Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 

A prolonged QT interval can be congenital or acquired. Women are at a greater risk for Torsades de pointes. Acquired Torsades de pointes is much more common than congenital and is pause-dependent, triggered by a slow heart rate.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 

Torsades de pointes is literally translated as “twisting of the points” and is a form of polymorphic ventricular tachycardia. Torsades de pointes occurs in the setting of a prolonged QT interval, a reflection of abnormal ventricular repolarization.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 

Unstable patients or those with ventricular tachycardia refractory to pharmacotherapy should undergo synchronized cardioversion with 100 J, with procedural sedation. Escalating doses are occasionally needed.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
For stable patients with ventricular tachycardia, amiodarone (3-5 mg/kg IV over 20 minutes) is the best choice, with reported successful termination of up to 90%. Procainamide (30-50 mg/min IV, up to a total of 18 mg/kg) is a second-line agent.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Monomorphic ventricular tachycardia (VT) is the most common form of VT and is characterized by morphologically consistent QRS complexes, usually in a regular pattern and at a rate of 150 to 200 beats/min.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 

Ventricular tachycardia originates within or below the His bundle. Nonsustained VT refers to short episodes (< 30 seconds) reverting spontaneously, whereas sustained VT is more prolonged.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Treat unstable patients with a wide-complex tachycardia with electrical cardioversion. For borderline patients, electrical cardioversion or pharmacologic treatment with procainamide or amiodarone are options.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Wide-complex tachycardia refers to any tachydysrhythmia accompanied by a QRS duration of 0.12 second or more. Wide-complex tachycardia can start in the ventricles or can originate from above the AV node.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Junctional tachycardia is associated with structural heart disease, metabolic disturbances or drug toxicity. Treatment is aimed at addressing underlying conditions, although nodal blockade with calcium or beta blockers is an option.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
If vagal maneuvers fail to restore sinus rhythm, first-line field or ED therapy for atrioventricular nodal reentrant tachycardia (AVNRT) is adenosine (6 mg rapid, large-bore IV bolus followed by a flush. Repeat with 12 mg if no effect on rate).

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
The onset and spontaneous end of atrioventricular nodal reentrant tachycardia (AVNRT) is typically abrupt, and it frequently arises in the context of strenuous exercise or emotional stress.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Also known by the less precise term supraventricular tachycardia, atrioventricular nodal reentrant tachycardia (AVNRT) is a regular, narrow-complex rhythm with a ventricular rate of 130 beats/min or greater, commonly more than 160 beats/min.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Atrial flutter is characterized by atrial depolarization occurring at a regular rate of 250 to 350 beats/min (300 beats/min is typical) caused by an atrial reentry mechanism. Flutter waves on the ECG are broad and sawtooth-appearing.

Nursing School | Medication & Pharmacology Tips

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Various agents are available for the pharmacologic cardioversion of patients with stable atrial fibrillation, including class IA, IC, and III antidysrhythmics. In practice, IV procainamide, amiodarone and ibutilide are the agents most commonly.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
If atrial fibrillation has been present longer than 2 days or for an uncertain interval in the absence of ongoing anticoagulation, do not attempt cardioversion to avoid the increased risk of systemic embolization (1 to 4% at 30 days).

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
For stable patients with new-onset or newly recurrent atrial fibrillation (a duration of 48 hours or less) or in those with therapeutic anticoagulation, cardioversion is an option unless valve disease, hypokalemia, or digitalis toxicity exist.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
For stable patients with persistent or recurrent rapid atrial fibrillation, administration of a nodal blocking agent with a goal of achieving a target ventricular rate of 120 beats per minute or less is a first step.

Nursing Tip of the Day! - Fundamentals

Category: Fundamentals 
Atrial fibrillation is usually associated with underlying heart disease (myopathic or valvular) or hypertension, but can also occur in isolation (so-called lone atrial fibrillation) or as a manifestation of hyperthyroidism.