• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content







Total Views
Views on SlideShare
Embed Views



1 Embed 1

http://www.slideshare.net 1



Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
Post Comment
Edit your comment

    Ppt1 Ppt1 Presentation Transcript

    • Chapter 27 Management of Patients With Dysrhythmias and Conduction Problems
    • Dysrhythmias
      • Disorders of the formation and/or conduction of electrical impulses in the heart
      • Cause disturbances of heart rate and/or heart rhythm
      • May be evidenced by changes in hemodynamics
      • Diagnosed by analyzing electrocardiogram
    • ECG Interpretation
      • P wave represents atrial depolarization
      • QRS complex represents ventricular depolarization
      • T wave represents ventricular repolarization
      • U wave may represent repolarization of Purkinje fibers. May also be seen in hypokalemia, hypertension, or heart disease
      • PR interval normal range is 0.12-0.20 seconds
      • ST segment is identified as isoelectric, or above or below isoelectric line
      • QT interval normal range is 0.32-0.40 seconds
      • TP interval is isoelectric period
      • PP interval signifies atrial rhythm and rate
      • RR interval signifies ventricular rate and rhythm
    • Analyzing the ECG Rhythm Strip
      • Determine ventricular rate
      • Determine ventricular rhythm
      • Determine QRS duration
      • Determine whether QRS duration is consistent
      • Identify QRS shape
    • Analyzing the ECG Rhythm Strip (cont’d)
      • Identify P waves, is there a P in front of every QRS?
      • Identify P wave shape
      • Determine atrial rate
      • Determine atrial rhythm
    • Analyzing the ECG Rhythm Strip (cont’d)
      • 10. Determine PR interval
      • 11. Determine if PR intervals are consistent, irregular but with a pattern, or just irregular
      • 12. Determine how many P waves for each QRS (P:QRS ratio)
    • Sinus Node Dysrhythmias
      • Sinus Bradycardia
      • Sinus Tachycardia
      • Sinus Arrhythmia
    • Atrial Dysrhythmias
      • Premature Atrial Complex
      • Atrial Flutter
      • Atrial Fibrillation
    • Junctional Dysrhythmias
      • Premature Junctional Complex
      • Junctional Rhythm
      • Atrioventricular Nodal Reentry Tachycardia
        • Supraventricular tachycardia
    • Ventricular Dysrhythmias
      • Premature Ventricular Complex
      • Ventricular Tachycardia
      • Ventricular Fibrillation
      • Idioventricular Rhythm
      • Ventricular Asystole
    • Conduction Abnormalities
      • First-Degree Atrioventricular Block
      • Second-Degree Atrioventricular Block, Type I
      • Second-Degree Atrioventricular Block, Type II
      • Third-Degree Atrioventricular Block
    • Nursing Interventions
      • Monitoring and managing the dysrhythmia
      • Minimizing anxiety
      • Teaching self-care
    • Pacemaker Therapy
      • Provides electrical stimuli to heart muscle
      • Used for slower-than-normal impulse formation, to control some tachycardias, or for advanced heart failure
      • May be permanent or temporary
    • Pacemaker Therapy (cont’d)
      • NASPE-BPEG code
        • First letter identifies chambers being paced
        • Second letter describes the chambers being sensed
        • Third letter describes type of response by pacemaker to what is sensed
    • Cardioversion and Defibrillation
      • Delivery of electrical current to depolarize a critical mass of myocardial cells
      • When cells repolarize the SA node, is usually able to recapture its role as pacemaker of heart
      • Cardioversion involves use of “timed” electrical current to terminate a tachydysrhythmia
    • Cardioversion and Defibrillation (cont’d)
      • Defibrillation is used in emergency situations as treatment for ventricular fibrillation and pulseless VT