Med-Surg: Telemetry
1. 12-lead EKG - ANS-uses 10 electrodes (one of each limb, 6 on chest)
2. produces 12 difference waveforms
3. gives us full picture of what is going on in heart
4. 1st degree AV block - ANS-consistent prolonged PR interval (>0.20)
5. P:QRS ratio is 1:1
6. patient is usually asymptomatic
7. maybe the result of medications
8. 2nd degree type 1 AV block - ANS-PR interval is progressively longer until QRS is
dropped
9. inconsistent
10. Wenckebach
11. 2nd degree type 2 AV block - ANS-PR interval is consistent until QRS is dropped
12. P waves not followed by QRS
13. conduction is blocked below the AV node, caused by ischemia
14. 3rd degree AV block - ANS-PR interval varies
15. more P waves than QRS complexes
16. no atrial impulse is conducted through AV node into the ventricles
17. two separate impulses are happening at same time
18. a-fib management - ANS-CHECK PATIENT
19. treat underling cause
20. control the rate, slow conduction through AV node (goal)
21. ANTICOAGULATION
22. medically control rate - amiodarone, beta-blockers, calcium-channel blockers, digoxin
23. synchronized cardioversion if unstable
24. A-fib RVR - ANS-A-fib rapid ventricular response
25. reduced ventricular filling causing smaller stroke volume
26. adenosine - ANS-stops the heart to see underlying heart rhythm
27. nurse can push, but have to have provider at bedside
28. good working IV, closest to heart
29. have to immediately flush
30. give 6mg then 12mg then another 12mg
31. adult bradycardia algorithm - ANS-1. get 12 lead EKG
32. 2. identify underlying cause
33. 3. give atropine 0.5mg IV
34. 4. start an infusion
35. 5. transcutaneous pacing
36. afterload - ANS-the amount of resistance the ventricle must overcome to eject the blood
out of the heart
37. analyze the regularity - ANS-same number of boxes in between the QRS
, 38. arrhythmias - ANS-"dysrhythmias"
39. disorders of the electrical impulse within the heart that causes disturbances
40. named according to site of origin of impulse and mechanism of conduction
41. asystole - ANS-MEDICAL EMERGENCY
42. no pulse, no waveforms
43. absence of cardiac electricity
44. start CPR and epinephrine
45. atrial fibrillation (A-fib) - ANS-rapid, disorganized, and uncoordinated electrical activity in
atria
46. no defined P wave
47. ventricle rate is variable
48. muscles of atria quiver
49. ineffective atrial "kick" causing blood to pool in atria
50. atrial flutter - ANS-atria contracts more than ventricle
51. more P waves than QRS complexes
52. P wave - variable, sawtooth appearance
53. atrial flutter causes - ANS-PE
54. hyperthyroidism
55. mitral or tricuspid valve disease
56. atrial flutter treatment - ANS-cardioversion (if unstable)
57. beta-blockers
58. anticoagulation (blood can clot in atria)
59. automaticity - ANS-ability to initiate and maintain electrical rhythm
60. AV node - ANS-synchronizes atrial and ventricular activity
61. picks up slack of SA node at rate of 40-60 bpm
62. bigeminal pattern of premature complex - ANS-every other complex is premature
63. bundle of HIS - ANS-located between atria and ventricles
64. should be the only pathway (if not, indicates conduction issues)
65. next stop is R and L Bundle Branches
66. calculate the HR - ANS-count number of QRS complexes in sex second strip and
multiple by 10
67. cardiac output - ANS-stroke volume X heart rate
68. amount of blood pumped by each ventricle in liters per minute
69. causes of A-fib - ANS-most common dysrhythmia
70. increased age
71. CAD
72. HTN
73. CHF
74. DM
75. OSA
76. obesity
77. cardiomyopathy
78. causes of junctional rhythms - ANS-valvular disease
79. hypoxia
1. 12-lead EKG - ANS-uses 10 electrodes (one of each limb, 6 on chest)
2. produces 12 difference waveforms
3. gives us full picture of what is going on in heart
4. 1st degree AV block - ANS-consistent prolonged PR interval (>0.20)
5. P:QRS ratio is 1:1
6. patient is usually asymptomatic
7. maybe the result of medications
8. 2nd degree type 1 AV block - ANS-PR interval is progressively longer until QRS is
dropped
9. inconsistent
10. Wenckebach
11. 2nd degree type 2 AV block - ANS-PR interval is consistent until QRS is dropped
12. P waves not followed by QRS
13. conduction is blocked below the AV node, caused by ischemia
14. 3rd degree AV block - ANS-PR interval varies
15. more P waves than QRS complexes
16. no atrial impulse is conducted through AV node into the ventricles
17. two separate impulses are happening at same time
18. a-fib management - ANS-CHECK PATIENT
19. treat underling cause
20. control the rate, slow conduction through AV node (goal)
21. ANTICOAGULATION
22. medically control rate - amiodarone, beta-blockers, calcium-channel blockers, digoxin
23. synchronized cardioversion if unstable
24. A-fib RVR - ANS-A-fib rapid ventricular response
25. reduced ventricular filling causing smaller stroke volume
26. adenosine - ANS-stops the heart to see underlying heart rhythm
27. nurse can push, but have to have provider at bedside
28. good working IV, closest to heart
29. have to immediately flush
30. give 6mg then 12mg then another 12mg
31. adult bradycardia algorithm - ANS-1. get 12 lead EKG
32. 2. identify underlying cause
33. 3. give atropine 0.5mg IV
34. 4. start an infusion
35. 5. transcutaneous pacing
36. afterload - ANS-the amount of resistance the ventricle must overcome to eject the blood
out of the heart
37. analyze the regularity - ANS-same number of boxes in between the QRS
, 38. arrhythmias - ANS-"dysrhythmias"
39. disorders of the electrical impulse within the heart that causes disturbances
40. named according to site of origin of impulse and mechanism of conduction
41. asystole - ANS-MEDICAL EMERGENCY
42. no pulse, no waveforms
43. absence of cardiac electricity
44. start CPR and epinephrine
45. atrial fibrillation (A-fib) - ANS-rapid, disorganized, and uncoordinated electrical activity in
atria
46. no defined P wave
47. ventricle rate is variable
48. muscles of atria quiver
49. ineffective atrial "kick" causing blood to pool in atria
50. atrial flutter - ANS-atria contracts more than ventricle
51. more P waves than QRS complexes
52. P wave - variable, sawtooth appearance
53. atrial flutter causes - ANS-PE
54. hyperthyroidism
55. mitral or tricuspid valve disease
56. atrial flutter treatment - ANS-cardioversion (if unstable)
57. beta-blockers
58. anticoagulation (blood can clot in atria)
59. automaticity - ANS-ability to initiate and maintain electrical rhythm
60. AV node - ANS-synchronizes atrial and ventricular activity
61. picks up slack of SA node at rate of 40-60 bpm
62. bigeminal pattern of premature complex - ANS-every other complex is premature
63. bundle of HIS - ANS-located between atria and ventricles
64. should be the only pathway (if not, indicates conduction issues)
65. next stop is R and L Bundle Branches
66. calculate the HR - ANS-count number of QRS complexes in sex second strip and
multiple by 10
67. cardiac output - ANS-stroke volume X heart rate
68. amount of blood pumped by each ventricle in liters per minute
69. causes of A-fib - ANS-most common dysrhythmia
70. increased age
71. CAD
72. HTN
73. CHF
74. DM
75. OSA
76. obesity
77. cardiomyopathy
78. causes of junctional rhythms - ANS-valvular disease
79. hypoxia
