Solutions
r
,Cardiac Dysrhythmias Part 2 Questions With Complete
Solutions
Describe treatment of dysrhythmias - To determine if treatment is necessary, assess
the patient. Then ask the following questions:
Is he or she experiencing signs and symptoms of decreased cardiac output?
Is the dysrhythmia potentially life threatening?
If the answer to either of these questions is yes, the patient will need to
treatment for the dysrhythmia.
***WE WILL DISCUSS TREATMENTS OF DYSRHYTHMIAS BASED UPON CURRENT ACLS
TREATMENT ALGORITHMS
CLINICAL MANIFESTATIONS OF DECREASED CARDIAC OUTPUT INCLUDE CHEST PAIN,
DYSPNEA, DECREASED LEVEL OF CONSCIOUSNESS, HYPOTENSION, HEART FAILURE
IF PATIENT IS NOT SHOWING SIGNS OF DECREASED CO THEN SEARCH FOR
CONTRIBUTING CAUSES AND SEEK EXPERT CONSULTATION
POTENTIALLY LIFE THREATENING DYSRHYTHMIAS: SECOND DEGREE AV BLOCK TYPE II,
COMPLETE HEART BLOCK, VENTRICULAR TACHYCARDIA, VENTRICULAR FIBRILLATION
What are the Hs and Ts (potential causes of rhythm issues)? - Hypovolemia
Hydrogen ions (acidosis)
Hyper/hypokalemia
Hypoxia
Hypothermia
Hypervagal
Hypoglycemia
Malignant Hyperthermia
Tension pneumothorax
Tamponade (cardiac)
Toxins
Thrombosis (cardiac)
, Cardiac Dysrhythmias Part 2 Questions With Complete
Solutions
Thrombosis/embolus (pulmonary)
Trauma
QT prolongation
Pulmonary hypertension
What categories can dysrhythmias be divided into for determining treatment? -
Bradycardias
Tachycardias
Pulseless arrest
**AS A GENERAL RULE, IF A DYSRHYTHMIA IS CAUSING A DROP IN CARDIAC
OUTPUT AND IT IS TOO FAST, YOU SLOW IT DOWN; IF IT IS TOO SLOW, YOU
SPEED IT UP.
IF ECTOPICS ARE PRESENT, YOU SUPPRESS THEM BY DECREASING THE IRRITABILITY.
IF CARDIAC ARREST IS PRESENT, YOU GENERATE A MORE VIABLE RHYTHM.
What are the steps for treatment of dysrhythmias in general? - Identify and treat
underlying cause (might need to treat emergently if the patient has manifestations
of decreased cardiac output)
Maintain airway
Give O2
IV access
12 Lead ECG (but should not delay treatment)
How do you treat bradycardia dysrhythmias? - If a patient is experiencing altered
mental status, chest pain, dyspnea, lightheadedness, hypotension, or ventricular
ectopy, treatment should be instituted:
Give O2; give fluids (to normalize BP)
Atropine 0.5 mg IV (drug of choice) (maximum dose 3 mg) (while awaiting
pacemaker)
Transcutaneous pacing (if available)