Assi g n m e n t

IAS)
(ARRHYTHM
b y : A l i z a A . Bakil
Submitte d
NCM118j
BSN IV -B
 1. WHAT ARE ARRHYTHMIAS?
An arrhythmia is a heartbeat that is irregular. It indicates that your heart is
not beating normally.
It may feel like your heart skipped a beat, added a beat, or is "fluttering." It
may feel like it's beating too fast (tachycardia) or too slowly (bradycardia).
You might not notice anything at all.
Arrhythmias can be an emergency, or they could be harmless. If you notice
anything unusual about your heartbeat, seek medical attention immediately
so that doctors can determine what is causing it and what you should do
about it.
Arrhythmias are classified into two categories: ventricular and
supraventricular. Ventricular arrhythmias occur in the heart's lower
chambers, known as the ventricles. Supraventricular arrhythmias occur
above the ventricles, usually in the upper chambers of the heart known as
the atria.
 2. WHAT ARE THE DIFFERENT TYPES OF
ARRHYTHMIAS THAT AFFECT PERFUSION?
There are several types of arrhythmias that can affect perfusion, here are some common ones:
1. Atrial Fibrillation (AFib): This is a rapid, irregular heartbeat originating in the atria, leading to
improper pumping of blood and reduced perfusion.
2. Ventricular Fibrillation (VFib): In VFib, the ventricles quiver instead of pumping blood effectively.
This is a medical emergency as it can quickly lead to cardiac arrest and loss of perfusion.
3. Supraventricular Tachycardia (SVT): SVT is a rapid heart rhythm originating above the ventricles.
This condition can lead to decreased perfusion if left untreated.
4. Bradycardia: When the heart beats too slowly, it can significantly reduce perfusion. Bradycardia can
occur due to various factors, including certain medications, heart diseases, or dysfunction in the
heart's electrical system.
5. Premature Ventricular Contractions: A less serious type of ventricular arrhythmia is a premature
ventricular contraction (PVC). As the name suggests, the condition happens when the ventricles
contract too soon, out of sequence with the normal heartbeat.
6. Tachycardia. is a very fast heart rate of more than 100 beats per minute. The many forms of
tachycardia depend on where the fast heart rate begins. If it begins in the ventricles, it is called
ventricular tachycardia. If it begins above the ventricles, it is called supraventricular tachycardia.
7. Ventricular tachycardia. A condition in which the SA node no longer controls the beating of the
ventricles. Instead, other areas along the lower electrical pathway take over the pacemaking role. Your
heartbeat quickens, and you feel as if your heart is “skipping beats.” This rhythm may cause severe
shortness of breath, dizziness, or fainting (syncope).
8. Atrial flutter. Similar to atrial fibrillation, though the fast heartbeat can be more regular. Many
people with atrial flutter develop atrial fibrillation over time. Also make it harder for your heart to push
blood into your ventricles, which are the lower chambers of your heart. It means your heart sends less
blood throughout your body. Symptoms include a fluttering feeling in the chest, palpitations, shortness
of breath, anxiety, lightheadedness, and fainting. This condition increases the risk of stroke and heart
failure.
9. Atrial tachycardia. A Type of supraventricular tachycardia caused by the abnormal firing of a group
of cells in one of the top chambers of the heart (atria). The result is an unhealthy resting heartbeat of
100 beats per minute or higher. Symptoms may include heart palpitations (sensations of a racing
heart), lightheadedness, chest tightness, shortness of breath and fainting.
10. AV nodal reentrant tachycardia (AVNRT). This is caused by an extra pathway through a part of your
heart called the AV node. It can cause heart palpitations, fainting, or heart failure.
 3. WHAT ARE THE SIGNS AND SYMPTOMS?
An arrhythmia can be silent, which means you are unaware of any
symptoms. During a physical exam, your doctor may notice an
irregular heartbeat. If you have symptoms, they could be as follows:
Palpitations (the sensation of missing heartbeats, fluttering, or
"flip-flops")
Pounding in your chest
Feeling dizzy or lightheaded
Fainting
Shortness of breath
Pain or tightness in the chest
Weakness or fatigue (extreme tiredness)
