Kaiser Tele Rhythms-questions and answers

Sinus Arrhythmia Sinus Arrhythmia Looks almost normal Action: none, continue to monitor First Drug: none Possible cause: respiratory deviation, peds, aging heart Sinus Bradycardia Action: oxygen, notify MD - if symptomatic, follow AHA guidelines. First Drug: Atropine if symptomatic - low BP Possible cause: vagal-stimulation, athlete, sleep, ischemia to SA node, Meds, ↑ ICP Sinus Tachycardia Action: Determine & Treat the cause - this is key First Drug: None, watch for drugs that may be the cause Possible causes: pain, fever, anxiety, exercise, hypoxia, caffeine, sympathetic stimulation. Premature Atrial Contraction - PAC's Action: no action needed; if new or frequent notify MD First Drug: None Possible causes: caffeine, fatigue, tobacco, alcohol, stress, atrial enlargement Atrial Flutter Action: If new, notify MD, O2 if dyspneic First Drug: Digoxin, beta blockers, amiodarone, Cardizem Possible causes: Atrial enlargement - CHF, HTN, edema post heart surgery, valve disease, hyperthyroidism Atrial Fibrillation Action: If new, notify MD; O2 if dyspneic First Drug: Digoxin, beta blockers, amiodarone, Cardizem Possible causes: Atrial enlargement - CHF, HTN, edema post heart surgery, valve disease, hyperthyroidism Premature Junctional Contraction - PJC's Action: If frequent or new notify MD First Drug: None Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, meds Junctional Rhythm Actions: If new notify MD, O2 if dyspneic,meds (if extreme Brady, Call RRT) FirstDrug: Atropine(0.5mg)ifsymptomatic-BP Possible causes: ischemia -SA node, SA node function due to meds - Digoxin tox. Accelerated Junctional Actions: If new notify MD, O2 if dyspneic, meds First Drug: none Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, med toxicity - esp. Dig Toxicity (check potassium) Junctional Tachycardia Actions: If new notify MD, O2 if dyspneic, meds First Drug: none Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, med toxicity - esp. Dig Toxicity (check potassium) SVT-Supraventricular Tachycardia Action: Vagal Maneuvers, O2, notify MD - Call RRT if symptomatic First Drug: Adenosine (6mg, 12mg, 12mg - Rapid IV push) Possible causes: stimulants, CHF, thyroid, med toxicity (Could be Sinus Tach; Atrial Tach; Atrial Flutter; or Junctional Tach - cannot determine!) 1st Degree AV Block Action: observe for further PR prolongation; meds; if new notify MD First Drug: None Possible causes: heart disease or meds 2nd Degree AV Block Wenckebach-Type I Action: meds; O2 if dyspneic; If new notify MD First Drug: Atropine if symptomatic -BP Possible causes: AV blocking meds, acute MI, edema post open-heart surgery