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NCM 118 - Lesson 11 (Arrhythmia)

The document discusses different types of arrhythmias including their characteristics and treatments. It provides a table outlining common dysrhythmias including sinus bradycardia, sinus tachycardia, atrial fibrillation, different types of heart block, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, and asystole.

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Bobby Christian Duron
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93 views

NCM 118 - Lesson 11 (Arrhythmia)

The document discusses different types of arrhythmias including their characteristics and treatments. It provides a table outlining common dysrhythmias including sinus bradycardia, sinus tachycardia, atrial fibrillation, different types of heart block, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, and asystole.

Uploaded by

Bobby Christian Duron
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Lesson 11

ARRHYTHMIA

CONTENTS

I. Introduction
II. Table of Common Dysrhythmias (Rhythm, Characteristics, and Implication/Intervention)
III. Self Test / Self Directed Learning / Critical Thinking Drill
IV. References/Further Readings

I. Introduction
 A dysrhythmia (arrhythmia) is defined as an interruption in the normal conduction of the heart,
either in the rate or the rhythm.
 Characteristics of Normal Sinus Rhythm
o Rate: 60-100 beats/min
o Rhythm: Regular
o P-waves: present, precede each QRS complex
o PR interval: 0.12 to 0.20 second
o QRS complex: present and under 0.10 second
 Dysrhythmias may be classified according to rate (bradycardia or tachycardia) or their origin
(atrial or ventricular).
 Ventricular dysrhythmias are more life threatening than atrial dysrhythmias.

II. Table of Common Dysrhythmias (Rhythm, Characteristics, and Implication/Intervention)

Rhythm Characteristics Implication and Intervention


Sinus Bradycardia Sinus rhythm below a rate of Assess client for tolerance of the rate; if
60 bpm with hypotension or decreasing LOC
occurs, the rhythm is treated.

Treatment: Atropine
Sinus Tachycardia Regular rhythm Assess client for tolerance of the rate.
P waves present Most often caused by caffeine, alcohol, or
Rate: 100 to 150 bpm physiological response to stimuli.
Most often will decrease when stimuli are
removed

Treatment: Digitalis, beta-blockers,


diltiazem
Atrial Fibrillation Grossly irregular rate; cannot Evaluate client for systemic emboli from
identify P-waves or PR clots that tend to form in the fibrillating
interval on ECG atrium; a decrease in cardiac output will
occur with the tachycardia; maintain bed
Controlled rate: 60-100 bpm rest until rate is controlled. Pulse deficit
Uncontrolled rate: 140-180 may occur.
bpm
Treatment: Digitalis, quinidine, verapamil,
cardioversion
First Degree and Prolonged PR interval; all May be due to digitalis toxicity or
Second Degree AV waves are followed by a QRS electrolyte imbalance; also seen in
Block complex myocardial ischemia; identify and treat the
underlying cause

Must have an ECG tracing to identify.

Treatment: Atropine, pacemaker


Third Degree or No correlation between atrial May occur after an MI; symptoms depend
Complete Block impulses and ventricular on client’s tolerance to the rhythm; very
response. unstable and frequently leads to cardiac
standstill
Atrial rate is 80-90 bpm;
Ventricular rate is around 30 Treatment: Atropine, pacemaker
bpm
Premature Ventricular Premature ectopic beats; Indicative of ventricular irritability;
Contractions (PVCs) occur within a basic rhythm; considered to be significant and should be
are of ventricular origin; no P treated if they:
waves; bizarre QRS complex 1. Occur in excess of 6 bpm
2. Occur in a consecutive manner or in
pairs

Treatment: Oxygen, lidocaine,


procainamide
Note: PVCs frequently precede V-Tac
Ventricular Looks like a row of PVCs, Severe decrease in cardiac output;
Tachycardia wide and bizarre potentially life-threatening situation
Very rapid rate of 125 to 200
bpm Treatment: Lidocaine, Procainamide,
Bretylium, Cardioversion
Ventricular Very rapid, disorganized rate; If client is unconscious and there is no
Fibrillation cannot identify QRS cardiac output, initiate an emergency code
complexes; erratic and begin CPR
conduction
Treatment: Defibrillation, Epinephrine,
Lidocaine, Bretylium, Procainamide
Asystole No electrical activity No cardiac output
“Straight line” Initiate CPR

Treatment: External pacemaker,


Epinephrine, Atropine

V. Self Test / Critical Thinking Drill

SELF-DIRECTED LEARNING (RESEARCH ASSIGNMENT)

1. Read more about arrhythmias from other sources. Describe the following words related to the heart
conduction system.
a. Normal sinus rhythm
_________________________________________________________________________________
b. AV Node
_________________________________________________________________________________
c. Purkinje fibers
_________________________________________________________________________________
d. P wave
_________________________________________________________________________________
e. Cardioversion
_________________________________________________________________________________

2. Read about medications given for dysrhythmia/arrhythmia. Provide 3 common antiarrhythmic drugs
and give 2 nursing implications for each.
a. _______________________________________
1. _____________________________________________________________________
2. _____________________________________________________________________
b. ________________________________________
1. _____________________________________________________________________
2. _____________________________________________________________________
c. _________________________________________
1. _____________________________________________________________________
2. _____________________________________________________________________

VIDEO OBSERVATION
To reinforce your idea in the concept, watch a video online about pacemakers and how it works.
Provide a brief description of what you watched and cite a few important idea you’ve learned about it.
Check the following links for videos regarding this topic.
Pacemaker video: https://www.youtube.com/watch?v=53_jyoA47Fk

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_____________________________________________________________________________________
_____________________________________________________________________________________
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_____________________________________________________________________________________

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