Chapter 36: Nursing Management: Dysrhythmias Flashcards by Heidi Demuynck (2022)

Table of Contents
1. To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patients ANS: A 2. The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be best to use? ANS: D 3. A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of _____ beats/minute. ANS: C 4. The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patients cardiac rhythm as ANS: D 5. The nurse notes that a patients cardiac monitor shows that every other beat is earlier than expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse document the rhythm? ANS: B 6. A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute. The nurse determines that the P-R interval is 0.24 seconds. The most appropriate intervention by the nurse would be to ANS: D 7. A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following actions should the nurse take next? ANS: D 8. After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree atrioventricular (AV) block, which finding indicates that the medication has been effective? ANS: A 9. A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. The priority teaching needed for this patient would include information about ANS: A 10. Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter? ANS: C 11. After providing a patient with discharge instructions on the management of a new permanent pacemaker, the nurse knows that teaching has been effective when the patient states ANS: D 12. Which intervention by a new nurse who is caring for a patient who has just had an implantable cardioverter-defibrillator (ICD) inserted indicates a need for more education about care of patients with ICDs? ANS: A 13. Which action should the nurse perform when preparing a patient with supraventricular tachycardia for cardioversion who is alert and has a blood pressure of 110/66 mm Hg? ANS: B 14. A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54, and the student denies any health problems. What action by the nurse is most appropriate? ANS: A 15. When analyzing the rhythm of a patients electrocardiogram (ECG), the nurse will need to investigate further upon finding a(n) ANS: D 16. A patient has ST segment changes that support an acute inferior wall myocardial infarction. Which lead would be best for monitoring the patient? ANS: B 17. Which laboratory result for a patient with multifocal premature ventricular contractions (PVCs) is most important for the nurse to communicate to the health care provider? ANS: D 18. A patients cardiac monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious and pulseless. Which action should the nurse take first? ANS: A 19. A patients cardiac monitor shows sinus rhythm, rate 64. The P-R interval is 0.18 seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM. Which action should the nurse take next? ANS: D 20. A patient develops sinus bradycardia at a rate of 32 beats/minute, has a blood pressure (BP) of 80/42 mm Hg, and is complaining of feeling faint. Which actions should the nurse take next? ANS: D 21. A 19-year-old student comes to the student health center at the end of the semester complaining that, My heart is skipping beats. An electrocardiogram (ECG) shows occasional premature ventricular contractions (PVCs). What action should the nurse take next? ANS: B 22. The nurse has received change-of-shift report about the following patients on the progressive care unit. Which patient should the nurse see first? ANS: D 23. A patient who is on the progressive care unit develops atrial flutter, rate 150, with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first? ANS: C 24. A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic and has no palpable pulses. What is the first action that the nurse should take? ANS: B 25. Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin? ANS: A 26. Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as a telemetry technician on the cardiac care unit? ANS: C 27. Which action by a new registered nurse (RN) who is orienting to the progressive care unit indicates a good understanding of the treatment of cardiac dysrhythmias? ANS: A 28. A patient reports dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains the following electrocardiographic (ECG) tracing. ANS: C 29. A patient who is complaining of a racing heart and feeling anxious comes to the emergency department. The nurse places the patient on a heart monitor and obtains the following electrocardiographic (ECG) tracing. ANS: C 1. When preparing to defibrillate a patient. In which order will the nurse perform the following steps? (Put a comma and a space between each answer choice [A, B, C, D, E].) ANS: FAQs

1. To determine whether there is a delay in impulse conduction through the atria, the nurse will measure the duration of the patients

a.

P wave.

b.

Q wave.

c.

P-R interval.

d.

QRS complex.

ANS: A

The P wave represents the depolarization of the atria. The P-R interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and the Purkinje fibers. The QRS represents ventricular depolarization. The Q wave is the first negative deflection following the P wave and should be narrow and short.

2. The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be best to use?

a.

Count the number of large squares in the R-R interval and divide by 300.

b.

Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.

c.

Calculate the number of small squares between one QRS complex and the next and divide into 1500.

d.

Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10.

ANS: D

This is the quickest way to determine the ventricular rate for a patient with a regular rhythm. All the other methods are accurate, but take longer.

3. A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of _____ beats/minute.

a.

