ABDOMINAL AORTIC ANEURYSM • Weak or absent pulse

Key signs and symptoms • Dizziness

• Commonly asymptomatic Key test results
Key test results Atrial fibrillation
• Chest X-ray shows aneurysm. • ECG shows irregular atrial rhythm, atrial rate
Key treatments possibly greater than 400 beats/minute, irregular
• Abdominal aortic aneurysm resection ventricular rhythm, QRS complexes of uniform
Key interventions configuration and duration, indiscernible PR
• Assess cardiovascular status, and monitor and interval, and no P waves (fibrillation waves).
record vital signs. Asystole
• Monitor intake and output and laboratory studies. • ECG shows no atrial or ventricular rate or
• Observe the client for signs of hypovolemic rhythm and no discernible P waves, QRS
shock from aneurysm rupture, such as anxiety, complexes, or T waves.
restlessness, severe back pain, decreased pulse Ventricular fibrillation
pressure, increased thready pulse, and pale, • ECG shows rapid and chaotic ventricular
cool, moist, clammy skin. rhythm, wide and irregular or absent QRS
ANGINA complexes, and no visible P waves.
Key signs and symptoms Ventricular tachycardia
• Pain that may be substernal, crushing, or • ECG shows ventricular rate of 140 to 220 beats/
compressing; minute, wide and bizarre QRS complexes, and no
may radiate to the arms, jaw, or back; discernible P waves. Ventricular tachycardia may
and usually lasts 3 to 5 minutes; usually occurs start or stop suddenly.
after exertion, emotional excitement, or exposure
to cold but can also develop when the client is at
rest; in women, may manifest as atypical symptoms
of pain, such as indigestion, back pain, and
less severe complaints of substernal pain
Key test results
• Electrocardiogram (ECG) shows ST-segment
depression and T-wave inversion during anginal
pain.
Key treatments
• Percutaneous transluminal coronary angioplasty
or coronary artery stent placement
Key interventions
• Assess for chest pain and evaluate its
characteristics.
• Administer medications, as prescribed. Hold
nitrates and notify physician for systolic blood
pressure less than 90 mm Hg. Hold betaadrenergic
blocker and notify physician for heart
rate less than 60 beats/minute.
• Obtain 12-lead ECG during an acute attack.
ARRHYTHMIAS
Key signs and symptoms
Atrial fibrillation
• Commonly asymptomatic
• Irregular pulse with no pattern to the irregularity
Asystole
• Unresponsive
• Apnea
• Cyanosis
• No palpable blood pressure
• Pulselessness
Ventricular fibrillation
• Unresponsive
• Apnea
• No palpable blood pressure
• Pulselessness
Ventricular tachycardia
• Diaphoresis
• Hypotension