Chapter 26 Cardiac Dysrhythmias.docx - Chapter 26 Cardiac Dysrhythmias Usual cardiac rhythm is called normal sinus rhythm Dysrhythmia(arrhythmia \u2013

Chapter 26 Cardiac Dysrhythmias.docx - Chapter 26 Cardiac...

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Chapter 26 Cardiac Dysrhythmias Usual cardiac rhythm is called normal sinus rhythm Dysrhythmia (arrhythmia) – conduction disorder that results in an abnormally slow or rapid heart rate or one that does not proceed through the conduction system in the usual manner Cardiac Dysrhythmias Dysrhythmias originating in the Atria Sinus Bradycardia proceeds normally but ≤60 beats/minute usually found in healthy athletes or patients who are physically fit Well toned heart conditioned through regular exercise Pathologic in clients with heart disorders, increased ICP, hypothyroidism, or digitalis toxicity Low HR = insufficient maintenance of CO Atropine Sulfate IV to increase slow HR 0.5-1.0 mg of atropine sulfate may be given Q1-2Hrs to increase HR Max = 2.0 mg IV Isoproterenol (Isuprel) – beta adrendergic blocker also used to increase HR Monitor pulse rate for drug response with both Rx Sinus Tachycardia Proceeds normally but faster than usual (100-150 BPM) D/T physiologic response to: Strenuous exercise Anxiety or fear Pain Fever Hyperthyroidism Hemorrhage Shock Hypoxemia Tx Eliminate cause Inderel watch for hypoglycemia, bradycardia, and hypotension Supraventricular Tachycardia Loosely translates to “above ventricles” or atrial tachycardia HR is consistent but beats dangerously high ( 150 BPM) CO drops dangerously low Signs of low CO
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Tachycardia Angina Hypotension Syncope Reduced renal output Pharmacological Management Digoxin Inderal Calcium channel blockers Nitroglycerin IV adenosine Non-Pharmacological Tx Do valsalva maneuver = decreases HR and increases BP “try to strain as if you are constipated” Unilateral carotid massage = decreased HR Face emersion in ice water = decreased HR Cardioversion Atrial Flutter Single atrial impulse outside of SA node causes atria to contract at exceedingly rapid rate (200-400 contractions/min) Ventricular rate slower than atrial rate Sawtooth pattern on ECG Low CO TX: Digoxin Quinidine Verapamil Atrial Fibrillation Multiple areas in right atrium initiate impulses = disorganized, rapid activity ( 400 BPM) Atria quivers rather than contracts = irregular ventricular HR
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