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

2021
Views:

161

Pages:

1
Author:

Dominick Dickson

Ventricular Tachycardia Rate: 100 – 250 BPM PRI: P waves may be present if SA node is functional, however there is no relation to the QRS. It is unlikely that P waves will be visible, since this rhythm typically moves at a very fast rate, and the P waves will be buried in the QRS. QRS: Wide/Bizarre > .12 QT: Rate dependant may be < .40 seconds with a fast rhythm. Difficult to differentiate between the QRS and the T wave. Rhythm: Ventricular rhythm regular. Source of pacer: Ventricular/Purkinje Fibers Characteristics: Ventricular Tachycardia (VT) is defined as three or more consecutive PVCs in a row at a rate greater than 100 beats per minute. VT is generally caused by single foci in either ventricle that fire at a rapid rate to override the SA node and thereby take control of the heart’s rhythm. A short run of consecutive PVCs is often called a “burst” of VT. ECG characteristics include a rapid, regular rhythm with a wide QRS. The QRS is wide since the origin of the rhythm is outside the bundle branches, thereby taking a longer time to conduct cell to cell within the ventricle. Ventricular tachycardia may be monomorphic (all QRSs with the same shape) or polymorphic (varying QRS shapes during the tachycardia). This arrhythmia may be either well tolerated or associated with lifethreatening hemodynamic compromise. The hemodynamic consequences of VT depend largely on the presence or absence of myocardial dysfunction (such as might result from ischemia or infarction) and on the rate of VT (the faster the rate, the less well tolerated). Causes: Ventricular tachycardia may be caused by: R on T PVC phenomenon, hypoxia, ischemia, AMI, acidosis, cardiomyopathy, mitral valve prolapse, digitalis toxicity, antiarrhythmics, electrolyte imbalances, liquid protein diets, increased intracranial pressure and central nervous system disorders. Nursing Priorities: Check your patient’s pulse and blood pressure to determine if this is stable, unstable (B/P <90) or pulseless VT, Notify physician, Treatment depends on the patient’s response to the VT rhythm. Potential Treatments: Asymptomatic or stable: Oxygen, obtain 12-lead ECG, consider Lidocaine or Amiodarone. Check electrolytes such as potassium and magnesium. Apply multifunction pads as cardioversion may be necessary if patient becomes unstable. Symptomatic: If unstable, prepare for immediate synchronized cardioversion. Consider amiodarone bolus and infusion. If pulseless, administer one defibrillation shock followed by CPR. Activate your code resuscitation team and follow ACLS guidelines.