Dysrhythmia – Answers

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ArrhythmiaWhat’s wrong on the EKG?Treatment or medicationWhat should the nurse do?
Normal sinus rhythmP,QRS and T normal time and patternnoneHeart 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 bradycardiaNormal P,QRS and T at slow rate of 60 or belowAtropinepacemakerObverse for adequate organ perfusion
Sinus tachycardiaNormal P,QRS and T at slow rate of 100 or aboveBeta blocker, correct the underlying problemObverse for adequate organ perfusion
PACP,QRS and T normal time and pattern the occur early, then primary rate continuesNone, observeObverse for adequate organ perfusion
A trial fibrillationIrregular R to R intervalNo p wavesWavy baseline between QRS Digoxin, Amiodarone, Diltiazem, Verapamil,Anticoagulant,cardioversionMonitor for emboli   blood clots causing stroke or other organ ischemia
Atrial flutterSaw tooth baseline between QRS complexDigoxin, Amiodarone, Diltiazem, Verapamil,Anticoagulant,Cardioversion observe
First degree heart blockProlong PR intervalnoneObserve for further progression
Second degree heart block (Mobitz type II)2:1 block of 2 or more P waves before QRS (Pacemaker if necessaryobserve
Second degree heart block (WenckebachMobitz type I)Lengthening of PR interval before QRS until a beat is droppedPacemaker if necessaryobserve
Third degree heart blockAtria 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.pacemakerPrepare for pacemaker and do post operative teaching
PVCWide bizarre QRS occur early in cycle with compensatory pause following T waveCorrect underlying problem,Lidocaine , Procainamide, Amiodarone, Magnesium SulfateObverse for adequate organ perfusion
Ventricular tachycardiaCoiled spring QRSLidocaineProcainamideAmiodaroneMagnesium Sulfate



Obverse for adequate organ perfusion
Ventricular fibrillationBizarre baseline with no QRSDefibrillation and CODE for CPRFollow CODE protocol