Annual Rhythmn Examination for Med-Surg / BLS providers
Sinus bradycardia with first degree AV heart block, lethal rhythm
Sinus tachycardia with first degree AV heart block, stable rhythm
Sinus bradycardia with first degree AV heart block, stable rhythm
Sinus tachycardia with first degree AV heart block, lethal rhythm
Ventricular Tachycardia
Normal Sinus Rhythm
Sinus Tachycardia
SupraVentricular Tachycardia (SVT)
Sinus Tachycardia
Normal Sinus Rhythm
Ventricual Fibrillation
Supraventricular Tachycardia (SVT)
Normal Sinus Rhythm
Atrial Fibrillation
Atrial Flutter
Sinus Bradycardia
No immediate action necessary - this is a normal sinus rhythm
VOCERA the primary nurse and have him / her check the patient after their break
The RN should check the patient immediately, you recognize this rhythm as potentially unstable for the patient.
Call the MD stat
Call 7911, this is a lethal rhythm
Go check on the patient
Implement the 'Chest Pain Protocol
This is a transient, benign rhythm
Nothing, this is a normal sinus rhythm
Call the cardiologist ASAP
Anticipate the patient will be returninig the cath lab
Anticipate implementing the 'Chest Pain Protocol' because this is an impending MI rhythm
Check the patient ASAP, this looks like the lethal rhythm Torsades de Pointe
Wait for Telemetry to call and tell you what to do
Anticipate CPR / using the AED / caling a Dr. Heart
VOCERA the primary nurse to check the patinet - it's probably just artifact
Tell her to mind her own business
Explain that the patient has an implanted pacemaker and allow the student nurse to go with you to check the patient's vital signs
Call 7911, this is a lethal rhythm
Call a Dr. heart
True
False
True
False
True
False
Prepare prior to placement of electrodes
Ensure lead placement is correct
Use surgical scrub on entire chest
Adjust alarms appropriately for the patient
Irregular Heart Rhythm
Normal Sinus Rhythm
Atrial Fibrillation
Prior to administration of cardiac medications
Decreased Blood Pressure
Altered Mental Status
Increased Appetite
Chest Pain
Diaphoretic
Altered Mental Status
Decreased O2 Level
Cyanosis
Tachycardia
Sit in upright position
Place patient in prone position
Call respiratory to administer hand held nebulizer if ordered PRN or due soon
Cough and Deep Breath
Ascultate bilateral breath sounds
Initiate CPR
Call a Rapid Response
Assess the patient
Review admission documentation to determine if this is an existing condition
Finish administering the scheduled morning medications - this a normal rhythm
Assess B/P and respiratons
Instruct the paient to perform a vagal maneuver (cough / bear down)
Call a Dr. Heart - this is a lethal rhythm
Anticipate calling RRT for electrical or chemical cardioversion if this rhythm is sustained or symptomatic.
Notify MD
Call a Rapid Response
Instruct patient to vagal down and prepare for mechanical or chemical cardioversion
Check vital signs including apical pulse; continue to monitor
Call telemetry to confirm their reading.
Initiate CPR and call a Dr. Heart
Attempt to awaken patient with a sternal rub or ammonia capsule
Write up the telemetry technitition for providing you with false information
Place the leads on cleaned skin
Change the battery
Assess to determine if additional hair from where the leads should be placed needs to be clipped or cut.
Put the leads on the easy to reach spots on the chest - lead placement is irrelevant
Call 7911 because this is this is a lethal rhythm
Assess now and continue with routine monitoring of this patient - this is not a lethal rhythm
Initial the 'chest pain protocol' - anticipate that this patient is going to have a heart attack
Medications like beta blockers
Well conditioned heart (like an athlete)
As a result fof a vasovagal response - from vomitting or coughing
Smoking
Medications like cocaine, albuterol, epinephrine
Smoking
Anxiety
Pain
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