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EKG Review 3:
BBB, PAT, Sinus Arrest
| Course Number |
LWN303 |
| Objectives |
At the end of this course, you will define, know
the characteristics and nursing interventions of 1. BBB, 2. PAT, 3.
Sinus Arrest |
| Credit Hours and Fee |
3.0 CE Credit Hours with a fee of $24.00 |
| Instructor/developer |
Rudolf Klimes, PhD (Indiana U), MPH
(Johns Hopkins U);
Adjunct Professor at Folsom Lake
College, Folsom CA;
Robyn Nelson, RN, DNSc |
Welcome to an accredited continuing education
course in health for nurses, counselors and others. Take
this course for free 24/7. Or study this web-site for an
approved (RN-CEP 11430, MFT- PCE 39) 3-hours Continuing Education Certificate (0.3
CEUs) and take the 12-question multiple-choice quiz that is linked
to the bottom of this page.
Definition:
The QRS complex represents the amount of time required to depolarize the
ventricles. A normal QRS is 0.08-0.12 seconds in length. A length greater than
0.12 seconds is considered a BBB. This means that there may be a block in one of
the bundle branches, or the electrical impulse was conducted through an abnormal
conduction pathway. This can occur in any rhythm. The causes range from normal
to pericarditis, myocarditis, congested heart failure and congenital heart
disease.
EKG Characteristics.
Rate: Atrial and ventricular rate can vary depending on the specific rhythm
involved. Any rhythm can have BBB. The P Wave depends on the intrinsic rhythm
involved. The QRS is the determining factor and it must be greater than 0.12
seconds.
Nursing Intervention:
If it is a new BBB, observe for further changes, get vital signs, and check the
medication for etiology. If it is an old or existing BBB, there are no specific
nursing interventions.
PAT: Paroxysmal Atrial
Tachycardia
Definition:
PAT is an arrhythmia which begins as frequent PACs. This arrhythmia then becomes
a very rapid heartbeat caused by rapid firing of an ectopic focus through a
reentry circuit involving the SA node and the VA node. PAT starts and ends
abruptly. Heart block will result if it is left untreated. Possible causes are
stimulants, atrial enlargement, valvular heart disease, coronary artery disease,
and digitalis toxicity.
EKG Characteristics:
Rate of greater than 140 beats per minute. Regular rhythm. P Wave is normal, but
may not be visible. PR interval is un-measurable. QRS has normal configuration.
ST Segment is un-measurable. T Wave is un-measurable.
Nursing Interventions:
Oxygen administration, obtain vital signs, and notify the MD. Cardioversion may be a procedure
used to treat PAT.
Definition:
Sinus Arrest is where there is no conduction through the SA node, the result is
a minimum of 3 seconds. Possible causes include increase in vagal tone, damage
to the SA node, hypoxia, hyperkalemia, digitalis, beta blockers, calcium channel
blockers, decreased PB, shock, and congestive heart failure.
EKG Characteristics:
Rate: The rate of the intrinsic rhythm. Irregular rhythm during sinus arrest. P
Wave is not present during sinus arrest. PR Interval not present when sinus
arrest occurs. QRS Complex is usually normal for the intrinsic rhythm and absent
during the sinus arrest.
Nursing Intervention:
Follow nursing protocols. Notify the MD if it is a new occurrence. Determine
cause and treat cause. If drug
treatment does not work, a pacemaker may be used to treat chronic sinus
arrest.
Study this web-site for 3 hours for
an approved (RN-CEP 11430, MFT- PCE 39) 3-hours Continuing Education
Certificate (0.3 CEUs).
Click
here for the self-correcting test & online payment, and 2) receive your
certificate immediately online. All is online, nothing by post-mail.
Course developed by California State University of California Nursing
Students Kristi Cargill, Tommy Ferguson, Leslie Keear, Tracy Milne Leach and
Jennifer Moores. Instructors: Robyn Nelson, RN, DNSc and R.
E. Klimes, PhD, MPH.
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