present, Upright, Every QRS
- PR Interval
- < 0.20 seconds
- QRS Interval
- < 0.12 seconds
- Treatment
- Treat Underlying Cause
2 mins
ECG: Atrial Flutter
- Rate
- Variable
- Rhythm
- Regular or Irregular
- P Wave
- Saw Tooth, Multiple Before Every QRS
- PR Interval
- Non-measurable
- QRS Interval
- < 0.12 seconds
2 mins
ECG: Atrial Fibrillation
- Rate
- Variable Rate
- Rhythm
- Irregular Rhythm
- P Wave
- No P Wave
- PR Interval
- No PR Interval
- QRS Interval
- QRS < 0.12 Seconds
1 min
Atrial Fibrillation/Flutter Pharmacologic Treatment (USD SSOM)
- Acute Rhythm Control
- Cardioversion
- Anticoagulants
- Ibutilide
- Chronic Rhythm Control
- Sotalol
- Amiodarone
- Dronedarone
- Acute & Chronic Rhythm Control
- Dofetilide
- Flecainide
- Propafenone
- Acute & Chronic Rate Control
- Verapamil
- Diltiazem
- Beta Blockers
- Amiodarone
- Digoxin
8 mins
AV Block Types
- 1st Degree
- 1st degree
- The PR interval is prolonged (> 200 msec)
- Benign and asymptomatic. No treatment required
- Slow conduction of AV Node
- 2nd degree
- Mobitz type I (Wenckebach)
- Mobitz type I (Wenckebach)
- Progressive lengthening of PR interval until a beat is “dropped” (a P wave not followed by a QRS complex)
- Usually asymptomatic
- Variable RR interval with a pattern (regularly irregular)
- Slow conduction of AV Node
- Mobitz type II
- Mobitz type II
- Dropped beats that are not preceded by a change in the length of the PR interval (as in type I)
- PR interval normal because problem is in Bundle of His, not AV node
- May progress to 3rd-degree block.
- Often treated with pacemaker
- 3RD DEGREE (COMPLETE)
- 3rd degree (complete)
- The atria and ventricles beat independently of each other.
- P waves and QRS complexes not rhythmically associated.
- Atrial rate > ventricular rate.
- Usually treated with pacemaker.
- Can be caused by Lyme disease.
Atrioventricular Block Types
- First Degree
- First Degree
- PR Interval > 200ms
- No Treatment Needed
- Second Degree
- Second Degree
- Mobitz I (Wenckebach)
- Progressive PR Interval Lengthening with Nonconducted QRS Complex
- Mobitz II
- Constant PR Interval with Nonconducted QRS Complex
- Third Degree
- Third Degree
- Atrioventricular Dissociation
3 mins
Amiodarone
- Blocks K channels
- Blocks Na Channels
- Weak Calcium Channel Blocking
- Peripheral Vasodilation
- Oral and IV
- Hepatic Metabolism
- Levels Detected over Long Period
- CYP Induction
- Life-threatening Antiarrythmic
- Hospitalize for First Dose
- Adverse Effects
- Drug Deposits
- Photodermatitis
- Corneal Microdeposits
- Bradycardia and AV Block with IV
- Pulmonary Toxicity
- Hepatotoxicity
- Proarrythmic
- Pregnancy Risk Factor D
- Hypo or Hyperthyroidism
Ventricular Fibrillation (V-fib)
- Causes
- Myocardial Infarction
- Ischemia
- Disease States
- Cardiac Catheterization
- Pacemaker
- Symptoms
- Unresponsive
- Pulseless
- Apnea
- Treatment
- CPR/ACLS
- Defibrillation
- Drugs (epinephrine & vasopressin)
2 mins
Ventricular Fibrillation / Pulseless Ventricular Tachycardia Treatment (USD SSOM)
- Termination
- Cardioversion
- Amiodarone
- Procainamide
- Lidocaine
- Magnesium
- Prophylaxis
- Implantable Cardioverter Defibrillator
- Beta Blockers
- Amiodarone
6 mins
Nitroglycerin
- Mechanism of Action
- Decreases Preload
- Indications
- Angina
- Up to 3 doses q 5 mins
- Side Effects
- Headache
- Hypotension
- Contraindications
- Viagra (Sildenafil)
- Nursing Considerations
- Assess Blood Pressure
- Protect From Light
- Use Glass Bottle and Special Tubing
- Gloves for Applying Topically
2 mins
Myocardial Infarction Interventions
- MONA
- Morphine
- Oxygen
- Nitrates
- Aspirin
- Thrombolytics (tPA)
- Invasive Procedures
- Cardiac Catheterization
- Stent Placement
- Angioplasty
- Coronary Artery Bypass Grafting (CABG)
- Considerations
- Decrease Modifiable Risk Factors
- Resuming Activity (Physical, Sexual)
2 mins
Coronary Artery Bypass Grafting (CABG)
- Indications
- ST-Segment Elevation Myocardial Infarction (STEMI)
- Cardiovascular Disease (CAD)
- Uncontrolled Angina
- Considerations
- Internal Mammary Artery
- Saphenous (Leg) Vein
- Transient Limb Edema
- Closely Monitor Patients
- Venous Thromboembolism (VTE) Prophylaxis
- Incentive Spirometer
2 mins
Cardiac Tamponade
- Mechanism
- Fluid in the Pericardial Sac
- Pericarditis
- Decreased Cardiac Output
- Signs/Symptoms
- Beck's Triad
- Hypotension
- Jugular Venous Distention (JVD)
- Distant Heart Sounds
- Pulsus Paradoxus
- Electrical Alternans
- Treatment
- Pericardiocentesis
1 min
Heparin (Unfractionated)
- Mechanism of Action
- Suppresses Coagulation
- Indications
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Side Effects
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Considerations
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Antidote
- Protamine Sulfate
2 mins
Digoxin (Lanoxin)
- Mechanism of Action
- Increases Inotropy
- Indications
- Heart Failure
- Atrial Fibrillation
- Side Effects
- Bradycardia
- Fatigue
- Contraindications
- Heart Block
- Nursing Considerations
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
2 mins
Acute Digoxin Toxicity
- Clinical Symptoms
- Hyperkalemia
- Cholinergic (Nausea, Vomiting, Diarrhea)
- Blurry Yellow Green Vision with Halo of Light
- Arrhythmia
- Bradycardia
- EKG Changes
- Prolonged PR interval
- Decreased QT
- Scooping on EKG
- T Wave Inversion
2 mins
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