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NurseFaith
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Atrial Arrhythmias occur where?
In the Atria, NOT in the SA node
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Regularity of Premature Atrial Contractions:
Depends on underlying rhythm
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When you see a beat that comes in too early think:
"I have a premature ____ contraction"
and find out which one it is
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Premature Atrial Contraction on an EKG:
P wave looks normal, it just comes in a little early (look at P wave in comparison to other P waves)
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Questions to ask yourself to determine Premature Atrial Contraction:
- Does you see any that come in early? YES
- Does it have a P wave? YES
Does it have a QRS? YES
Does it have an overall normal rhythm? YES
(normal sinus rhythm with one premature atrial contraction)
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PAC (Premature Atrial Contraction) on an EKG indicate:
Irrability except for occasional premature beats
(most common are from caffeine and nicotine!)
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Treatment with someone that has troublesome PAC (premature atrial contraction)
- Teach about limiting caffeine and stimulants
- (Lifestyle modifications)
Usually PACs do put out cardiac output and are benign/asymptomatic
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Atrial Tachycardia on EKG:
- Rate between 150-250 times a min!
- Norm QRS
- May not see P wave because it is going so fast
- ***it will look like sinus tachy but SA node cannot go that fast, so we know it's Atrial Tach!
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Atrial Tachycardia is also called ____ because the irritable point is coming from above the ventricles
Supraventricular Tachycardia (SVT)
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Causes of Atrial Tachycardia
- Caffeine and Stimulants
- Hypoxia
- Asthma
- Chemo (adriomysine)
**anything causing irratibility
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Treatment of Atrial Tachycardia
- Corotid Sinus Massage > stimulates PNS and slows HR
- *Never do this unless pt is on monitor and there are emergency items around
- Vagal Maneuvers
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When an EKG presents with a rate of 250-400, and more P waves than QRS complexes:
Atrial Flutter
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Sawtooth Pattern on EKG:
Atrial Flutter
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To measure Atrial Rate on EKG, measure from ____ to _____
P wave to P wave
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Treatment of A Flutter
Beta Blockers, Cal Chan Blockers, Antiarrhythmic, Flecanide
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Only arrhythmia that has a totally irregular rhythm
Atrial Fibrillation (A fib)
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Atrial Rate greater than 350 bpm, No discernible P waves, grossly irregular
A Fib
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Ocean Waves appearance on EKG
A Fib
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Treatment of A Fib
- Calcium Channel Blockers
- Beta Blockers
- Coumadin, Plavix, Zereta (clot prevention)
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A fib reduces cardiac output by ____% immediately because there is no strong contraction
1/3
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EKG changes from A Fib
Distance between QRS totally irregular
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If someone is deteriorating quickly from A Fib you may have to do _____
Cardioversion Shock
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