Anxiety
Blurry vision
Sweating
ADDITIONAL INFOS!
What Are Some Arrhythmia Risk Factors? Causes of Arrhythmia:
Things that may make you more likely to have an You could have an arrhythmia even if
arrhythmia include your: your heart is healthy. Or it could
Age. The chances go up as you get older. happen because of:
Genes. Your odds might be higher if a close Heart disease
The wrong balance of electrolytes
relative has had an arrhythmia. Some types of
(such as sodium or potassium) in your
heart disease can also run in families. blood
Lifestyle. Alcohol, tobacco, and recreational Heart injury or changes such as
drugs can raise your risk. reduced blood flow or stiff heart
Medical conditions. High blood pressure, tissue
diabetes, low blood sugar, obesity, sleep Healing process after heart surgery
apnea, and autoimmune disorders are among Infection or fever
the conditions that may cause heart rhythm Certain medications
problems. Problems with the electrical signals in
your heart
Environment. Things in the world around
Strong emotions, stress, or surprise
you, like air pollution, can make an Things in your daily life like alcohol,
arrhythmia more likely. tobacco, caffeine, or exercise
BSN
4. GIVE NURSING AND MEDICAL
MANAGEMENT FOR EACH ARRHYTHMIAS?
Medications
Medicines that treat uneven heart
rhythms include:
Adenosine (Adenocard)
Atropine (Atropen)
Beta-blockers
Calcium channel blockers
Digoxin (Digitek, Digox, Lanoxin)
Potassium channel blockers
Sodium channel blockers
Vagal maneuvers
These techniques trigger your body to relax by
affecting your vagus nerve, which helps control
your heart rate. Your doctor might tell you to:
Cough or gag
Hold your breath and bear down (Valsalva
maneuver)
Lie down
Put a cold, wet towel over your face
Electrical cardioversion
If drugs can't control an uneven heart rhythm
(such as atrial fibrillation), you might need
cardioversion. For this, doctors put you under and
then send an electrical shock to your chest wall to
trigger your heart’s regular rhythm.
Pacemaker
This device sends small electrical impulses to your
heart muscle to keep a safe heart rate. It includes
a pulse generator, which houses the battery and a
tiny computer, and wires that send impulses to the
heart muscle.
Implantable cardioverter defibrillator (ICD)
Doctors mainly use ICDs to treat ventricular
tachycardia and ventricular fibrillation, two life-
threatening heart rhythms.
The ICD constantly tracks your heart rhythm. When
it detects a very fast, unusual rhythm, it delivers
an electric shock to the heart muscle to make it
beat in a regular rhythm again. The ICD has two
parts: the leads and a pulse generator.
Nursing Interventions: Arrhythmias
1. Document any arrhythmias in a
monitored patient.
2. Notify the doctor if a change in pulse
pattern or rate occurs in an
unmonitored patient.
3. As ordered, obtain an ECG tracing in
an unmonitored patient to confirm
and identify the type of arrhythmia
present.
4. Be prepared to initiate
cardiopulmonary resuscitation, if
indicated, when a life threatening
arrhythmia occurs.
5. Administer medication as ordered,
monitor for adverse effect, and
perform nursing interventions related
to monitoring vital signs,
hemodynamic monitoring, and
appropriate laboratory work.
6. Provide adequate oxygen and reduce
heart workload while carefully
maintaining metabolic, neurologic,
respiratory, and hemodynamic status.
7. Evaluate the monitored patient’s ECG
regularly for arrhycthmia.
8. Monitor for predisposing factors, such
as fluid and electrolyte imbalance, and
signs of drug toxicity, especially with
digoxin.
9. Teach the patient how to take his
pulse and recognize an irregular
rhythm and instruct him to report
alterations from his baseline to the
doctor.
10. Emphasize the importance of keeping
laboratory and physician’s
appointments.
WEBMD. (N.D.). ARRHYTHMIA: SYMPTOMS, TYPES, CAUSES, DIAGNOSIS, AND
TREATMENT. WEBMD. HTTPS://WWW.WEBMD.COM/HEART-
DISEASE/ATRIAL-FIBRILLATION/HEART-DISEASE-ABNORMAL-HEART-
RHYTHM

RUBYKS. (2010, SEPTEMBER 6). NURSING FILE.

HTTPS://NURSINGFILE.COM/NURSING-CARE-PLAN/NURSING-
INTERVENTIONS/NURSING-INTERVENTIONS-FOR-ARRHYTHMIAS.HTML

ATENEO DE ZAMBOANGA UNIVERSITY

NCM118j - NURSING CARE OF CLIENTS WITH LIFE
THREATENING CONDITIONS
BSN IV -B

By Aliza A. Bakil