15 to 20

b.

20 to 40

c.

40 to 60

d.

60 to 100

ANS: C

If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates are typical of the bundle of His and the Purkinje system and may be seen with failure of both the SA and AV node to discharge. The normal SA node rate is 60 to 100 beats/minute.

4. The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patients cardiac rhythm as

a.

atrial flutter.

b.

sinus tachycardia.

c.

ventricular fibrillation.

d.

ventricular tachycardia.

ANS: D

The absence of P waves, wide QRS, rate >150 beats/minute, and the regularity of the rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS configuration, and has flutter waves present representing atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration.

5. The nurse notes that a patients cardiac monitor shows that every other beat is earlier than expected, has no visible P wave, and has a QRS complex that is wide and bizarre in shape. How will the nurse document the rhythm?

a.

Ventricular couplets

b.

Ventricular bigeminy

c.

Ventricular R-on-T phenomenon

d.

Multifocal premature ventricular contractions

ANS: B

Ventricular bigeminy describes a rhythm in which every other QRS complex is wide and bizarre looking. Pairs of wide QRS complexes are described as ventricular couplets. There is no indication that the premature ventricular contractions (PVCs) are multifocal or that the R-on-T phenomenon is occurring.

6. A patient has a normal cardiac rhythm and a heart rate of 72 beats/minute. The nurse determines that the P-R interval is 0.24 seconds. The most appropriate intervention by the nurse would be to

a.

notify the health care provider immediately.

b.

give atropine per agency dysrhythmia protocol.

c.

prepare the patient for temporary pacemaker insertion.

d.

document the finding and continue to monitor the patient.

ANS: D

First-degree atrioventricular (AV) block is asymptomatic and requires ongoing monitoring because it may progress to more serious forms of heart block. The rate is normal, so there is no indication that atropine is needed. Immediate notification of the health care provider about an asymptomatic rhythm is not necessary.

7. A patient who was admitted with a myocardial infarction experiences a 45-second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98 beats/minute. Which of the following actions should the nurse take next?

a.

Immediately notify the health care provider.

b.

Document the rhythm and continue to monitor the patient.

c.

Perform synchronized cardioversion per agency dysrhythmia protocol.

d.

Prepare to give IV amiodarone (Cordarone) per agency dysrhythmia protocol.

ANS: D

The burst of sustained ventricular tachycardia indicates that the patient has significant ventricular irritability, and antidysrhythmic medication administration is needed to prevent further episodes. The nurse should notify the health care provider after the medication is started. Defibrillation is not indicated given that the patient is currently in a sinus rhythm. Documentation and continued monitoring are not adequate responses to this situation.

8. After the nurse gives IV atropine to a patient with symptomatic type 1, second-degree atrioventricular (AV) block, which finding indicates that the medication has been effective?

a.

Increase in the patients heart rate

b.

Increase in strength of peripheral pulses

c.

Decrease in premature atrial contractions

d.

Decrease in premature ventricular contractions

ANS: A

Atropine will increase the heart rate and conduction through the AV node. Because the medication increases electrical conduction, not cardiac contractility, the quality of the peripheral pulses is not used to evaluate the drug effectiveness. The patient does not have premature atrial or ventricular contractions.

9. A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. The priority teaching needed for this patient would include information about

a.

anticoagulant therapy.

b.

permanent pacemakers.

c.

electrical cardioversion.

d.

IV adenosine (Adenocard).

ANS: A

Atrial fibrillation therapy that has persisted for more than 48 hours requires anticoagulant treatment for 3 weeks before attempting cardioversion. This is done to prevent embolization of clots from the atria. Cardioversion may be done after several weeks of anticoagulation therapy. Adenosine is not used to treat atrial fibrillation. Pacemakers are routinely used for patients with bradydysrhythmias. Information does not indicate that the patient has a slow heart rate.

10. Which information will the nurse include when teaching a patient who is scheduled for a radiofrequency catheter ablation for treatment of atrial flutter?

a.

The procedure will prevent or minimize the risk for sudden cardiac death.

b.

The procedure will use cold therapy to stop the formation of the flutter waves.

c.

The procedure will use electrical energy to destroy areas of the conduction system.

d.

The procedure will stimulate the growth of new conduction pathways between the atria.

