Heart Beats: Rhythm self-quiz: Fast and deadly
Karen Jean Craig BS, RN

\$3.95
Nursing2015 Critical Care
January 2013
Volume 8  Number 1
Pages 5 - 6

ABSTRACT
Mr. M, 52, comes to the ED complaining of intermittent palpitations, shortness of breath, and lightheadedness. Triage takes Mr. M back into the treatment area after a quick evaluation. His vital signs are BP, 140/80; pulse, 148 and regular; respirations, 18; and SpO2, 97% on room air.While a colleague obtains peripheral I.V. access, you attach a cardiac monitor, which shows sinus tachycardia with frequent premature ventricular contractions (PVCs). Next, you use the SAMPLE mnemonic to conduct a secondary survey:Signs and symptoms: palpitations, shortness of breath with exertion; lightheadedness when changing from a supine to a sitting position; no chest pain, nausea, or other signs and symptomsAllergies: none knownMedications: nonePast medical history: noneLast meal: light breakfast 2 hours agoEvent history: signs and symptoms started about a half-hour ago while working in his basement.Mr. M says that now his chest "feels funny," and he feels as if he's "going to pass out." Mr. M becomes unresponsive, apneic, and pulseless and the monitor shows a wide-complex tachycardia.In a previous Heart Beats, we reviewed the five basic steps of rhythm analysis: * Determine the rhythm by measuring the distance between R waves and noting any variations in R-wave regularity. Determine if a 0.12-second or greater variance exists between the shortest and longest R-wave variations. * Calculate the heart rate, using the rapid rate calculation (counting the number of R waves in a 6-second strip and multiplying by 10 to calculate the heart rate per minute), for regular or irregular rhythms. For a regular rhythm, you can also use the precise rate calculation: Count the number of small squares between two consecutive R waves, and divide this number into 1,500 (the number of small squares in a 1-minute rhythm strip) to obtain the heart rate in beats per minute. Report the atrial and ventricular rates separately if they're different. * Identify and examine P waves to see if one precedes each

 Purchase Now !

 Cost: \$3.95
 1) If you're not already logged in, enter your information below to save this item in your File Drawer for future viewing. User name: Password Forgot your user name or password? 2)  If you have a coupon or promotional code, enter it here.(If not, just click Continue. Digital Coupon: (optional) 3)  Click Continue to go to the next screen, where you'll enter your payment details.

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles Recommended Nursing Articles

Pain management in patients with rheumatoid arthritis
The Nurse Practitioner, 15May 2015
Free access will expire on June 22, 2014.

The three R's of patient deterioration
Nursing Made Incredibly Easy!, May/June 2015
Free access will expire on June 8, 2015.

Hold the phone? Nurses, social media, and patient care
Nursing2015, May 2015
Free access will expire on June 8, 2015.

More Recommended Articles

Evidence Based Practice

Skin Care Network