NURS 2245 Exam 2 Guide With
Complete Solution
Dysrhythmias originating in the atria - ANSWER premature atrial
contractions
paroxysmal supra ventricular tachycardia
atrial flutter
atrial fibrillation
premature atrial contractions - ANSWER rate: depends upon underlying
rhythm
rhythm: usually regular except for PAC
pacemaker site: ectopic sites in atria
P waves: occurs earlier than expected
PRI: varies dependent on foci of impulse
QRS: usually normal
paroxysmal supra ventricular tachycardia - ANSWER rate: 150-250 bpm
rhythm: regular
pacemaker site: atria (outside SA node)
P waves: often buried in preceding T wave
PRI: usually normal
,QRS: usually normal
adenosine (adenocard): action - ANSWER slows conduction through AV node
interrupts re-entry
will not convert a flutter or a-fib
**given rapidly: IVP, followed with saline flush
adenosine: S/E - ANSWER brief period asystole
flushing
HA
lightheadedness
dizziness
nausea
SOB
rarely: chest pain
atrial flutter - ANSWER rate: atrial, 250-350 bpm
ventricular rate: varies
rhythm: usually regular
pacemaker site: atrial (outside SA node)
P waves: F waves are present
PRI: usually normal
QRS: usually normal
,Atrial Fibrillation (A-Fib) - ANSWER rate: atrial rate: 350-750 bpm
ventricular: varies
rhythm: irregularly irregular
pacemaker site: atrial (outside of SA node)
P waves: none discernible; f waves present
PRI: none
QRS: normal
mechanism of A-fib - ANSWER structural &/or electrophysiologic
abnormalities alter atrial tissue
promoting abnormal impulse formation
caused by diverse mechanisms
mechanisms: not completely understood
AF is the common rhythm seen - the end result so to speak
Atrial Fibrillation (A-Fib) extra cardiac factors - ANSWER HTN
obesity
sleep apnea
hyperthyroidism
alcohol
drugs
atrial structure abnormalities - ANSWER fibrosis
, dilation
ischemia
hypertrophy
atrial electrical abnormalities - ANSWER increase:
heterogeneity
automaticity
decrease:
conduction
action potential duration
abnormal: Ca ++ handling
Treatment of A-fib and a-flutter - ANSWER rate control
prevent thromboembolism
rhythm control by:
chemical
direct current cardioversion
catheter ablation
rate control - ANSWER beta blockers: LOL
calcium channel blockers: verapamil, diltiazem
digoxin
Complete Solution
Dysrhythmias originating in the atria - ANSWER premature atrial
contractions
paroxysmal supra ventricular tachycardia
atrial flutter
atrial fibrillation
premature atrial contractions - ANSWER rate: depends upon underlying
rhythm
rhythm: usually regular except for PAC
pacemaker site: ectopic sites in atria
P waves: occurs earlier than expected
PRI: varies dependent on foci of impulse
QRS: usually normal
paroxysmal supra ventricular tachycardia - ANSWER rate: 150-250 bpm
rhythm: regular
pacemaker site: atria (outside SA node)
P waves: often buried in preceding T wave
PRI: usually normal
,QRS: usually normal
adenosine (adenocard): action - ANSWER slows conduction through AV node
interrupts re-entry
will not convert a flutter or a-fib
**given rapidly: IVP, followed with saline flush
adenosine: S/E - ANSWER brief period asystole
flushing
HA
lightheadedness
dizziness
nausea
SOB
rarely: chest pain
atrial flutter - ANSWER rate: atrial, 250-350 bpm
ventricular rate: varies
rhythm: usually regular
pacemaker site: atrial (outside SA node)
P waves: F waves are present
PRI: usually normal
QRS: usually normal
,Atrial Fibrillation (A-Fib) - ANSWER rate: atrial rate: 350-750 bpm
ventricular: varies
rhythm: irregularly irregular
pacemaker site: atrial (outside of SA node)
P waves: none discernible; f waves present
PRI: none
QRS: normal
mechanism of A-fib - ANSWER structural &/or electrophysiologic
abnormalities alter atrial tissue
promoting abnormal impulse formation
caused by diverse mechanisms
mechanisms: not completely understood
AF is the common rhythm seen - the end result so to speak
Atrial Fibrillation (A-Fib) extra cardiac factors - ANSWER HTN
obesity
sleep apnea
hyperthyroidism
alcohol
drugs
atrial structure abnormalities - ANSWER fibrosis
, dilation
ischemia
hypertrophy
atrial electrical abnormalities - ANSWER increase:
heterogeneity
automaticity
decrease:
conduction
action potential duration
abnormal: Ca ++ handling
Treatment of A-fib and a-flutter - ANSWER rate control
prevent thromboembolism
rhythm control by:
chemical
direct current cardioversion
catheter ablation
rate control - ANSWER beta blockers: LOL
calcium channel blockers: verapamil, diltiazem
digoxin
