Dysrhythmia – Answers

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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