Download RELIAS DYSRHYTHMIA BASIC TEST 2026 COMPREHENSIVE ASSESSMENT and more Exams Nursing in PDF only on Docsity!
RELIAS DYSRHYTHMIA BASIC TEST 2026
COMPREHENSIVE ASSESSMENT
โ the initiation of impulses. Answer: automaticity โ the speed of impulses. Answer: conductivity โ Cardiac tissue is depolarized multiple times by the same impulse. Answer: reentry of impulse โ Normal calcium levels. Answer: 9-10.5 mg/dL โ Normal magnesium levels. Answer: 1.7-2.2 mg/dL โ How would kidney dz increase the risk for dysrhythmias?. Answer: inability to excrete K+ โ Two major concepts related to dysrhythmias. Answer: 1. perfusion: decreased CO
- oxygenation: decreased O
โ Normal conduction ensures that the circulation of blood occurs in an _____ manner. With abnormal conduction, blood circulates in an _______ manner, causing decreased ______ to the body and increased risk for ______.. Answer: even, uneven, perfusion, emboli โ True or false: every cardiac cell has the potential to produce an impulse.. Answer: TRUE โ Explain the movement of a NORMAL impulse through the heart. Answer: SA Node - > AV Node - > R & L bundle branches - > Purkinje Fibers โ Pacemaker of the heart. Answer: SA node โ If the SA node fails, what takes over?. Answer: AV node โ If the AV node fails, what takes over?. Answer: Bundle of His โ Rate of the SA node. Answer: 60-100 bpm โ Rate of the AV node. Answer: 40-60 bpm โ Rate of the bundle branches. Answer: 20-40 bpm
โ The QRS complex should be ______, less than _____ seconds, and smaller than the _____ interval.. Answer: narrow, 0.12, PR โ How to measure whether a EKG is regular vs. irregular?. Answer: measure R-wave to R-wave โ Explain how to measure the HR when looking at a 6-second strip.. Answer: Count the number of R-waves in 6 seconds and multiply by 10 (there are 6, 10 seconds in one minute) โ What THREE things do we want to look at when observing a P- wave?. Answer: 1. present?
- upright?
- p-wave for every QRS complex? โ How to observe whether a rhythm is stable or unstable?. Answer: observe the patient - check pulse โ What EKG change do we see with hyperkalemia (K > 5.0)?. Answer: peaked t-waves (taller than r-wave) โ What two EKG changes do we see with hypokalemia (K < 3.5)?. Answer: 1. inverted t-waves
- presence of a U-wave โ Normal sinus rhythm:
- HR
- Rhythm
- P wave
- PR interval
- QRS interval. Answer: HR: 60-100 bpm Rhythm: regular P wave: upright and present - occurs before every QRS complex PR interval: 0.12-0.20 sec QRS interval: 0.06-0.12 sec โ Dysrhythmia where the SA node is firing at LESS than 60bpm. Answer: sinus bradycardia โ Name some of the causes for sinus bradycardia. Answer: medications, hypoxia, increased ICP, athletes (normal) โ When do we treat sinus bradycardia?. Answer: when the patient is symptomatic
โ Disorganized, very rapid, irregular atrial rhythm with either an increase or decrease in ventricular rate. Answer: atrial fibrillation โ Explain how the P-waves look in a-fib. Answer: quivering, more p- waves than QRS complexes, are hard to distinguish โ What happens to the HR w/ a-fib?. Answer: either increase or decrease โ What characteristic will you feel when palpating the pulse in a patient with a-fib?. Answer: irregularity โ What two types of medications may be given for a-fib?. Answer: 1. medications to decrease HR: BB, CCB
- anticoagulant medications โ Explain why a patient with a-fib will need anticoagulant therapy?. Answer: when the atrium quivers, blood stasis occurs, increasing the risk for clot development and therefore embolisms to occur โ What may be the first sign of a-fib?. Answer: presentation of stroke symptoms
โ What other intervention may be appropriate for a-fib?. Answer: cardioversion โ It is important to monitor for s/s of embolisms in a-fib patients. How should the RN monitor for this?. Answer: signs of a stroke, MI, or PE โ A-Fib: Atrial & Ventricular HR. Answer: Atrial: 350-650 bpm Ventricular: increased or decreased โ Explain controlled vs. uncontrolled a-fib. Answer: controlled a-fib is when the ventricular rate remains within the normal limits of 60- 100 bpm. uncontrolled a-fib is when the ventricular rate is above 100 bpm. โ Rhythm of a-fib. Answer: irregular โ A-fib: QRS interval. Answer: normal (0.06-0.12 seconds) โ a-fib. Answer: โ How do P-waves appear in atrial flutter?. Answer: saw-toothed
โ Compare the QRS or SVT and V-tach. Answer: SVT: QRS remains narrow (< 0.12 seconds) V-tach: QRS is wide (> 0.12 seconds) โ Interventions for SVT:
- ______ maneuvers
- medications
- ______ or cardiac _____. Answer: vagal, cardioversion, ablation โ Name the two vagal maneuvers used to treat SVT. Answer: 1. carotid massage
- valsalva maneuver: bearing down โ What medication is administered for SVT?. Answer: 6 mg of adenosine IV rapid over 1-3 seconds, followed by a 20 ml NS flush - can repeat in 1-2 minutes with 12 mg IV rapid over 1-4 seconds, followed by 20 ml flush โ What kind of half-life does adenosine have?. Answer: very short โ elective procedure where a SYNCHRONIZED shock is delivered at a very low voltage to allow to SA node to take back over as the pacemaker. Answer: cardioversion
โ What does a synchronized shock mean?. Answer: in synchrony with the QRS complex โ Voltage used w/ cardioversion. Answer: 50-100 joules โ What is used for the patient during cardioversion?. Answer: conscious sedation โ Two main dysrhythmias indicated for cardioversion. Answer: A- fib & SVT โ What medication must be adminstered prior to cardioversion for a-fib patients and why?. Answer: anticoagulants to prevent to dislodgement of thrombi โ Delivery of an unsynchronized countershock to the heart - stops all electrical activity to allow the SA node the take back over. Answer: defibrillation โ Two indications for defibrillation. Answer: pulseless v-tach & v-fib โ Explain the placement of the chest pads for defibrillation. Answer: one placed on the right chest near shoulder, one placed on the left chest under the breast
โ Explain the QRS of PVCs. Answer: wide (> 0.12 seconds) and bizzare โ PVCs. Answer: โ Definition of V-tach. Answer: > 3 PVCs in a row at a rate of > 100 bpm โ What is the most important thing to assess with v-tach?. Answer: whether the patient has a pulse or not โ Interventions for v-tach with a pulse:
- meds: ______ & ______. Answer: cardioversion, amiodarone, lidocaine โ Intervention for pulseless v-tach. Answer: start CPR, prepare to defibrillate โ Medication of choice for pulselessness (either V-tach or V-fib). Answer: Epinephrine โ V-Tach:
- HR
- Rhythm
- QRS interval. Answer: HR: 150-250 bpm Rhythm: regular QRS interval: widened > 0.12 seconds โ ventricular tachycardia. Answer: Which rhythm is this? โ rapid, disorganized depolarization of the ventricles with NO pulse. Answer: ventricular fibrillation โ What is a common cause of v-fib?. Answer: electrocution โ V-fib:
- HR
- Rhythm. Answer: HR: 300-600 bpm Rhythm: extremely irregular โ Interventions for V-fib:
- call a ______
- begin ______
- prepare for _____
