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Cardiac Monitoring and DysrhythmiasMedical-Surgical Nursing-7th edition

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What symptom is normally associated with a right side, inferior MI?
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How should an EKG be analyzed? Order?
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Regular R-Rs? Rate? P waves? PRI length and QRS length
What is the normal measurement of a PRI?
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.12 - .20 *Beginning of P to beginning of QRS. Atrial depolarization and time between SA-AV.
How long is a normal QRS?
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Under .12 seconds. *Ventricular depolarization.
What interventions are initially performed on a patient with possible MI?
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Oxygen, IV, cardiac monitoring.
How is a NSTEMI diagnosed?
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Only thru cardiac markers.
Which leads are considered chest leads?
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VI - V6. *10 electrodes = 12 views of the heart.
Calculating bpm rate
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1. Count the number of R intervals in the 6 sec. strip and multiply by 10 to get bpm. Not very accurate, only used for irregular rates and quick estimates. 2. Count the number of small squares between two consecutive R waves and divide into 1500. Most
What are second line treatments for an MI?
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IV nitroglycerin, IIb - IIIa inhibitor (like Reapro and Integrilin), beta blocker, heparin, ACE inhibitors after 24 hours, stool softeners, and Plavix.
What medications should be prescribed for a patient with atrial fibrillation?
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Warfarin, heparin to decrease risk of blood clots, Cardizem, and diltiazem.
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How are stable tachydysrhythmias/SVT typically treated?
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Adenosine/Adenocard, calcium channel blockers like Cardizem or Verapamil, and vagal maneuvers (facial ice=baby).
How are unstable tachydysrhythmias/SVT typically treated?
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Cardioversion with synchronized shock. Versed is given.
How is ventricular tachycardia typically treated?
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If stable: cardioversion and amiodarone or lidocaine. If unstable: defibrillation. Call code, start CPR, shock, lidocaine, amiodarone.
How is ventricular fibrillation typically treated?
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Defibrillation; call code, CPR, shock.
How is asystole treated?
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CPR, atropine, epinephrine, pacemaker. *non-shockable
A systolic BP of _______ or higher or a MAP of _______ or higher is adequate to maintain organ perfusion.
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systolic of 90 and higher, MAP of 60 and higher.
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