Palpitations Sinus Arrhythmia o o Once the rhythm is off the rhythm is

Palpitations sinus arrhythmia o o once the rhythm is

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Palpitations Sinus Arrhythmia: o o Once the rhythm is off, the rhythm is irregular o Take a second strip and multiply by 10 for rate o Everything is normal except for the rhythm o Heart rate speeds up and slows down a little with inspiration/expriation o Sinus Rhythm with irregular rhythm has normal PQRST, normal intervals, just irregular rhythm o Normal and common in children and young Atrial Rhythms: o Premature Atrial Complex o Atrial Flutter o Atrial Fibrillation Premature Atrial Complexes: o o Premature indicates that the rhythm is irregular, atrial means that its coming from the atria o Different means ectopic o This strip has multiple different p-waves mixed in with regular p-waves (p-waves are present, but ectopic p waves are present as well) o Can happen for 1 beat or can happen in patterns o This strip would also be called atrial bigeminy o COPD, HF, and valve disease patients have problems with this Atrial Fibrillation:
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o o If atrial flutter continues, you can get atrial fibrillation o Atria is not contracting (no period of systole and diastole) o Causes: Mitral valve disease MI Ischemic heart disease Rheumatic heart disease Hypertension Thyrotoxicosis May be seen in absence of disease o No discernible P-waves o Wavy baseline o Irregular R-R interval o Narrow QRS o Heart rate 300-600 o Ventricular rate varies (normal, slow, or fast) o Atria not contracting simultaneously, normal through ventricles, irregular at AV junction o Rhythm: irregulary regular o Goal is to give medications so that the ventricular rate is normal o CO output is normal o First onset is very rapid (>110-120), can cause decrease in Cardiac output (try to convert patient back to normal rhythm either by electrocardio therapy or mediactions) o Patients at A-fib are at very high risk for stroke o Assessment: Change in LOC
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BP Medications o Diagnoses: Decreased CO Rapid A-fib Anxiety Make sure taking meds Knowledge deficit o Complications: Cardiac arrest HF o Most common sustained dysrhythmia o Atria twitch, do not contract normally, thrombi can form o Treatment depends on the underlying cause o If sudden onset, cardioversion or chemical cardioversion o >48 hours anticoagulate prior to cardioversion o If persistent keep rate normal with meds (beta blockers) o Anticoagulation if rhythm persists for long period Atrial Flutter: o o Ventricular rhythm is either regular or irregular depending on how the AV node is blocking them o Do not measure PR interval o Can measure QRS interval o Assess rhythm and characteristics o Supraventricula rhythm: above the ventricle, AV node is blocking a lot of the impulses o Atrial rate of 230-430 (would equal 0 cardia output)
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o Classic saw toothed flutter waves o Causes: Hyperthyroidism Valvular heart disease Pericardial disease Acute pulmonary embolism Congenital heart disease Sick sinus syndrome Idiopathic causes Pre-excitation syndromes Septal defects Pulmonary emboli
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