NUR 114 Dysrhythmias student copy.pptx - Perfusion Dysrhythmias Lauren Cain MSN RN NUR 114 Northeast Alabama Community College Overview of Anatomy and

NUR 114 Dysrhythmias student copy.pptx - Perfusion...

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Perfusion: Dysrhythmias Lauren Cain, MSN, RN NUR 114 Northeast Alabama Community College
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Overview of Anatomy and Physiology Three layers: endocardium, myocardium, epicardium Four chambers: Right atrium and ventricle, left atrium and ventricle Atrioventricular valves: tricuspid and mitral Semilunar valves: aortic and pulmonic Coronary arteries Cardiac conduction system (electrophysiology) Cardiac hemodynamics
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Anatomy of the Heart Figure 25-1
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Cardiac Conduction System: Electrophysiology Fig ure 25-3 (60-100) (40-60) (30-40) (30-40)
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Inherent Rates ‘Built-in’ rate at which the three major areas of the conduction system initiate impulses. SA Node: 60-100 BPM AV Junction: 40-60 BPM Ventricle: 20-40 BPM
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Cardiac Action Potential Depolarization: electrical activation of cell caused by influx of sodium into cell while potassium exits cell Repolarization: return of cell to resting state caused by reentry of potassium into cell while sodium exits
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Cardiac Action Potential (cont’d) Refractory periods Effective refractory period: phase in which cells are incapable of depolarizing Relative refractory period: phase in which cells require stronger-than-normal stimulus to depolarize
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Dysrhythmias Disorders of formation or conduction (or both) of electrical impulses within heart Can cause disturbances of Rate Rhythm Both rate and rhythm Potentially can alter blood flow and cause hemodynamic changes Diagnosed by analysis of electrographic waveform
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Normal Electrical Conduction SA node (sinus node) AV node Conduction Bundle of His Right and left bundle branches Purkinje fibers Depolarization = stimulation = systole Repolarization = relaxation = diastole
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Relationship of ECG Complex, Lead System, and Electrical Impulse
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The Electrocardiogram (ECG) Electrode placement Electrode adhesion Types of ECG ECG Interpretation P wave QRS complex T wave U wave PR interval ST segment QT interval TP interval PP interval
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ECG Electrode Placement
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EKG (ECG) Paper
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EKG (ECG) Paper
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ECG Graph and Commonly Measured Components
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P-wave Atrial depolarization ≤ 2.5mm in height ≤ 0.11 seconds in duration P-R segment/interval: Period of electrical inactivity Delay in AV node Isoelectric segment 0.12-.020; constant
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QRS complex Ventricular depolarization < 0.12 seconds
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T- wave Ventricular re-polarization Should be deflected in same direction as QRS ST segment: from end of QRS complex to beginning of T wave Isoelectric
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Systematic Rhythm Strip Interpretation Regularity (rhythm) Rate P waves PR interval QRS complex
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Heart Rate Determination
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  • Summer '18
  • Cain
  • Cardiac electrophysiology, PR interval, atrial rate

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