Dysrhythmia Treatment Exam Questions With Accurate
Answers.
Sinus Bradycardia - accurate answers-- IV Atropine (anticholinergic)
- If atropine is ineffective, transcutaneous pacing or dopamine or epinephrine
infusion considered
- Avoid Valsalva
- Hold Rate Slowing Drugs (Digoxin, Beta Blockers)
Transcutaneous pacing - accurate answers-- Also known as external pacing
- Temporary means of pacing a patient's heart during a medical emergency,
accomplished by delivering pulses of electric current through the patient's
chest through 2 electrodes, one placed anteriorly and the other placed
posteriorly, which stimulates the heart to contract.
Sinus Tachycardia - accurate answers-- May resolve with treatment of
underlying cause (e.g., pain)
- In clinically stable patients: vagal maneuver
- Digoxin, Beta Blockers (-olol), adenosine, calcium channel blockers
(verapamil, diltiazem) to reduce HR and decrease myocardial O2 consumption
- In clinically unstable patients: synchronized cardioversion
Premature atrial contraction - accurate answers-Withdrawal of sources of
stimulation such as caffeine or sympathomimetic drugs may be needed.
β-Blockers may be used to decrease PACs.
Paroxysmal Supraventricular Tachycardia (PSVT) - accurate answers-Vagal
stimulation: Valsalva maneuver, carotid massage, coughing
Drug therapy: IV adenosine (drug of choice because 10 second half-life and
well tolerated); beta blockers; calcium channel blockers
, If vagal stimulation and drug therapy are ineffective, synchronized
cardioversion is used
Atrial flutter - accurate answers-Goal: slow ventricular response by increasing
AV block
Drugs to control ventricular rate: calcium channel blockers and beta blockers
Cardioversion may be used to convert it to normal sinus rhythm in an
emergency or electively
Antidysrhythmia drugs that convert it to normal sinus rhythm (e.g., ibutilide
[Corvert])
Antidysrhythmia drugs that maintain sinus rhythm (e.g., amiodarone,
flecainide, dronerdarone [Multaq])
Radiofrequency catheter ablation is the treatment of choice for atrial flutter.
The procedure is done in an EPS laboratory and involves placing a catheter in
the right atrium. With the use of a low-voltage, high-frequency form of
electrical energy, the ectopic foci are ablated (or destroyed), dysrhythmia is
ended, and normal sinus rhythm is restored.
Atrial fibrillation - accurate answers-Goal: decrease ventricular response (to
less than 100 beats/minute), prevent stroke, convert to sinus rhythm (if
possible)
Drugs for ventricular rate control: calcium channel blockers, beta blockers,
dronedarone (antiarrhythmic), and digoxin (cardiac glycoside [increase force
of myocardial contraction, decrease HR])
Drugs for conversion to and maintenance of sinus rhythm: antidysrhythmia
drugs amiodarone and ibutilide
Electrical cardioversion: if patient is in AFib for longer than 48 hours, they
need to be on anticoagulation therapy for 3-4 weeks before cardioversion and
several weeks after (because the procedure can cause clots to dislodge,
placing patient at risk for stroke). However, if a transesophageal
Answers.
Sinus Bradycardia - accurate answers-- IV Atropine (anticholinergic)
- If atropine is ineffective, transcutaneous pacing or dopamine or epinephrine
infusion considered
- Avoid Valsalva
- Hold Rate Slowing Drugs (Digoxin, Beta Blockers)
Transcutaneous pacing - accurate answers-- Also known as external pacing
- Temporary means of pacing a patient's heart during a medical emergency,
accomplished by delivering pulses of electric current through the patient's
chest through 2 electrodes, one placed anteriorly and the other placed
posteriorly, which stimulates the heart to contract.
Sinus Tachycardia - accurate answers-- May resolve with treatment of
underlying cause (e.g., pain)
- In clinically stable patients: vagal maneuver
- Digoxin, Beta Blockers (-olol), adenosine, calcium channel blockers
(verapamil, diltiazem) to reduce HR and decrease myocardial O2 consumption
- In clinically unstable patients: synchronized cardioversion
Premature atrial contraction - accurate answers-Withdrawal of sources of
stimulation such as caffeine or sympathomimetic drugs may be needed.
β-Blockers may be used to decrease PACs.
Paroxysmal Supraventricular Tachycardia (PSVT) - accurate answers-Vagal
stimulation: Valsalva maneuver, carotid massage, coughing
Drug therapy: IV adenosine (drug of choice because 10 second half-life and
well tolerated); beta blockers; calcium channel blockers
, If vagal stimulation and drug therapy are ineffective, synchronized
cardioversion is used
Atrial flutter - accurate answers-Goal: slow ventricular response by increasing
AV block
Drugs to control ventricular rate: calcium channel blockers and beta blockers
Cardioversion may be used to convert it to normal sinus rhythm in an
emergency or electively
Antidysrhythmia drugs that convert it to normal sinus rhythm (e.g., ibutilide
[Corvert])
Antidysrhythmia drugs that maintain sinus rhythm (e.g., amiodarone,
flecainide, dronerdarone [Multaq])
Radiofrequency catheter ablation is the treatment of choice for atrial flutter.
The procedure is done in an EPS laboratory and involves placing a catheter in
the right atrium. With the use of a low-voltage, high-frequency form of
electrical energy, the ectopic foci are ablated (or destroyed), dysrhythmia is
ended, and normal sinus rhythm is restored.
Atrial fibrillation - accurate answers-Goal: decrease ventricular response (to
less than 100 beats/minute), prevent stroke, convert to sinus rhythm (if
possible)
Drugs for ventricular rate control: calcium channel blockers, beta blockers,
dronedarone (antiarrhythmic), and digoxin (cardiac glycoside [increase force
of myocardial contraction, decrease HR])
Drugs for conversion to and maintenance of sinus rhythm: antidysrhythmia
drugs amiodarone and ibutilide
Electrical cardioversion: if patient is in AFib for longer than 48 hours, they
need to be on anticoagulation therapy for 3-4 weeks before cardioversion and
several weeks after (because the procedure can cause clots to dislodge,
placing patient at risk for stroke). However, if a transesophageal
