Relias Assessments Assistance Material DYSRHYTHMIAS |100% Verified Study Set|
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Course
DYSRHYTHMIA
Institution
DYSRHYTHMIA
Relias Assessments Assistance Material
DYSRHYTHMIAS |100% Verified Study
Set|
Atrial Fibrillation *Ans*Atrial fibrillation is disorganized and uncoordinated twitching of atrial
musculature caused by overly rapid production of atrial impulses. This arrhythmia has the following
characte...
Relias Assessments Assistance Material
DYSRHYTHMIAS |100% Verified Study
Set|
Atrial Fibrillation *Ans*✨Atrial fibrillation is disorganized and uncoordinated twitching of atrial
musculature caused by overly rapid production of atrial impulses. This arrhythmia has the following
characteristics:
Atrial Rate: 350 to 600 bpm
Ventricular Rate: 120 to 200 bpm
P wave is not discernible with an irregular baseline
PR interval is not measurable
QRS complex is normal
Rhythm is irregular and usually rapid unless controlled.
Causes includes atherosclerosis, heart failure, congenital heart disease, chronic obstructive pulmonary
disease, hypothyroidism and thyrotoxicosis. Atrial fibrillation may be asymptomatic but clinical
manifestation may include palpitations, dyspnea, and pulmonary edema. Nursing goal is towards
administration of prescribed treatment to decrease ventricular response, decrease atrial irritability and
eliminate the cause.
Atrial Flutter *Ans*✨Atrial flutter is an abnormal rhythm that occurs in the atria of the heart. Atrial
flutter has an atrial rhythm that is regular but has an atrial rate of 250 to 400 beats/minute. It has
sawtooth appearance. QRS complexes are uniform in shape but often irregular in rate.
Normal atrial rhythm
Abnormal atrial rate: 250 to 400 beats/minute
Sawtooth P wave configuration
QRS complexes uniform in shape but irregular in rate
Causes includes heart failure, tricuspid valve or mitral valve diseases, pulmonary embolism, cor
pulmonale, inferior wall MI, carditis and digoxin toxicity.
Management if the patient is unstable with ventricular rate of greater than 150 bpm, prepare for
immediate cardioversion. If patient is stable, drug therapy may include calcium channel blocker, beta-
adrenergic blockers, or antiarhythmics. Anticoagulation may be necessary as there would be pooling of
blood in the atria.
, Atrioventricular Blocks *Ans*✨AV blocks are conduction defects within the AV junction that impairs
conduction of atrial impulses to ventricular pathways. The three types are first degree, second degree
and third degree.
EKG interpretation *Ans*✨One of the most useful and commonly used diagnostic tools is
electrocardiography (EKG) which measures the heart's electrical activity as waveforms. An EKG uses
electrodes attached to the skin to detect electric current moving through the heart. These signals are
transmitted to produce a record of cardiac activity. Arrhythmia or dysrhythmia are disturbances in the
normal cardiac rhythm of the heart which occurs as a result of alterations within the conduction of
electrical impulses. These impulses stimulate and coordinate atrial and ventricular myocardial
contractions that provide cardiac output.
First Degree AV Block *Ans*✨Rate is usually 60 to 100 bpm
PR intervals are prolonged for usually 0.20 seconds
QRS complex is usually normal
Rhythm is regular
First degree AV block is asymptomatic and may be caused by inferior wall MI or ischemia, hyperkalemia,
hypokalemia, digoxin toxicity, calcium channel blockers, amiodarone and use of antidysrhythmics.
Management includes correction of underlying cause. Administer atropine if PR interval exceeds 0.26
second or symptomatic bradycardia develops.
Junctional Rhythm *Ans*✨the SA node is nonfunctional, P waves are absent, and heart is paced by the
AV node at 40-60 beats/min
Premature Atrial Contraction *Ans*✨Premature Atrial Contraction are ectopic beats that originates
from the atria and they are not rhythms. Cells in the heart starts to fire or go off before the normal
heartbeat is supposed to occur. These are called heart palpitations and has the following characteristics:
Premature and abnormal-looking P waves that differ in configuration from normal P waves
QRS complex after P waves except in very early or blocked PACs
P waves often buried in the preceding T wave or identified in the preceding T wave.
Causes includes coronary or valvular heart diseases, atrial ischemia, coronary artery atherosclerosis,
heart failure, COPD, electrolyte imbalance and hypoxia. Usually there is no treatment needed but may
include procainamide and quinidine administration (antidysrhythmic drugs) and carotid sinus massage.
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