Study with the several resources on Docsity
Earn points by helping other students or get them with a premium plan
Prepare for your exams
Study with the several resources on Docsity
Earn points to download
Earn points by helping other students or get them with a premium plan
Telemetry-Capstone Nursing Study Guide
Typology: Exams
1 / 15
This page cannot be seen from the preview
Don't miss anything!
Normal Sinus Rhythm Heart Rate: 60-100 bpm Regularity: Regular PRI: .12-.20 seconds QRS: <.12 seconds Normal Sinus Bradycardia Heart Rate: <60 bpm Regularity: Regular PRI: .12-.20 seconds QRS: <.12 seconds Normal Sinus Tachycardia Heart Rate: >100 bpm Regularity: Regular PRI: .12-.20 seconds QRS: <.12 seconds
Normal Sinus Arrhythmia Heart Rate: 60-100 bpm; can be < Regularity: Irregular PRI: .12-.20 seconds QRS: <.12 seconds Premature Atrial Contraction (PAC) Heart Rate: Depends on underlying rhythm Regularity: Interrupts the regularity of underlying rhythm P-Wave: can be flattened, notched, or unusual. May be hidden within the T wave PRI: measures between .12-.20 seconds and can be prolonged; can be different from other complexes QRS: <.12 seconds Atrial Tachycardia (SVT) Regularity: R-R intervals are constant; Regular Rate: artial/ventricular rates are equal; heart rate is between 150- bpm. P-Wave: One P Wave in front of every QRS; may be flattened or notched; because of the rapid rate, the P waves can be hidden within the T waves PRI: .12-.20 seconds and constant QRS: <.12 seconds
PRI: Since no P wave is present, PRI is not determined QRS: <.12 seconds Junctional Rhythms -Occurs when the AV node takes over as the primary pacemaker in the heart rather than the SA node. AV node takes over when is moves faster than SA node. Rate: 40-60 bpm; Accelerated Junctional: 60-100 bpm; Junctional Tachycardia: 100 bpm or greater P Wave: If before QRS, P wave will be inverted. P Wave can also be hidden within the QRS complex. P Wave is usually <.12 seconds QRS: <.12 seconds What are the four Supra-Ventricular Tachycardias (SVT)? Sinus Tachycardia (100-160 bpm) Atrial Tachycardia (150-250 bpm) Atrial Flutter (150-250 bpm) Junctional Tachycardia (100-180 bpm) First Degree Heart Block Regularity: depend on the rhythm Rate: Depend on underlying rhythm P Waves: Upright and Uniform; each P Wave will be followed by a QRS complex
PRI: constant across entire strip, but always > .20 seconds. QRS: < .12 seconds Second Degree Heart Block (Wenckebach) Regularity: R-R Wave is irregular; R-R interval gets progressively shorter as PRI gets progressively longer Rate: Ventricular rate is slightly slower than normal; atrial rate is normal P-Waves: upright and uniform; some p waves are not followed by the QRS complex PRI: gets progressively longer until one p wave is not followed by a QRS complex; after the blocked beat, cycle starts over QRS: < .12 seconds Second Degree Heart Block (Morbitz) Regularity: if conduction ratio is consistent, R-R interval will be constant and rhythm, regular. If conduction ratio varies, the R-R will be irregular Rate: atrial rate is usually normal; ventricular rate will be in bradycardia P Waves: upright and uniform; always be more P waves than QRS PRI: constant; might be longer than normal QRS: <.12 seconds
Regularity: chaotic Rate: cannot be determined P Waves: no P waves present PRI: no PRI QRS: no discernible QRS complexes Asystole No electrical activity; only a straight line 3rd Degree Heart Block Regularity: Regular Rate: 40-60 bpm if junctional; 20-40 bpm if focus is ventricular. P Wave: upright and uniform; more p waves than QRS complexes PRI: no relationship between p waves and QRS complexes QRS: < .12 seconds if junctional; > .12 seconds if ventricular Bundle Branch Block (Left) Wide QRS (>.12 seconds) Left Bundle Branch ("M") Can deteriorate to a 3rd Degree HB
Bundle Branch Block (Right) Wide QRS (>.12 seconds) Right Bundle Branch Block ("V") Can deteriorate to a 3rd Degree HB Lead Placement Left: Smoke (Black) over Fire (Red) Right: Snow (White) over Grass (Green) Center: Chocolate (place a little off center for possible CPR) Sinus Tachycardia Etiology/Clinical Signs Etiology: -Physiologic demand for oxygen -Sympathomimetric Drugs -Fever -Pain Clinical Signs: -increased HR; increased oxygen demand Sinus Tachycardia Treatment -May resolve with treatment of underlying cause -Digoxin, Beta Blockers (-olol), Verapamil -Vagal Maneuver
We have an expert-written solution to this problem! Atrial Flutter Etiology/ Clinical Signs Etiology: -occurs w/ heart disease -CAD -Valve Disorders Clinical Signs: -may cause thrombus -"saw tooth" -250-400 bpm Atrial Flutter Treatment -Give anticoagulants (faster the HR, more risk for thrombus) -treat underlying cause -digoxin (slows rate by enhancing AV block) -Quinidine (supresses atrial ectopic block) -Amiodarone -Calcium Channel Blockers (Cardizem)/Beta Blockers (-olol) -consider cardioversion Atrial Fibrillation Etiology/Causes Etiology: -Advanced Age -Valve Disorders -cardiomyopathy Causes: -chocolate (theobromine-stimulant) -sleep apnea -athletes -tall athletes
-aging heart -men more than women Atrial Fibrillation Treatment
Cardiac Arrest Ventricular Asystole due to VFib Etiology: trauma, overdose, MI Clinical Signs: asystole or VFib, no definable waves, absence of VS Ventricular Asystole TEA: trans-cutaneous pacemaker, epinephrine, atropine 1st Degree Heart Block Causes May be normal variant; inferior wall MI; drugs: verapamil or digoxin 1st Degree Heart Block Treatment Monitor; Observe for symptoms 2nd Degree Heart Block Causes organic heart disease, MI, Dig Toxicity, Beta and Calcium Blockers 2nd Degree Heart Block Treatment Monitor HR, Atropine, Temp Pacemaker, Avoid meds that decrease conductivity 3rd Degree Heart Block Causes Organic Heart Disease, MI, Drugs, Electrolyte Imbalance, Excess Vagal Tone 3rd Degree Heart Block Signs & Symptoms Extreme Dizziness, Hypotension, Syncope, Decrease CO, Altered Mental Status 3rd Degree Heart Block Treatment Pacemaker (temporary or permanent)
