Term
| What causes Sinus Bradycardia? |
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Definition
| Excessive vagal stimulation (parasympathetic) causes a decreased rate of SA node discharge. Athletes, excessive vagal stim from carotid sinus massage, vomiting, suctioning, Valsalva maneuvers, pain, hypoxia, beta blockers, calcium channel blockers and digitalis. |
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Term
| What causes Sinus Tachycardia? |
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Definition
| Sympathetic nervous system stimulation or vagal inhibition results in increased SA node firing rate. It increases cardiac output and bp INITALLY but if continues, decreases happen while increasing myocardial oxygen demand. |
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Term
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Definition
| Most common dysrhythmia seen. Increases w/age.Multiple atrial foci impulses fire, depolarizing the atrium in disorganized way. No atrial contractions, loss of atrial kick & irregular ventricular response. Blood pools in atria-risk of thrombus. |
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Term
| What causes Paroxysmal Supraventricular Tachycardia? |
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Definition
| Paroxysmal=intermittant. SVT=rapid stimulation of atrial tissue (100-280) Supra - atrial tissues are irritated and fire impulses. PSVT is initated suddenly by a complex change such as PAC and stops suddenly with without intervention. |
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Term
| What causes Atrio-ventricular Block? |
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Definition
| Supraventricular impulses are delayed or totally blocked in the AV node or intraventricular conduction system. SA node continues to function. normally.Atrial depolarizations & P waves occur regularly. |
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Term
| What causes Atrio-Ventricular Tachycardia? |
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Definition
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Term
| What causes PVCs? Nursing interventions? |
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Definition
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Term
| What causes V-tach? Nursing interventions? |
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Definition
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Term
| What causes V-Fib? Nursing interventions? |
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Definition
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Term
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Definition
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Term
| What are the types of CAD? |
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Definition
| Angina, MI, Complicated MI, Cardiac tamponade, Myocardial rupture, Cardiogenic shock, Ventricular rupture, Ventricular aneurysm |
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Term
| What is angina and what causes it? Nursing interventions? |
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Definition
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Term
| What is an MI and what causes it...some signs/symptoms (s/s) Nursing interventions? |
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Definition
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Term
| What is the difference between an MI and a complicated MI? |
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Definition
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Term
| What is cardiac tamponade...nursing interventions as well. |
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Definition
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Term
| What is cardiogenic shock? What are some nursing interventions? |
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Definition
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Term
| What is myocardial rupture? Nursing interventions? |
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Definition
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Term
| What is cardiogenic shock? Nursing interventions? |
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Definition
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Term
| What is ventricular rupture? Nursing interventions? |
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Definition
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Term
| What are the various methods of stress testing? What substances can be used in the chemical tests? |
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Definition
| Graded Exercise Tolerance...treadmill only. Thallium (radiopharmaceutical) is injected. Pictures resting of blood flow, then treadmill, more dye on table following exercise.Persantine=for people that can't exercise. It dilates vessels, then Cardiolite (radioactive tracer) then pictures. |
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Term
| Explain a cardiac catherization. |
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Definition
| Usually via femoral artery in groin, cath. is threaded up to heart. May feel pressure-no pain. Dye is injected to see blockages. May feel heat. Return to recovery room. Depending on plug, stay flat for 2-8 hrs. |
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Term
| Nursing prep for cardiac cath and post-procedure considerations... |
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Definition
| Clip hair up to mohawk, hibaclens scrub, explain procedure again, reinforce need to stay flat (when back give them the time frame), palpate femoral artery area for hardness, dressing for bleeding (circle), v/s q15 min for 2 hrs/q30min-2hrs/qhr-2 hrs |
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Term
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Definition
| Syncope, dizziness/weakness, confusion, hypotension, diaphoresis, SOB, anginal pain |
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Term
| Treatment for sinus bradycardia |
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Definition
| Atropine,oxygen, fluid bolus, external pacemaker |
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Term
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Definition
| May be asympotomatic other than >100 HR or fatigue, weakness, SOB, orthopnea, neck vein distention, decreased o2 saturation, decreased bp. Restlessness & anxiety d/t lowered cerebral perfusion, less urine d/t lower kidney perfusion. Anginal pain & palpitations. |
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Term
| Treatment of sinus tachycardia? |
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Definition
