RELIAS DYSRHYTHMIA QUIZ-BASIC A QUIZ WITH ANSWERS TREATMENT IDENTIFIED FOR EACH CASE,2023

Atrial Flutter. Note the sawtooth baseline, no definable P wave. Treatment: Correct any metabolic derangement or electrolyte imbalance then use Antidsyrhythmics. Usually Amiodarone, Digoxin, beta blocker (Metoprolol, Toprol) or calcium channel blocker (Diltiazem, Cardizem) for rate control and control of the aberrant atrial impulse. If severely elevated and symptomatic may need synchronized cardioversion. Remember—all atrial flutter and atrial fibrillation patients must be anticoagulated to prevent throwing a clot when they go back into regular rhythm. This means Heparin, Coumadin and/or antiplatelet like Aspirin and Clopidogrel (Plavix). 2. Supraventricular tachycardia (SVT). Rate 200 Treatment: Attempt Valsalva maneuver usually once. Then Adenosine 6mg IV slow push. Adenosine WILL CAUSE ASYSTOLE briefly. Half life is 10 seconds. If no response after first dose, may repeat with Adenosine 12mg IV slow push. Again, asystole. Monitor closely. 3. Atrial Fibrillation (afib). No P wave, irregular rate. Treatment: same as atrial flutter. 4. 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. 5. 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) 6.