Arrhythmias Flashcard 7

D. Rationale: These are all potential symptoms or signs of bradycardia. Other symptoms/signs might include chest discomfort, shortness of breath, weakness/fatigue, dizziness, diaphoresis, and pulmonary congestion/heart failure.

D. Rationale: Signs and symptoms typically associated with unstable tachycardia include hypotension, signs of shock, acute heart failure, ischemic chest discomfort, and acutely altered mental status. Hypertension, facial drooping, slurred speech, and an unsteady gait are associated with stroke, not unstable tachycardia.

C. Rationale: Synchronized cardioversion is used for patients with an unstable VT, unstable atrial fibrillation/flutter, and unstable regular monomorphic tachycardia with a pulse. Defibrillation is used for pulseless rhythms, polymorphic VT when a delay in converting the rhythm may lead to cardiac arrest, and monomorphic or polymorphic VT in an unstable patient.

D. Rationale: Diagnosing the type of tachyarrhythmia will guide the interventions for symptomatic patients, particularly if they are unstable. The classification depends on the ECG morphologic findings. Clinicians classify tachyarrhythmias based on the appearance of the QRS complex, its rate, and its regularity.

C. Rationale: Bradyarrhythmia’s that are unlikely to respond to atropine are second-degree AV block, Mobitz type 2, and third-degree AV block with wide QRS complex that indicates a block is non-nodal. (ACLS Case: Symptomatic Bradycardia)

A. Rationale: The first drug intervention is atropine 1 mg IV/IO. Epinephrine and dopamine are the drugs of choice for maintaining the heart rate.

D. Rationale: The primary decision point in the ACLS bradycardia algorithm is the determination of adequate perfusion. If the patient is adequately perfused, monitoring is indicated; if there are signs of poor perfusion, treatment is indicated, starting with the administration of atropine.

C. Rationale: Bradyarrhythmia’s are typically heart rates < 60 bpm. But when the rate has fallen below 50 beats per minute, the patient usually becomes symptomatic, and this is the working definition of bradycardia.

A. Rationale: The ACLS recommendations for narrow complex QRS tachycardia with regular rhythm include vagal maneuvers.

C. Rationale: Differentiating between the morphologies and characteristics of tachyarrhythmias helps the provider decide the best course of treatment. Wide complex tachycardias have QRS complexes ≥ 0.12 seconds.