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Arrhythmia | What’s wrong on the EKG? | Treatment or medication | What should the nurse do? |
Normal sinus rhythm | P,QRS and T normal time and pattern | none | Heart rhythm is stable impulse is originated in SA node and following normal conduction to AV node, bundle of HIS right and left bundle branches and into the perkinjie fibers. |
Sinus bradycardia | Normal P,QRS and T at slow rate of 60 or below | Atropinepacemaker | Obverse for adequate organ perfusion |
Sinus tachycardia | Normal P,QRS and T at slow rate of 100 or above | Beta blocker, correct the underlying problem | Obverse for adequate organ perfusion |
PAC | P,QRS and T normal time and pattern the occur early, then primary rate continues | None, observe | Obverse for adequate organ perfusion |
A trial fibrillation | Irregular R to R intervalNo p wavesWavy baseline between QRS | Digoxin, Amiodarone, Diltiazem, Verapamil,Anticoagulant,cardioversion | Monitor for emboli blood clots causing stroke or other organ ischemia |
Atrial flutter | Saw tooth baseline between QRS complex | Digoxin, Amiodarone, Diltiazem, Verapamil,Anticoagulant,Cardioversion | observe |
First degree heart block | Prolong PR interval | none | Observe for further progression |
Second degree heart block (Mobitz type II) | 2:1 block of 2 or more P waves before QRS ( | Pacemaker if necessary | observe |
Second degree heart block (WenckebachMobitz type I) | Lengthening of PR interval before QRS until a beat is dropped | Pacemaker if necessary | observe |
Third degree heart block | Atria beat 60 to 100 times per minute ventricles beat 20 to 40 beats per minute, two are not related but go at their own rate. | pacemaker | Prepare for pacemaker and do post operative teaching |
PVC | Wide bizarre QRS occur early in cycle with compensatory pause following T wave | Correct underlying problem,Lidocaine , Procainamide, Amiodarone, Magnesium Sulfate | Obverse for adequate organ perfusion |
Ventricular tachycardia | Coiled spring QRS | LidocaineProcainamideAmiodaroneMagnesium Sulfate Cardioversion
| Obverse for adequate organ perfusion |
Ventricular fibrillation | Bizarre baseline with no QRS | Defibrillation and CODE for CPR | Follow CODE protocol |