| Treat underlying cause. If angina, give O2, rest, nitroglycerine or morphine as rx'd. Fluid blous for hypovolemia, antipyretics/antibiotics if fever/infection. Bedrest for pt. is hypotensive. |
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Term
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Definition
| atrial tissue become irritable. Fires before the next sinus impulse is due. PAC is usually follow by a pause. |
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Term
| Causes of atrial irritability |
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Definition
| Stress, fatigue, anxiety, inflammation, infection, caffeine, nicotine, alcohol, durgs such as catecholamines, sympathomimetics, amphetamines, digitalis, or anesthetic agents. May result from MI, electrolye imbalances and atrial stretch |
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Term
| What causes atrial stretch? |
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Definition
| It can result from congestive heart failure, valvular disease, and pulmonary hypertension with cor pulmonale.. |
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Term
| s/s and treatment of PACs |
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Definition
| usually no symptoms other than possible heart palpitations. No intervention is needed except to treat causes such as heart failure. If PACs occur frequently, may lead to more serious atrial tachydysrhythmias and then need more treatment. Teach pt. to manage stress and avoid substances that increase atrial irritability. |
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Term
| s/s of PSVT and treatment |
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Definition
| depends on rate & duration of SVT. If sustained, may see palpitations, chest pain, weakness, atigue, shortness of breath, nervousness, anxiety, hypotension & syncope. Can result in angina, heart failure, and cardiogenic shock if sustained. No intervention needed if PSVT is short duration.If sustained, ablation. O2 given, Cardizem or Adenosine(Adenocard) which slow the ventricular rate by increasing the AV block. Severe prob. may do cardioversion. |
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Term
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Definition
| At risk for embolism, incl. pulmonary. Assess for SOB, chest pain, hemoptysis, doom feeling, activity intolerance, distended neck veins, anxiety, palpitations,dizziness. |
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Term
| Treatment for a-fib (pharmacological) |
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Definition
| antidysrhythmics to slow the ventricular conduction or to convert the AF to NSR. Cardizem, Cordarone (amiodarone) for more difficult to control AF. anticoagulants such as heparin, Lovenox, Coumadin for those at high ris for emboli |
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Term
| Treatment for A-Fib (electrical) |
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Definition
| Cardioversion is the electrical treatment of choice. 6 wks of antigoagulation therapy event if the rhythm is successfully converted in an elective cardioversion. Contraindication=presence of atrial clots. |
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Term
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Definition
| transesophageal echocardiogram - scope put down your throat to esophagus...sound waves are used to get pictures of your heart from many angles. Used to check for the valve condition, presence of clots. Often, used before emergency cardioversion. |
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Term
| What's next if heart does not respond to medications or cardioversion and you have A-Fib? |
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Definition
| Radiofrequency catheter ablation. Creates scar tissue that blocks impulses and disconnects the pathway of the abnormal rhythm. If needed, a ventricular pacemaker is implanted. |
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Term
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Definition
| Rapid atrial depolarization occurring at a rate of 250-350 beats/min.The AV node blocks the number of impulses that reach the ventricles as a protective mechanism. Rheumatic or ischemic heart disease, heart failure, AV valve disease, pulmonary emboli, alcoholism or pericarditis are some of the causes. |
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Term
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Definition
| same as SVT or A-Fib. Oxygen, Cardizem or Cordarone (amiodarone) to slow the rapid ventricular response. Cardioversion is the electrical treatment of choice. Ablation may be necessary if the other options do not work. |
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Term
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Definition
| repetitive firing of an irritable ventricular focus, usually 140-180 beats/min. VT can cause cardiac arrest. |
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Term
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Definition
| Electrical chaos in the ventricles and is life threatening. Impulses from many irritable foci fire in a totally disorganized manner so that ventricular contraction cannot occur. The ventricles merely quiver, consuming a tremendous amount of oxygen. NO cardiac output, NO pulse, NO cerebral, myocardial or systemic perfusion. Fatal if not ended w/i 3-5 minutes. |
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Term
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Definition
| NO electrical impulses in the ventricals, NO ventricular depolarization, no QRS complex, no contraction, no cardiac output and NO pulse, respirations or blood pressure. |
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Term
| 1st degree AV block details |
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Definition
| all sinus impulses EVENTUALLY reach the ventricles. PR interval is > 0.20 |
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Term
| 2nd degree AV block Mobitz type 1 |
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Definition
| delayed PR interval until one QRS is dropped...then starts again. |
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Term
| 2nd degree AV block, type II |
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Definition
| consistent interval then 1 or more dropped qrs complex |
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Term
| What is released when the atria are stretched? |
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Definition
| ANP atria natiuretic peptide It is a powerful vasodilator that is a protein enzyme that is involved is released by heart muscle. |
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