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Dysrhythmia (question and answer) 2023
Typology: Exams
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This study source was downloaded by 100000868537585 from CourseHero.com on 07-10-2023 13:01:50 GMT -05:
Treatment: same as atrial flutter.
Sinus bradycardia. Rate 40 Treatment: if symptomatic, Atropine 0.5mg IV push. May repeat up to a total dose of 3mg. If atropine fails to increase the rate, you will then proceed on to transcutaneous pacing and the patient will likely need to have a permanent pacemaker placed.
Sinus Tachycardia. P, QRS all normal. Rate 120 Treatment: address underlying cause if new. Usually dehydration, stress, pain, blood loss, fever, etc. If symptomatic, can treat with IV beta blocker (Metoprolol, Toprol) or IV calcium channel blocker (Diltiazem, Cardizem)
Premature Atrial Complex (PAC), (if the irregularity is before the QRS it’s an atrial problem)
This study source was downloaded by 100000868537585 from CourseHero.com on 07-10-2023 13:01:50 GMT -05:
Ventricular Tachycardia (Vtach). Wide QRS complexes on top of each other. Treatment: Check pulse, start CPR, perform defibrillation.
First degree heart block. Note how long the PR interval is (distance between the P and the QRS). There’s the block/conduction delay. Treatment: correct underlying metabolic issue, stop QT prolonging agents or pro-dysrhythmics.
Second degree heart block type 1. (Wenkebach)…increasing length of the PR interval leading to a dropped beat. (longer, longer, longer, drop then you have a Wenkebach!) Treatment: correct underlying metabolic issues, stop QT prolonging agents or prodysrhythmics. If symptomatic may need antidysrhythmic such as Digoxin or amiodarone. If slow rate, may need IV atropine or transvenous or transcutaneous pacemaker with long-term pacemaker placement.
This study source was downloaded by 100000868537585 from CourseHero.com on 07-10-2023 13:01:50 GMT -05:
Second degree heart block type 2. P’s without partners. Most are paired but a few are solo. Treatment: Correct underlying metabolic issues. Treatment for a Mobitz type II involves initiating pacing as soon as this rhythm is identified. Type II blocks imply structural damage to the AV conduction system. This rhythm often deteriorates into complete heart block. These patients require transvenous pacing until a permanent pacemaker is placed
3 rd^ degree heart block. P’s are independent of any QRS complex and the ventricular rate is slow. Treatment: IV atropine to attempt to improve rate but only after patient has transcutaneous pacing pads placed in case it fails. Transcutaneous pacing is the treatment of choice for any symptomatic patient. All patients who have third-degree atrioventricular (AV) block (complete heart block) associated with repeated pauses, an inadequate escape rhythm, or a block below the AV node (AVN) should be stabilized with temporary pacing
This study source was downloaded by 100000868537585 from CourseHero.com on 07-10-2023 13:01:50 GMT -05: