dysrhythmias

• problems with dysrhythmias?

  affect cardiac output (amount of blood pushed out of the heart), affects cardiomyo oxygenation, increases the risk of CHF and infarction, lethal
• normal sinus rhythm: rate is 60-100, regular, 1 P to every QRS, PR interval and QRS intervals within normal range
• tachycardia: too fast (over 100 bpm)
• bradycardia: too slow (less than 60 bpm)
• symptoms of tachycardia and bradycardia: chest pain, anxiety, hypotension, SOB, dizziness, confusion, nausea, weakness, increase in respirations
• sinus tachycardia: SOB, lightheaded; treatment is treat underlying cause (pain), dehydration, hypoxic, anemic
• sinus tachycardia medications: calcium channel blockers and beta blockers
• pts with sinus tachycardia feel how a normal person feels during a workout but while laying in bed and is normally due to pain
• sinus bradycardia: decreased perfusion (dizzy, SOB, angina, confusion); treatment is to reverse the cause (drugs, MI) or a pacemaker
• medications for sinus bradycardia: atropine (astros go fast so taking something slow to make it go fast)
• supraventricular tachycardia (SVT): fast HR (150-280 bpm)
• if SVT is prolonged the heart can give out and the patient can become hemodynamically unstable
• treatment of SVT: oxygen, EP study (find the cause), cardioversion
• medications for SVT: adenosine (stops the heart and takes a bad rhythm and make it good), calcium channel blockers (block the contractions to slow it down)
• atrial flutter: pulse may or may not be regular, ventricular rate 100-150 or may be normal, palpitations, angina
• atrial flutter: looks like a saw blade and more uniform
• treatment of atrial flutter: oxygen, cardioversion, ablation, treat underlying cause
• medications for atrial flutter: anticoagulants, amiodarone, calcium channel blockers, corvert
• DO NOT convert is dysrhythmia is older than 48 hours (high risk for blood clot to dislodge causing a stroke)
• atrial fibrillation: caused by hypoxia, electrolyte imbalance, anything that causes cardiac irritation, not unusual after open heart surgeries
• treatment for atrial fibrillation: oxygen, cardioversion, ablation; chronic treatment is rate control with anticoagulants or surgery
• atrial fibrillation is more irregular flutters then atrial flutter
• asystole: CHECK PATIENT FIRST; no pulse, no blood pressure, unconscious
• asystole treatment: CPR (do NOT shock), pacing
• asystole medications: epinephrine, atropine, oxygen
• CPR?

  compressions FIRST then establish airway