ANS: C

Radiofrequency catheter ablation therapy uses electrical energy to burn or ablate areas of the conduction system as definitive treatment of atrial flutter (i.e., restore normal sinus rhythm) and tachydysrhythmias. All other statements regarding the procedure are incorrect.

11. After providing a patient with discharge instructions on the management of a new permanent pacemaker, the nurse knows that teaching has been effective when the patient states

a.

I will avoid cooking with a microwave oven or being near one in use.

b.

It will be 1 month before I can take a bath or return to my usual activities.

c.

I will notify the airlines when I make a reservation that I have a pacemaker.

d.

I wont lift the arm on the pacemaker side up very high until I see the doctor.

ANS: D

The patient is instructed to avoid lifting the arm on the pacemaker side above the shoulder to avoid displacing the pacemaker leads. The patient should notify airport security about the presence of a pacemaker before going through the metal detector, but there is no need to notify the airlines when making a reservation. Microwave oven use does not affect the pacemaker. The insertion procedure involves minor surgery that will have a short recovery period.

12. Which intervention by a new nurse who is caring for a patient who has just had an implantable cardioverter-defibrillator (ICD) inserted indicates a need for more education about care of patients with ICDs?

a.

The nurse assists the patient to do active range of motion exercises for all extremities.

b.

The nurse assists the patient to fill out the application for obtaining a Medic Alert ID.

c.

The nurse gives amiodarone (Cordarone) to the patient without first consulting with the health care provider.

d.

The nurse teaches the patient that sexual activity usually can be resumed once the surgical incision is healed.

ANS: A

The patient should avoid moving the arm on the ICD insertion site until healing has occurred in order to prevent displacement of the ICD leads. The other actions by the new nurse are appropriate for this patient.

13. Which action should the nurse perform when preparing a patient with supraventricular tachycardia for cardioversion who is alert and has a blood pressure of 110/66 mm Hg?

a.

Turn the synchronizer switch to the off position.

b.

Give a sedative before cardioversion is implemented.

c.

Set the defibrillator/cardioverter energy to 360 joules.

d.

Provide assisted ventilations with a bag-valve-mask device.

ANS: B

When a patient has a nonemergency cardioversion, sedation is used just before the procedure. The synchronizer switch is turned on for cardioversion. The initial level of joules for cardioversion is low (e.g., 50). Assisted ventilations are not indicated for this patient.

14. A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. Blood pressure (BP) is 114/54, and the student denies any health problems. What action by the nurse is most appropriate?

a.

Allow the student to participate on the soccer team.

b.

Refer the student to a cardiologist for further diagnostic testing.

c.

Tell the student to stop playing immediately if any dyspnea occurs.

d.

Obtain more detailed information about the students family health history.

ANS: A

In an aerobically trained individual, sinus bradycardia is normal. The students normal BP and negative health history indicate that there is no need for a cardiology referral or for more detailed information about the familys health history. Dyspnea during an aerobic activity such as soccer is normal.

15. When analyzing the rhythm of a patients electrocardiogram (ECG), the nurse will need to investigate further upon finding a(n)

a.

isoelectric ST segment.

b.

P-R interval of 0.18 second.

c.

Q-T interval of 0.38 second.

d.

QRS interval of 0.14 second.

ANS: D

Because the normal QRS interval is 0.04 to 0.10 seconds, the patients QRS interval of 0.14 seconds indicates that the conduction through the ventricular conduction system is prolonged. The P-R interval and Q-T interval are within normal range, and ST segment should be isoelectric (flat).

16. A patient has ST segment changes that support an acute inferior wall myocardial infarction. Which lead would be best for monitoring the patient?

a. I

b. II

c. V2

d. V6

ANS: B

Leads II, III, and AVF reflect the inferior area of the heart and the ST segment changes. Lead II will best capture any electrocardiographic (ECG) changes that indicate further damage to the myocardium. The other leads do not reflect the inferior part of the myocardial wall and will not provide data about further ischemic changes in that area.

17. Which laboratory result for a patient with multifocal premature ventricular contractions (PVCs) is most important for the nurse to communicate to the health care provider?

a.

Blood glucose 243 mg/dL

b.

Serum chloride 92 mEq/L

c.

