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Signed consent (if elective)oSedation Usually versed and/or propofoloElectrode placementBiphasic -front to back
oSet monitor in synchronized modeoCharge monitor at rate 50-75-100-120 Joules biphasic (rhythm dependent)oRemove 02oI’m clear you’re clear we are all clear…oDeliver synchronized shockoIf VF results, then asynchronized defibrillationAfter CardioversionoMaintaining a patent airwayoAdministering oxygenoAssessing vital signs and the level of consciousnessoAdministering antidysrhythmic drug therapy, as prescribedoMonitoring for dysrhythmiasoAssessing for chest burns from electrodesoProviding emotional supportoDocumenting the results of cardioversionRadiofrequency Catheter AblationoInvasive procedure (ablation)Used to destroy an irritable focus causing atrial fibrillation, atrial flutter, supraventricular or ventricular tachydysrhythmiasoElectrophysiological studiesMappingoAblationMay lead to heart blocksCould require the insertion of a permanent pacemakerLab values you must know for Cardia IV, V, VIoNa+136-145 mEq/LoK+ 3.5-5.0 mEq/LoCa++9-10.5 mg/dloPhosphorus 3.0-4.5mg/dloMagnesium 1.3-2.1mEq/LoDigoxin level 0.8-2.0 ng/mLoTSH 0.3-5.0mIU/LoT4 4-12 mcg/dloT3 70-205 ng/dl
ECG Rhythms to Know for the TestUse these rhythm strips to make your study cards. Some of these pictures will be on your exam.Ventricular pacemakeroAV sequential pacemakeroSinus RhythmoSinus bradycardiao
oSinus TachycardiaoSinus arrhythmia and Sinus dysrhythmia are the same rhythmooSinus Rhythm with premature atrial complexes or premature atrial contractions
Med Surg Test 3Med Surg Test 3Endocrine IIThyroiditisoInflammation of thyroid glandoThree typesAcuteCaused by bacterial invasion of thyroid glandPain, neck tenderness, malaise, fever, dysphagiaIncreased WBCsTreatment with ABXSubacute (Granulomatous Thyroiditis)Viral infection of thyroid gland after cold or other upper respiratory infectionFever, chills, dysphagia, muscle or joint pain, pain radiates to ears/jawThyroid hard upon palpation enlargedThyroid function normal, either hypo or hyperthyroidism can occurPain radiates to the ears and jaw
Chronic (Hasimoto’s Disease)Most common type of thyroiditisAffects more womenAutoimmune disorder triggered by bacterial or viral infectionAntithyroid antibodies and lymphocytes invade thyroid – selective thyroid tissue destructionWhen large amounts destroyed – serum thyroid hormones low, TSH increased = hypothyroidismDysphagia and painless enlargement of glandDiagnosis – circulating antithyroid antibodies, needle biopsy of thyroid gland, serum T3 and T4 and TSH levels varyTreat with thyroid hormone = decrease TSH secretion, decrease size of thyroidSurgery with subtotal thyroidectomy if compresses other structuresSimple GoiteroMost common typeoOccurs when iodine intake deficient or intake of large quantities of substances are