NURS 233 EXAM 2 MED SURG STUDY GUIDE
LATEST UPDATED AND VERIFIED TO PASS
HERZING UNIVERSITY.
when the electrical cardioversion will discharge?
Discharge during ventricular depolarization QRS wave
what can cause conduction abnormalities
medications (e.g., digitalis, calcium channel blockers, beta-blockers)
Lyme disease
myocardial ischemia and infarction
hypothyroidism
activities that cause an increase in vagal tone
First-Degree Atrioventricular Block
Consistent prolong PR
first-degree block the conduction is abnormally slow so the PR wave is >22
second.
It’s regular but PR Takes longer
usually this does not require treatment.
We need only to monitor
Types of Second degree atrioventricular
,Second degree has 2 types
Type 1 Wenckebach
Type 2 Mobitz ( this is the worst)
Second degree AV block type 1 Wenckebach characteristics
progressively slowed conduction from SA to AV nodes until a beat is block
PR interval Becomes progressively longer until QRS complex is dropped
"Longer, Longer, QRS drop"
Causes: coronary artery disease
Or drugs
How would you treat Second degree AV block type 1 Wenckebach
Only treat if symptomatic
Atropine or Pacing
Third degree AV block
Complete block - serious
no electrical stimulus is conducted from the SA from to AV node
Atria and ventricles are contracting independently of each other
“P waves march, QRS march, do not correlate”
Irregular PR interval / more P waves than QRS
treat with transcutaneous pacing
Atropine as needed
, Ventricular fibrillation V fib
This is a DEADLY rhythm
Firing of multiple ectopic sites in ventricles
Ventricular are “quivering”
No cardiac output
Patient is unresponsive & pulseless
What would the first action of the nurse with a patient with V fib ?
1 START CPR
2. Defibrillate ASAP
3. If after initial unsuccessful defib give epinephrine
What is the difference between "demand" pace and "fixed"pace ?
demand pace" refers to a pacemaker that only delivers electrical impulses to
stimulate the heart when it detects a missed beat or a slow heart rate,
essentially "on demand,"
Firing only when the heart rate falls below a present rate
"fixed pace" pacemaker delivers electrical impulses at a set, constant rate
regardless of the patient's natural heart rhythm. Fixed/ synchronized fire at a
constant fixed rate/ not on demand.
What is a permanent pacemaker?
Device used to “pace” the atrium and / or ventricles
Wires generally enter external jugular and pass into right ventricles
Permanent pacemaker teaching:
Don't raise hands above head for 2 weeks post op
LATEST UPDATED AND VERIFIED TO PASS
HERZING UNIVERSITY.
when the electrical cardioversion will discharge?
Discharge during ventricular depolarization QRS wave
what can cause conduction abnormalities
medications (e.g., digitalis, calcium channel blockers, beta-blockers)
Lyme disease
myocardial ischemia and infarction
hypothyroidism
activities that cause an increase in vagal tone
First-Degree Atrioventricular Block
Consistent prolong PR
first-degree block the conduction is abnormally slow so the PR wave is >22
second.
It’s regular but PR Takes longer
usually this does not require treatment.
We need only to monitor
Types of Second degree atrioventricular
,Second degree has 2 types
Type 1 Wenckebach
Type 2 Mobitz ( this is the worst)
Second degree AV block type 1 Wenckebach characteristics
progressively slowed conduction from SA to AV nodes until a beat is block
PR interval Becomes progressively longer until QRS complex is dropped
"Longer, Longer, QRS drop"
Causes: coronary artery disease
Or drugs
How would you treat Second degree AV block type 1 Wenckebach
Only treat if symptomatic
Atropine or Pacing
Third degree AV block
Complete block - serious
no electrical stimulus is conducted from the SA from to AV node
Atria and ventricles are contracting independently of each other
“P waves march, QRS march, do not correlate”
Irregular PR interval / more P waves than QRS
treat with transcutaneous pacing
Atropine as needed
, Ventricular fibrillation V fib
This is a DEADLY rhythm
Firing of multiple ectopic sites in ventricles
Ventricular are “quivering”
No cardiac output
Patient is unresponsive & pulseless
What would the first action of the nurse with a patient with V fib ?
1 START CPR
2. Defibrillate ASAP
3. If after initial unsuccessful defib give epinephrine
What is the difference between "demand" pace and "fixed"pace ?
demand pace" refers to a pacemaker that only delivers electrical impulses to
stimulate the heart when it detects a missed beat or a slow heart rate,
essentially "on demand,"
Firing only when the heart rate falls below a present rate
"fixed pace" pacemaker delivers electrical impulses at a set, constant rate
regardless of the patient's natural heart rhythm. Fixed/ synchronized fire at a
constant fixed rate/ not on demand.
What is a permanent pacemaker?
Device used to “pace” the atrium and / or ventricles
Wires generally enter external jugular and pass into right ventricles
Permanent pacemaker teaching:
Don't raise hands above head for 2 weeks post op