Serum sodium 134 mEq/L

d.

Serum potassium 2.9 mEq/L

ANS: D

Hypokalemia increases the risk for ventricular dysrhythmias such as PVCs, ventricular tachycardia, and ventricular fibrillation. The health care provider will need to prescribe a potassium infusion to correct this abnormality. Although the other laboratory values also are abnormal, they are not likely to be the etiology of the patients PVCs and do not require immediate correction.

18. A patients cardiac monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious and pulseless. Which action should the nurse take first?

a.

Perform immediate defibrillation.

b.

Give epinephrine (Adrenalin) IV.

c.

Prepare for endotracheal intubation.

d.

Give ventilations with a bag-valve-mask device.

ANS: A

The patients rhythm and assessment indicate ventricular fibrillation and cardiac arrest; the initial action should be to defibrillate. If a defibrillator is not immediately available or is unsuccessful in converting the patient to a better rhythm, the other actions may be appropriate.

19. A patients cardiac monitor shows sinus rhythm, rate 64. The P-R interval is 0.18 seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM. Which action should the nurse take next?

a.

Place the transcutaneous pacemaker pads on the patient.

b.

Administer atropine sulfate 1 mg IV per agency dysrhythmia protocol.

c.

Document the patients rhythm and assess the patients response to the rhythm.

d.

Call the health care provider before giving the next dose of metoprolol (Lopressor).

ANS: D

The patient has progressive first-degree atrioventricular (AV) block, and the b-blocker should be held until discussing the medication with the health care provider. Documentation and assessment are appropriate but not fully adequate responses. The patient with first-degree AV block usually is asymptomatic, and a pacemaker is not indicated. Atropine is sometimes used for symptomatic bradycardia, but there is no indication that this patient is symptomatic.

20. A patient develops sinus bradycardia at a rate of 32 beats/minute, has a blood pressure (BP) of 80/42 mm Hg, and is complaining of feeling faint. Which actions should the nurse take next?

a.

Recheck the heart rhythm and BP in 5 minutes.

b.

Have the patient perform the Valsalva maneuver.

c.

Give the scheduled dose of diltiazem (Cardizem).

d.

Apply the transcutaneous pacemaker (TCP) pads.

ANS: D

The patient is experiencing symptomatic bradycardia, and treatment with TCP is appropriate. Continued monitoring of the rhythm and BP is an inadequate response. Calcium channel blockers will further decrease the heart rate, and the diltiazem should be held. The Valsalva maneuver will further decrease the rate.

21. A 19-year-old student comes to the student health center at the end of the semester complaining that, My heart is skipping beats. An electrocardiogram (ECG) shows occasional premature ventricular contractions (PVCs). What action should the nurse take next?

a.

Start supplemental O2 at 2 to 3 L/min via nasal cannula.

b.

Ask the patient about current stress level and caffeine use.

c.

Ask the patient about any history of coronary artery disease.

d.

Have the patient taken to the hospital emergency department (ED).

ANS: B

In a patient with a normal heart, occasional PVCs are a benign finding. The timing of the PVCs suggests stress or caffeine as possible etiologic factors. It is unlikely that the patient has coronary artery disease, and this should not be the first question the nurse asks. The patient is hemodynamically stable, so there is no indication that the patient needs to be seen in the ED or that oxygen needs to be administered.

22. The nurse has received change-of-shift report about the following patients on the progressive care unit. Which patient should the nurse see first?

a.

A patient who is in a sinus rhythm, rate 98, after having electrical cardioversion 2 hours ago

b.

A patient with new onset atrial fibrillation, rate 88, who has a first dose of warfarin (Coumadin) due

c.

A patient with second-degree atrioventricular (AV) block, type 1, rate 60, who is dizzy when ambulating

d.

A patient whose implantable cardioverter-defibrillator (ICD) fired two times today who has a dose of amiodarone (Cordarone) due

ANS: D

The frequent firing of the ICD indicates that the patients ventricles are very irritable, and the priority is to assess the patient and administer the amiodarone. The other patients may be seen after the amiodarone is administered.

23. A patient who is on the progressive care unit develops atrial flutter, rate 150, with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

a.

Obtain a 12-lead electrocardiogram (ECG).

b.

