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Cardiac Monitoring and DysrhythmiasMedical-Surgical Nursing-7th edition

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What EKG changes can occur in a patient with decreased potassium levels?
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T wave flattens, U wave appears, as levels decrease, T wave may invert, and triggers ventricular irritability which can lead to fatal dysrhythmias.
What EKG changes can occur in a patient with increased potassium levels?
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Peaked T waves and flattened P waves. As conduction slows, QTI increases.
What does controlled atrial fibrillation mean?
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The AV node is blocking enough atrial impulses that the rate is 100 beats or less.
P wave = _______, PR interval = _______, QRS = _______, ST = _______, T = _______ QT = _______
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P = atrial depolarization and contraction, PR = time between atrial and ventricular depolarization. QRS = ventricular depolarization/contraction. ST = period from contraction to repolarization (*refractory is absolute), T = repolarization, and QT - PR -
What is considered a prolonged QT interval ?
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The distance from one R to the next R is over half the QT interval.
Hypocalcemia will _______ QT intervals. Hypercalcemia will _______ QT intervals.
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Increased Ca+ - QT shortens, Decreased Ca+ - QT prolongs
What heart view? Leads I, AVL, and V5-V6.
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Lateral
What heart view? VI-V2
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Ventricular septum
What heart view? V2-V4
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Anterior wall
Which part(s) of the heart are affected by the sympathetic nervous system?
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Both the atria and ventricles.
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Action Potentials/EKG: Phase 0, 1, 2, 3, and 4 =
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Phase 0 = QRS, Phase 1 = ST, Phase 2 = ST, Phase 3 = 1/2 thru the T wave, and Phase 4 = period between P and QRS.
Role of Potassium Ions in cardiac conduction...
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repolarization
Ions of the cardiac conduction cycle: Na+, K+, and Ca++ =
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Na+ = conduction (depolarization), K+ = repolarization, and Ca++ = contraction.
What are the two shockable, pulseless rhythms?
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V-fib and V-tach
What heart view? Leads V1, V2, and V3.
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Posterior (*note: will appear opposite of other leads).
What type of pacemaker lays on the outside of the heart, thru the chest and is usually used on patients during open heart surgery?
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Internal thoracic
What is the indication on an EKG that there might be a bundle branch block?
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A widened QRS over .12 sec.
What are the absolute contraindications for fibrinolytic therapy?
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Peptic ulcers, anticoagulants, hemorrhagic stroke, increased ICP, internal bleeding, aneurysm, pregnancy, surgery, trauma, uncontrolled hypertension, and systemic disease.
What medications are given to a patient with NSTEMI or UA?
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Aspirin, heparin, integrulin or Aggrastat.
Post PCI: Lift nothing heavier than milk for _______. Have someone with you for _______. No bath for _______. Exercise for _______ a day.
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Milk - 48 hours, company - 24 hours, bath - 6 weeks, exercise - 30 min.
What symptom is normally associated with a right side, inferior MI?
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N/V
  
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