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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher
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35 - Dysrhythmias

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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid

35 - Dysrhythmias
17 Picmonics to Learn | 27 mins
ECG Interpretation
Rate
Rhythm
P Waves
Upright, Rounded, Before Every QRS
PR Interval (< 0.20 seconds)
Normal QRS (< 0.12 seconds)
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2 mins
ECG: Sinus Bradycardia
Rate
< 60 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Atropine
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1 min
ECG: Sinus Tachycardia
Rate
> 100 bpm
Rhythm
Regular
P Wave
Present, Upright, Every QRS
PR Interval
< 0.20 seconds
QRS Interval
< 0.12 seconds
Treatment
Treat Underlying Cause
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2 mins
ECG: Atrial Flutter
Rate
Variable
Rhythm
Regular or Irregular
P Wave
Saw Tooth, Multiple Before Every QRS
PR Interval
Non-measurable
QRS Interval
< 0.12 seconds
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2 mins
Adenosine (Adenocard)
Mechanism
Slows AV Conduction
Indications
Supraventricular Tachycardia (Paroxysmal)
Side Effects
Bradycardia
Flushing
Dyspnea
Considerations
Rapid IV Push
Caffeine and Theophylline Decrease Effectiveness
Dipyridamole May Intensify Effects
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2 mins
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
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2 mins
ECG: Atrial Fibrillation
Rate
Variable Rate
Rhythm
Irregular Rhythm
P Wave
No P Wave
PR Interval
No PR Interval
QRS Interval
QRS < 0.12 Seconds
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1 min
Phenytoin (Dilantin)
Mechanism
Blocks Na+ Channels
Indications
Tonic-clonic Seizures
Side Effects
Ataxia
Nystagmus
Sedation
Gingival Hyperplasia
Purple Glove Syndrome
Hirsutism
Rash
Anemia
Considerations
Individualized Dosing
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2 mins
Magnesium Sulfate
Mechanism
Muscle Relaxant
Indications
Preterm Labor Contractions
Preeclampsia
Side Effects
Warm Feeling
Hypotension
Decreased Deep Tendon Reflexes (DTRS)
Decreased Respiratory Rate
Decreased Urine Output
Paralytic Ileus
Antidote
Calcium Gluconate
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2 mins
Cardiovascular Effects of Beta-Blockers
Cardiac Myocytes and Vasculature
Decrease cAMP
Decreases SA and AV Node Conduction Velocity
Lower Blood Pressure
Decrease O2 Consumption
Decreases Mortality Post-MI
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2 mins
Beta Blockers
"-olol" suffix
Mechanism
Decreases Heart Rate and Contractility
Decreases Peripheral Vascular Resistance
Decreases Renin Release
Indications
Hypertension
Heart Failure
Angina Pectoris
Contraindications
Asthma and Heart Block Patients
Nursing Considerations
Assess Blood Pressure and Heart Rate
Masking Signs of Hypoglycemia
Do Not Stop Abruptly
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2 mins
Calcium Channel Blockers (Verapamil and Diltiazem)
Mechanism of Action
Slows AV Conduction
Indications
Angina Pectoris
Arrhythmias
Essential Hypertension
Side Effects
Bradycardia
Hypotension
Constipation
Peripheral Edema
Gingival Hyperplasia
Nursing Consideration
Medication Education
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2 mins
Digoxin (Lanoxin)
Mechanism of Action
Increases Inotropy
Indications
Heart Failure
Atrial Fibrillation
Side Effects
Bradycardia
Fatigue
Contraindications
Heart Block
Nursing Considerations
Heart Rate Below 60
Hypokalemia
Monitor for Toxicity and Visual Changes
Digibind
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2 mins
12 Lead Contiguous Leads - Inferior Wall MI
Leads Elevated
Lead II
Lead III
Lead aVF
Artery Affected
Right Coronary Artery (RCA)
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56 secs
12 Lead Contiguous Leads - Anterior Wall MI
Leads Elevated
Lead V3
Lead V4
Artery Affected
Left Anterior Descending (LAD)
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56 secs
12 Lead Contiguous Leads - Septal Wall MI
Elevated Leads
Lead V1
Lead V2
Artery Affected
Left Anterior Descending (LAD)
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48 secs
12 Lead Contiguous Leads - Lateral Wall MI
Leads Elevated
Lead I
Lead aVL
Lead V5
Lead V6
Artery Affected
Circumflex
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1 min

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