Notify the health care provider of the change in rhythm.

c.

Give supplemental O2 at 2 to 3 L/min via nasal cannula.

d.

Assess the patients vital signs including oxygen saturation.

ANS: C

Because this patient has dyspnea and chest pain in association with the new rhythm, the nurses initial actions should be to address the patients airway, breathing, and circulation (ABC) by starting with oxygen administration. The other actions also are important and should be implemented rapidly.

24. A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic and has no palpable pulses. What is the first action that the nurse should take?

a.

Perform synchronized cardioversion.

b.

Start cardiopulmonary resuscitation (CPR).

c.

Administer atropine per agency dysrhythmia protocol.

d.

Provide supplemental oxygen via non-rebreather mask.

ANS: B

The patients clinical manifestations indicate pulseless electrical activity and the nurse should immediately start CPR. The other actions would not be of benefit to this patient.

25. Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin?

a.

Instruct the patient to call for assistance before getting out of bed.

b.

Explain the association between various dysrhythmias and syncope.

c.

Educate the patient about the need to avoid caffeine and other stimulants.

d.

Tell the patient about the benefits of implantable cardioverter-defibrillators.

ANS: A

A patient with fainting episodes is at risk for falls. The nurse will plan to minimize the risk by having assistance whenever the patient up. The other actions may be needed if dysrhythmias are found to be the cause of the patients syncope, but are not appropriate for syncope of unknown origin.

26. Which nursing action can the registered nurse (RN) delegate to experienced unlicensed assistive personnel (UAP) working as a telemetry technician on the cardiac care unit?

a.

Decide whether a patients heart rate of 116 requires urgent treatment.

b.

Monitor a patients level of consciousness during synchronized cardioversion.

c.

Observe cardiac rhythms for multiple patients who have telemetry monitoring.

d.

Select the best lead for monitoring a patient admitted with acute coronary syndrome.

ANS: C

UAP serving as telemetry technicians can monitor cardiac rhythms for individuals or groups of patients. Nursing actions such as assessment and choice of the most appropriate lead based on ST segment elevation location require RN-level education and scope of practice.

27. Which action by a new registered nurse (RN) who is orienting to the progressive care unit indicates a good understanding of the treatment of cardiac dysrhythmias?

a.

Injects IV adenosine (Adenocard) over 2 seconds to a patient with supraventricular tachycardia

b.

Obtains the defibrillator and quickly brings it to the bedside of a patient whose monitor shows asystole

c.

Turns the synchronizer switch to the on position before defibrillating a patient with ventricular fibrillation

d.

Gives the prescribed dose of diltiazem (Cardizem) to a patient with new-onset type II second degree AV block

ANS: A

Adenosine must be given over 1 to 2 seconds to be effective. The other actions indicate a need for more education about treatment of cardiac dysrhythmias. The RN should hold the diltiazem until talking to the health care provider. The treatment for asystole is immediate CPR. The synchronizer switch should be off when defibrillating.

28. A patient reports dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains the following electrocardiographic (ECG) tracing.

The nurse interprets this heart rhythm as

a.

junctional escape rhythm.

b.

accelerated idioventricular rhythm.

c.

third-degree atrioventricular (AV) block.

d.

sinus rhythm with premature atrial contractions (PACs).

ANS: C

The inconsistency between the atrial and ventricular rates and the variable P-R interval indicate that the rhythm is third-degree AV block. Sinus rhythm with PACs will have a normal rate and consistent P-R intervals with occasional PACs. An accelerated idioventricular rhythm will not have visible P waves.

29. A patient who is complaining of a racing heart and feeling anxious comes to the emergency department. The nurse places the patient on a heart monitor and obtains the following electrocardiographic (ECG) tracing.

Which action should the nurse take next?

a.

Prepare to perform electrical cardioversion.

b.

Have the patient perform the Valsalva maneuver.

c.

Obtain the patients vital signs including oxygen saturation.

d.

Prepare to give a b-blocker medication to slow the heart rate.

ANS: C

The patient has sinus tachycardia, which may have multiple etiologies such as pain, dehydration, anxiety, and myocardial ischemia. Further assessment is needed before determining the treatment. Vagal stimulation or b-blockade may be used after further assessment of the patient. Electrical cardioversion is used for some tachydysrhythmias, but would not be used for sinus tachycardia.

