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Understanding EKG Rhythms and Pacemaker Care NCLEX

NCLEX High Yield EKG Lecture: Master normal sinus rhythm, bradycardia, tachycardia, A-fib, V-fib, SVT, digoxin, anticoagulants, pacemakers & more! Perfect for nursing board prep. Simplified, high-yield, and test-focused.

Alice Edwards
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NCLEXHIGH YIELDEKG LECTURENORMAL SINUS RHYTHM:This is a regular rhythmHR: 60-100bpmECG of a Normal SinusRhythm has a P wave (atrium) followed by aQRST (ventricular)—Atrium is predominately controlled byCalciumVentricle is predominately controlled byPotassium(K+)—> ASK GRAPHSmus BradycardiaSINUS BRADYCARDIA:HR is less than 60bpmIn athletes this is notabnormal, it is expected.Causesinclude: Medicines (BB, COB, Digoxin),hypothyroidism, SA Node Dysfunction

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Treatment:Asymptomatic - No TreatmentSymptomatic - lightheaded, dizzy, SOB,hypotensive, unresponsive, pale, cool, AMS,syncope, we must treat them.Treatment:AdministerAtropine(anticholinergic drug)How to admin: IV 0.5mg q 3-5minUp to 3 Omg MAX (6 doses)Contraindications:GlaucomaGl ObstructionUrinary retentionAtropine is contraindicated in pregnancyIf atropine does not work, put in apermanentpacemaker:Notice where the pacemaker is placed, underneaththe clavicle.Post-op / post-procedure always look forAASHEducation:- Don't put arms over head untilhealed properly (~ 6wks)• Carry Pacemaker ID card•Take pulse daily■AVOID MRINCLEX HIGH YIELDnclexliighyielcl.com

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■AVOID carrying cell phones in a pocketnear the pacemaker and hold it on theopposite ear of the pacemaker■Notify airport security of handheldwands• Keep dressing on for 1 week and dry(showering ok with protective dressing)NO BATHS■No driving for a week or until HCP clears• No lifting anything above 5lbs. 4-6 weeks■No lifting arm above head for 4-6 weeks*These are the first two pacemakers Dr. Zeeshan didwith his attending Dr. Kenneth Shah!Shut TactiycardiaSINUS TACHYCARDIA:Sinus Rhythm with a HRgreater than 100bpmCausesinclude: pain, stress,anxiety, dehydration, caffeine, hyperthyroidism,elicit drugs, amphetamines, the NCLEX, and moreTreatment:Administer beta blockers:end in the suffix -lolEx: metoprolol, atenolol, labetalolHelp decrease HR and lower BPSE: bradycardia, bronchoconstriction, bronchospasm

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Contraindicated in Asthma/COPD patients —>ASK GRAPHTreat the underlying cause firstATRIAL FIBRILLATION:Thisrelates to the Atrium quivering orfibrillating, meaning the Atrium iisnot beating correctly.Therefore there is no discernibleAtrial Fibrillation (AF)L11LI 1 it 1P wave!There will bean IRREGULARLY IRREGULARRhythmCauses:ETOH, Pulm Dz, Ischemia, Thyrotoxicosis,and more.Treatment:There are many different combinations of treatmentsthat can work, we will cover the HIGH YIELD options!We must anti-coagulate along with fix thearrhythmia since they can clot!Administer:Heparin, Warfarin for anti-coagulation.BB:CCB (Diltiazem/Verapamil), or Digoxin for theArrhythmia.Alternative (used after the above don't work):
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