Atrial flutter will see multiple spiked P waves saw tooth pattern Treatment

Atrial flutter will see multiple spiked p waves saw

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Atrial flutter will see multiple “spiked” P waves “saw-tooth pattern” Treatment diltiazem or digoxin, amiodarone, beta blocker, or cardioversion
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Atrial Fibrillation
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Figure 29-6, C: Premature Ventricular Contractions
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Signs and Symptoms: Cardiac Conduction Disorders Premature ventricular contractions (PVCs) 19-6C pg 436 Up to 7/min considered “normal” Ventricles contract before being filled with blood Wide QRS complex without a P wave Complete heart block (third degree heart block) 19-6B Uncoordinated contractions by the atria & ventricles d/t separate impulses Ventricular Tachycardia 19-6D Life Threatening! Ventricles contract 120-200 beats/min Usually pulseless but can be awake and alert Drug therapy: amiodarone or synchronized cardioversion
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Figure 19-6B: Complete Heart Block
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Figure 20-6, D: Ventricular Tachycardia You can shock ventricular tachycardia
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Signs and Symptoms: Cardiac Conduction Disorders Ventricular fibrillation 19-6 E Ventricles quiver rather than contract NO CO CPR Defibrillation Death (THE MOST FATAL) Pulseless electrical activity Electrical signal present on EKG, but no pulse ALWAYS PALPATE FOR PULSES, DON’T TRUST THE MACHINES CPR
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Figure 19-6, E: Ventricular Fibrillation
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Treatment Options: Cardiac Conduction Disorders Artificial pacemakers – commonly used to treat symptomatic bradycardia Permanent pacemaker Indicated if the cardiac dysrhythmia is the result of an irreversible disorder I.E. SA node failure, complete heart block, secondary AV block, SVT, tachy brady syndrome Types: Single chamber, dual chamber, Biventricular, Rate responsive External pacemaker (HURTS) Pads attached to chest and electrical impulse generated through chest wall Causes uncomfortable muscle contractions, so ONLY short term use No heartrate/asystalein/ flatline Transvenous pacemaker Wires left in place after surgery
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Nursing Care pacemakers Temporary Check connection, keep wires dry Avoid contact with all electrical devices Permanent Continuous monitoring of heart rate and rhythm Dressing changes and care of insertion site Vitals, pulses, level of consciousness D/C instructions Amount of physical activity Usually takes no more than 6 weeks for wires to “seat” Limit other sources for electromagnetic signals (old microwaves), lawn mower motors. Cell phones? NO Batteries usually good for 6-9 yrs. How do you tell? HEARTRATE BELOW SETTING
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Nursing Care pacemakers Should wear medical ID bracelet or necklace Periodic check-ups are vitally important D/T the sensors implanted in the chambers of the heart, the patient is at risk for infection of the lining of the heart (endocarditis) See also patient teaching pg 440
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More disorders Synchronized cardioversion Electrical shock delivered to the heart at a specific time in the cardiac cycle to interrupt the abnormal rhythm and begin a new, rhythm Pharmacological – Adenosine for SVT AICD – automatic implantable cardiac defibrillators
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  • Fall '19
  • right ventricle, Heart block, Heart failure

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