1. When preparing to defibrillate a patient. In which order will the nurse perform the following steps? (Put a comma and a space between each answer choice [A, B, C, D, E].)

a. Turn the defibrillator on.

b. Deliver the electrical charge.

c. Select the appropriate energy level.

d. Place the paddles on the patients chest.

e. Check the location of other staff and call out all clear.

FAQs

What is dysrhythmia in nursing? ›

What is Dysrhythmia? Cardiac dysrhythmias are a problem with the rate or rhythm of your heartbeat caused by changes in your heart's normal sequence of electrical impulses. Your heart may beat too quickly, called tachycardia; too slowly, bradycardia; or with an irregular pattern.

What are some examples of Dysrhythmias? ›

Supraventricular arrhythmias
  • Atrial fibrillation.
  • Atrial flutter.
  • Atrial tachycardia.
  • Atrioventricular nodal reentrant tachycardia (AVNRT)
  • Atrioventricular reeentrant tachycardia.
  • Paroxysmal supraventricular tachycardia (PSVT)
  • Wolff-Parkinson-White syndrome.

Which dysrhythmia is common in older clients? ›

ATRIAL FIBRILLATION

AF is the most common arrhythmia in the elderly and affects about 1 in 10 individuals over the age of 80 years (49) (Figure 4).

What are priority nursing interventions for atrial fibrillation? ›

There are three main components to the treatment of AF: - Control of ventricular rate; - Restoration of sinus rhythm; - Prevention of embolism with anticoagulation therapy.

What are 3 life threatening dysrhythmias? ›

Ventricular fibrillation, ventricular tachycardia and prolonged pauses or asystole are dangerous.

What are the main causes of dysrhythmia? ›

Causes
  • Current heart attack or scarring from a previous heart attack.
  • Blocked arteries in the heart (coronary artery disease)
  • Changes to the heart's structure, such as from cardiomyopathy.
  • Diabetes.
  • High blood pressure.
  • Infection with COVID-19.
  • Overactive thyroid gland (hyperthyroidism)
  • Sleep apnea.
30 Apr 2022

What are the 4 heart rhythms? ›

Sinus rhythm, sinus bradycardia, sinus tachycardia and sinus arrhythmia are all normal heart rhythms where the electrical impulses travel in a normal way through the heart.

What's the definition of Dysrhythmias? ›

A cardiac dysrhythmia (arrhythmia) is an abnormal or irregular heartbeat. If you have a dysrhythmia, your heart might beat too fast or too slowly.

Is atrial fibrillation a dysrhythmia? ›

What is atrial fibrillation? Atrial fibrillation, often called AFib or AF, is the most common type of treated heart arrhythmia. An arrhythmia is when the heart beats too slowly, too fast, or in an irregular way.

Why do elderly have increased arrhythmias? ›

Structural and functional changes in the aging heart

Structural and functional alterations in cardiac mechanical and electrical system, as well as energetics and metabolism associated with the aging process increase predisposition to cardiac arrhythmias.

Which type of dysrhythmia is associated with a fever? ›

Thus, this systematic study indicated that fever increases the risk for ventricular arrhythmias and aggravates the typical ECG changes in BrS patients.

What rhythm has no P wave? ›

Accelerated junctional rhythm (nodal tachycardia) is a regular narrow-complex tachycardia in which no P wave can be seen preceding the QRS complex.

What two treatments may help a patient with atrial fibrillation? ›

Atrial fibrillation treatment may involve: Medications. Therapy to reset the heart rhythm (cardioversion) Surgery or catheter procedures.
...
Medications used to treat atrial fibrillation include:
  • Beta blockers. ...
  • Calcium channel blockers. ...
  • Digoxin. ...
  • Anti-arrhythmic medications. ...
  • Blood thinners.
19 Oct 2021

What is the latest treatment for atrial fibrillation? ›

In fall 2020, the FDA approved the Thermocool Smarttouch Catheter for use in AFib patients. This new treatment offers better long-term results for those with persistent atrial fibrillation. Atrial fibrillation is a common arrhythmia, especially among older people.

