411 Exam1 Dysrhythmia Tx

jsamuels12313's version from 2015-10-05 00:25

Section 1

Question Answer
Sinus bradyif sx present; treat with O2, and continuous monitoring, pt may need temporary pacing, atropine, epinephrine, or dopamine
Sick Sinus SyndromeIV atropine 0.5mg may need insertion of permanent pacemaker
SVTIf stable: O2, IV access, cardiac monitoring, and vagal maneuver If vagal maneuver unsuccessful, give ADENOSINE
A flutterCa+ blockers, beta blockers, amiodarone, synchronized cardioversion
A fibCoumadin, diltiazem, beta blockers, synchronized cardioversion
Which dysrhythmias do not need treatment?Sinus arrythmia, PAC, Sinus tach

Section 2

Question Answer
Junctional escape rhythmDepends on the cause If pt is hemodynamically unstable due to slow heart rate, same tx for bradycardia
1st degree AV blockIf caused by medication stop or decrease med. Monitor closely for severe AV block
2nd degree AV block type IIf pt is symptomatic due to slow HR treatment same as bradycardia (use atropine) , may need temporary pacing
2nd degree AV block type IIImmediate temporary pacing, give atropine 0.5mg while waiting for pacer. If temporary pacing is ineffective consider permanent pacing
3rd degree AV blockEmergent temporary pacing, give atropine 0.5mg while waiting for pacemaker. Epinephrine or dopamine may be considered while waiting or if pacing is ineffective. May need permanent pacing
BBBDoesn't usually require tx but if pt is hemodynamically compromised may need ventricular pacemaker

Section 3

Question Answer
PVCNo intervention needed except eliminate contributing factors (caffeine, meds etc). Post MI pt treat sx, may give amiodarone or lidocaine
Idioventricular rhythm CPR and advanced cardiac life support measures. If there is a pulse: treat for symptomatic bradycardia, immediate temporary pacing & atropine, epinephrine, and dopamine
V tachStable, with pulse: amiodarone, procainamide, sotalol, or synchronized cardioversion. Defib pulseless v tach, amiodarone
V fibCPR, defib. if v fib continues after CPR and defib, may give vasopressor (epinephrine 1mg IV q3-5min & vasopressin 40 units IV), amiodarone
Ventricular asystoleCPR, defib after 5 cycles of CPR recheck rhythm if in asystole, resume CPR and give vasopressor. Recheck rhythm after each 5th cycle to check for shockable rhythm

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