Arrythmias

ARRYTHMIAS  Arrhythmias and dysrhythmias are the same  Anything that is not a normal sinus rhythm (NSR)  Any arrhythmia can be after an MI EKG  Diagnostic test  EKG and ECG are the same thing; 12 or 15 lead (patches)  Shows measurements of the heart  EKG vs. Telemetry: telemetry is continuous. EKG is a snapshot at the moment from different view points (leads are placed in different spots)  Prepping for an EKG: Shave them if you have to so it can stick, no hand cream or lotion (wipe with alcohol), lay them on their back  Artifact: cannot read, if you stick the leads on hair you will get artifact. Patient sneezed, took a breath, Parkinson patient, asthma. Fix your leads if you get artifact Conduction System of the heart 4 properties of cardiac cells 1. Automaticity: cardiac cells ability to initiate an impulse, spontaneously or consistently 2. Excitability: ability for the cardiac cells to be electrically stimulated 3. Conductivity: ability to transmit impulse in an orderly fashion, smoothly 4. Contractility: cells ability to make a contraction when it gets an impulse Cell death damages all of this ˆ Atrial fibrillation (a-fib)  Atrial rate with A-FIB can be going 350-600bpm • A bunch of p waves, cannot measure them. No infinitive P wave, no PR interval because you can’t tell which one is the p wave • No normal LUB DUB; blood sits there, doesn’t’t go through the ventricle • Risk of blood clot between atrium and ventricle (pt. on Coumadin) • No regular conduction the pushes the blood through, gets stuck in the middle • Most common dysrhythmia • Atrium is not contracting = shaking/fibrillation, not an effective pump • People don’t know they have it “did anybody tell you you had an A-fib” give them Coumadin asap and then find out what is causing it. • Impaired perfusion • Cant feel it • Stethoscope: wont be able to hear a normal LUBDUB • Biggest concern is BLOOD clots Things that cause this: Caffeine, electrolyte imbalance, nutrient, recent cardiac surgery's. • ACS major cause of death is dysrhythmia, may see a-fib after an MI This study source was downloaded by from CourseH on :51:07 GMT -05:00 onlystudents Assessment: LOC because there may be a clot, may have an MI because of ischemia in the heart from clot TX Atrial Fibrillation (A-fib) CCB • A fib