What are nursing interventions for atrial flutter? ›

Treatments for atrial flutter

control the rate (beta blockers and calcium channel blockers are most often used) convert back to sinus rhythm if possible (no clots present!) decrease risk of stroke by getting your patient on an anticoagulation ASAP, with a goal INR of 3.

What are the 7 lethal heart rhythms? ›

You will learn about Premature Ventricular Contractions, Ventricular Tachycardia, Ventricular Fibrillation, Pulseless Electrical Activity, Agonal Rhythms, and Asystole. You will learn how to detect the warning signs of these rhythms, how to quickly interpret the rhythm, and to prioritize your nursing interventions.

What is the most serious cardiac dysrhythmia? ›

The most serious arrhythmia is ventricular fibrillation, which is an uncontrolled, irregular beat. Instead of one misplaced beat from the ventricles, you may have several impulses that begin at the same time from different locations—all telling the heart to beat.

What is a fatal heart rhythm? ›

Fatal or potentially fatal arrhythmias

The most dangerous arrhythmia is ventricular fibrillation, in which your ventricles quiver rather than beat steadily in time with your atria. Your ventricles will stop pumping blood to the rest of your body, including your heart muscle.

What is a normal heart rate? ›

A normal resting heart rate for adults ranges from 60 to 100 beats per minute. Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats per minute.

What foods to avoid if you have arrhythmia? ›

Foods to avoid for AFib
  • Caffeine and energy drinks.
  • Alcohol. A 2014 study found that even moderate alcohol intake could be a risk factor for AFib. ...
  • Red meat.
  • Processed foods. Processed foods, such as ready meals or sausages, tend to have large quantities of salt and preservatives. ...
  • Sugary foods and drinks.
  • Salt.
30 Jun 2020

How do you assess for cardiac dysrhythmia? ›

Tests to diagnose heart arrhythmias may include:
  1. Electrocardiogram (ECG or EKG). During an ECG , sensors (electrodes) that can detect the electrical activity of the heart are attached to the chest and sometimes to the arms or legs. ...
  2. Holter monitor. ...
  3. Event recorder. ...
  4. Echocardiogram. ...
  5. Implantable loop recorder.
30 Apr 2022

What rhythm is not shockable? ›

The two shockable rhythms are ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) while the non–shockable rhythms include sinus rhythm (SR), supraventricular tachycardia (SVT), premature ventricualr contraction (PVC), atrial fibrilation (AF) and so on.

What is a heart beat called? ›

Normal heart rhythm is often called normal sinus rhythm because the SA (sinus) node fires regularly. AV node (atrioventricular node). The AV node is a cluster of cells in the center of the heart between the atria and ventricles, and acts like a gate that slows the electrical signal before it enters the ventricles.

What rhythms do you do CPR? ›

The American Heart Association recommends having a song in mind if and when you need to perform CPR because it'll help you maintain a steady rhythm of 100 to 120 BPM (beats per minute). And while the rhythm is very important, so are the quality of the compressions.

What is dysrhythmia quizlet? ›

dysrhythmia aka arrhythmia. - abnormal cardiac rhythms. which can cause disturbances of: rate, rhythm, or both rate and rhythm.

What is the sudden onset or cessation of a dysrhythmia is called? ›

Paroxysmal is the term used to describe the sudden onset or cessation of a dysrhythmia and identification of the rhythm that preceded it. An SVT that starts or ends suddenly is called paroxysmal supraventricular tachycardia (PSVT).

What is the opposite of arrhythmia? ›

Bradyarrhythmias, by definition, are slow heart rhythms, typically less than 60 beats per minute.

Which dysrhythmia is most commonly diagnosed? ›

Atrial fibrillation is the most common sustained arrhythmia, increases with age, and presents with a wide spectrum of symptoms and severity.

What is the drug of choice for atrial fibrillation? ›

Beta blockers and calcium channel blockers are the drugs of choice because they provide rapid rate control. These drugs are effective in reducing the heart rate at rest and during exercise in patients with atrial fibrillation.

What is heart fluttering called? ›

Heart palpitations (pal-pih-TAY-shuns) are feelings of having a fast-beating, fluttering or pounding heart. Stress, exercise, medication or, rarely, a medical condition can trigger them. Although heart palpitations can be worrisome, they're usually harmless.

