Basic Characteristics of Cardiac Rhythms

University:
West Coast University
Course:
NURS 110 | Introduction to Professional Nursing
Academic year:

2021
Views:

42

Pages:

1
Author:

96XGbl6o

Accelerated Junctional Rhythm/Junctional Tachycardia Accelerated Junctional Rhythm Rate: 60-100 bpm (Remember: if Heart Rate is > 100 it is called Junctional Tachycardia) Rhythm: Ventricular rhythm is regular P waves: may be absent or may occur before, during or after the QRS (due to retrograde conduction) PR Interval: None (impulses are originating from the junction, not the SA node) QRS Width: VHFRQGVWKHLPSXOVHLVWUDYHOLQJGRZQWKHQRUPDOSDWKZD\VRIWKHULJKWDQGOHIWEXQGOHV Characteristics: The AV junctional area can “speed up” and pace at a rate faster than 40-60 beats per minute. For all of the same reasons a person might experience a junction escape rhythm, a person might also experience enhanced automaticity of the AV junction area. The result is a junctional rhythm, which depolarizes at a rate of 60100 bpm. This is an Accelerated Junctional Rhythm. If the rate is greater than 100 bpm the rhythm is called Junctional Tachycardia (see above). It might be tempting to call the ECG tracing a normal sinus rhythm, but make note that uniform looking P waves are absent along with a constant PR interval. The SA node is not working and the junction has taken over as the pacer, only a bit faster than its normal intrinsic rate of 40-60 bpm. Possible Causes of Accelerated Junctional Rhythm: Digoxin toxicity (most common cause), Hypoxia, cardiomyopathy, MI, and/or Valve replacement surgery Nursing Priorities: Check your patient’s blood pressure, assess for syncope, palpitations, or SOB. Lower blood pressure may result from loss of atrial kick. Potential Treatments: Asymptomatic: Observation. Symptomatic: Discontinue digoxin therapy. Check potassium levels. If heart rate becomes faster (100-180 bpm) the rhythm is called Junctional Tachycardia. Now consider treatment with IV amiodarone, beta-adrenergic blockers (Esmolol, Labetalol, Metoproplol), or calcium channel blockers. Junctional Tachycardia 27