By Margaret Eckman, Diane Labus
Editors: Margaret Eckman, Diane Labus
Updated with new remedies and algorithms, ECG evidence Made awfully fast! moment version offers rapid entry to info that each nurse wishes for secure sufferer care. The booklet suits with ease right into a pocket, and the wipeable web page floor permits nurses to put in writing notes and take away them simply. insurance contains simple electrocardiography together with cardiac conduction, lead placement, and center price calculation; rhythm strip interpretation; explanations, signs, interventions, and therapy for arrhythmias; 12-lead and 15-lead ECG interpretation; ECG adjustments with angina, MI, pericarditis, and package department block; and antiarrhythmic medicines, pacemakers, and ICDs. ratings of ECG waveforms, therapy algorithms, and charts are integrated. Distinctive-colored tabs establish every one part.
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Additional info for ECG Facts Made Incredibly Quick! (2nd Edition)
Tive HR has been maintained and patient is stable. • Tell patient and family about the serious nature of this arrhythmia and required treatment. • If patient needs a permanent pacemaker, explain how it works, how to recognize problems, when to contact doctor, and how pacemaker function will be monitored. qxd 5/13/09 12:17 PM Page 57 57 Accelerated idioventricular rhythm (continued) • Enforce bed rest until effecWhat causes it • Digoxin toxicity • Drugs – Beta-adrenergic blockers – Calcium channel blockers – Tricyclic antidepressants • Failure of all of heart’s higher pacemakers • Failure of supraventricular impulses to reach ventricles because of block in conduction system • Metabolic imbalance • MI • Myocardial ischemia • Pacemaker failure • SSS • Third-degree AV block What to look for • Evidence of sharply decreased CO (hypotension, dizziness, light-headedness, syncope) • Difficult auscultation or palpation of BP What to do • Monitor ECG continually; periodically assess patient until hemodynamic stability has been restored.
Because the cells haven’t fully repolarized, VT or VF can result. qxd 5/13/09 12:17 PM Page 55 55 Idioventricular rhythm (continued) • Enforce bed rest until effecWhat causes it • Digoxin toxicity • Drugs – Beta-adrenergic blockers – Calcium channel blockers – Tricyclic antidepressants • Failure of all of heart’s higher pacemakers • Failure of supraventricular impulses to reach ventricles because of block in conduction system • Metabolic imbalance • MI • Myocardial ischemia • Pacemaker failure • SSS • Third-degree AV block What to look for • Evidence of sharply decreased CO (hypotension, dizziness, feeling of faintness, syncope, light-headedness) • Difficult auscultation or palpation of BP What to do • Monitor ECG continually; periodically assess patient until hemodynamic stability has been restored.
Qxd 5/13/09 12:17 PM Page 51 51 Premature ventricular contractions (continued) • Palpitations if PVCs are frequent What causes them • Enhanced automaticity (usual cause) • Drug intoxication (amphetamines, cocaine, digoxin, phenothiazines, tricyclic antidepressants) • Electrolyte imbalances (hyperkalemia, hypocalcemia, hypomagnesemia, hypokalemia) • Enlargement of ventricular chambers • Hypoxia • Increased sympathetic stimulation • Irritable focus • Irritation of ventricles by pacemaker electrodes or PA catheter • Metabolic acidosis • MI • Mitral valve prolapse • Myocardial ischemia • Myocarditis • Sympathomimetic drugs such as epinephrine • Triggers (alcohol, caffeine, nicotine) What to look for • Possibly no symptoms • Normal pulse rate with momentarily irregular pulse rhythm when PVC occurs • Abnormally early heart sound with each PVC on auscultation • Evidence of decreased CO (hypotension, syncope) What to do • Promptly assess patients with recently developed PVCs, especially those with underlying heart disease or complex medical problems.