What's the definition of Dysrhythmias? ›

A cardiac dysrhythmia (arrhythmia) is an abnormal or irregular heartbeat. If you have a dysrhythmia, your heart might beat too fast or too slowly.

How is bradycardia usually treated? ›

Bradycardia treatment may include lifestyle changes, medication changes or an implanted device called a pacemaker. If an underlying health problem, such as thyroid disease or sleep apnea, is causing the slow heart rate, treatment of that condition might correct bradycardia.

What is sinus bradycardia? ›

Sinus bradycardia is a cardiac rhythm with appropriate cardiac muscular depolarization initiating from the sinus node and a rate of fewer than 60 beats per minute (bpm). The diagnosis of this condition requires an ECG showing a normal sinus rhythm at a rate lower than 60 bpm.

Is a sinus rhythm normal? ›

It means the electrical pulse from your sinus node is being properly transmitted throughout the heart muscle. In adults, normal sinus rhythm usually accompanies a heart rate of 60 to 100 bpm. However, it's possible for sinus rhythm to be faster or slower than this and still be considered normal.

What is the most common dysrhythmia? ›

Atrial fibrillation, often called AFib or AF, is the most common type of treated heart arrhythmia.

What is the most serious cardiac dysrhythmia? ›

The most serious arrhythmia is ventricular fibrillation, which is an uncontrolled, irregular beat. Instead of one misplaced beat from the ventricles, you may have several impulses that begin at the same time from different locations—all telling the heart to beat.

How do you assess for cardiac dysrhythmia? ›

Tests to diagnose heart arrhythmias may include:
  1. Electrocardiogram (ECG or EKG). During an ECG , sensors (electrodes) that can detect the electrical activity of the heart are attached to the chest and sometimes to the arms or legs. ...
  2. Holter monitor. ...
  3. Event recorder. ...
  4. Echocardiogram. ...
  5. Implantable loop recorder.
30 Apr 2022

What is the first line treatment for unstable bradycardia? ›

Atropine. Atropine is the first line medication for the treatment of bradycardia. The administration of atropine typically causes an increase in heart rate. This increase in the heart rate occurs when atropine blocks the effects of the vagus nerve on the heart.

What emergency drug is given to treat bradycardia? ›

Typically, atropine is the drug of choice for symptomatic bradycardia. An anticholinergic and potent belladonna alkaloid, it increases the heart rate, which improves hemodynamic stability. Epinephrine may be used as a secondary measure if atropine and temporary heart pacing don't improve hemodynamic stability.

What is the most common cause of bradycardia? ›

Typical heartbeat

Bradycardia can be caused by: Heart tissue damage related to aging. Damage to heart tissues from heart disease or heart attack. A heart condition present at birth (congenital heart defect)

What are the two types of bradycardia? ›

There are two main types of bradyarrhythmia: sinus node dysfunction and atrioventricular (AV) blocks.

What is normal pulse rate? ›

A normal resting heart rate for adults ranges from 60 to 100 beats per minute. Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats per minute.

What is 1st degree heart block? ›

First-degree atrioventricular (AV) block is a condition of abnormally slow conduction through the AV node. It is defined by ECG changes that include a PR interval of greater than 0.20 without disruption of atrial to ventricular conduction. This condition is generally asymptomatic and discovered only on routine ECG.

What is an unsafe heart rate? ›

Abnormal Heart Rates or Heart Beats reflect the cardiac conditions of the body. If unnoticed and untreated, this can sometimes be fatal. Conditions when the heartbeat goes beyond 120-140 beats per minute or falls below 60 beats per minute, can be considered dangerous, and immediate doctor's intervention is a must.

What is a normal ECG rhythm called? ›

Sinus rhythm is the name given to the normal rhythm of the heart where electrical stimuli are initiated in the SA node, and are then conducted through the AV node and bundle of His, bundle branches and Purkinje fibres. Depolarisation and repolarisation of the atria and ventricles show up as 3 distinct waves on ECG.

What is a dangerously low heart rate when sleeping? ›

Low Sleeping Heart Rate

Bradycardia, which is more common in older adults, describes a resting heart rate that is below 60 beats per minute (bpm). A number of health conditions can contribute to lower heart rates, including heart disease, rheumatic fever, Lyme disease, and sleep apnea.

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