Now for the nine need-to-know ECG strips on the NCLEX. Starting with the first one, normal sinus rhythm. The memory trick, just think a normal beat that's evenly spaced. The treatment, there is none, so we just continue to monitor, and the cause of it is just being very, very healthy. Now the second one to know is bradycardia.
So the memory trick, just think brady is below 60 beats per minute. Or the Brady Bunch is an old TV show for slower times. Now the treatment is very simple. We use atropine, but only if symptomatic, showing low perfusion, like pale, cool, or clammy. So the memory trick, think atropine, puts the heart rate high, like on top of a pine tree, with atropine, or atropine.
Now the causes of bradycardia is typically from a vasovagal maneuver. or even from meds that slow down the heart rate from calcium channel blockers which calm the heart or beta blockers that block the beats next is number three ventricular fibrillation also called v-fib so the memory trick just think fib is flopping around like a squiggly line now the number one treatment to know for v-fib is d-fib defibrillation immediately so stop cpr and do it before drugs And there's no need to synchronize. That's only for cardioversion, the controlled shock. Now, treatment number two is drugs like LAP.
So L for lidocaine, A for amiodarone, and P for procainamide. Now, the causes. Untreated VTAC will slip into ventricular fibrillation.
And we also see V-fib with post-MI or post-heart attack clients, as well as clients with electrolyte imbalances, and even... pro-arrhythmic medications. Next is ventricular tachycardia, number four here. So the memory trick, just think VTAC is for tombstone pattern.
We get these wavy-like tombstones here. The big cause is post-MI, post-heart attack here. And hypoxia is also another cause, as well as low potassium with hypokalemia, as well as low magnesium.
Just think magnesium mellows out the muscles. So with low mag, the heart muscles are going crazy and wild. Now the treatments to know for the NCLEX here. Number one is early defibrillation.
Huge NCLEX tip right there. Apply the defibrillator pads, call out and look for everyone to be clear, and then we shock and immediately continue chest compressions. Those are the three to know.
Now, when do you shock? So another big NCLEX tip here. VTAC with no pulse, we defibrillate. But VTAC with a pulse, we have to cardiovert. So memory trick here, if you can see, count a pulse, then we see cardiovert.
And always be sure to synchronize and sedate first. Now the double D's of deadly defibrillation. So D, if you're dead with no pulse, then you defib immediately. There's no need to synchronize.
So D, don't wait. There's no need to hit the synchronize button. Just defib for V-fib as well as pulseless V-tac.
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Visit simplenursing.com. Number five is atrial fibrillation, also called AFib. So the memory trick, if we have no P wave, then we have fibrillation flopping with the double Ps there.
So the causes is valvular disease, as well as heart failure, or even pulmonary hypertension with our CHF clients. And COPD, and especially after heart surgery. Now the treatments include, number one, cardioversion.
but only after a tte to rule out clots and we always push the synchronize button with cardio version number two for the long term we use digoxin to get a deeper contraction and we always check atp before giving digoxin so a is for apical pulse we have to listen for 60 seconds t is for toxicity max range is 2.0 and we always look for visual disturbances as well as nausea, vomiting, and anorexia, early signs of digoxin toxicity. And P is a potassium less than 3.5, which potassium makes a higher risk for toxicity. Now, number three is anticoagulants like warfarin.
We always have to monitor INR, keep vitamin K as an antidote, and monitor for green leafy veggies, not too high and not too low. Since green leafy veggies have vitamin K, and we don't want to block the effects of warfarin. Number six is for atrial flutter, also called a flutter.
So the memory trick is a flutter with two Ts, think of a saw tooth with two Ts. Now the causes and treatments are the same as atrial fibrillation, but just make sure to know that the saw tooth is for atrial flutter. The NCLEX loves to ask about that.
Now number seven is SVT. Supraventricular tachycardia. Just think the memory trick, super fast for supraventricular. So the causes are from stimulants, strenuous exercise, hypoxia, and even heart disease. And the treatments to know for the NCLEX here.
Number one, we go least invasive first. We use a vasovagal maneuver, so we ask the clients to bear down like having a bell movement, or even use ice-cold stimulation around the neck. Number two.
is adenosine. We rapidly push and flush with normal saline and the heart rate may stop. This is expected.
We want to stop this very fast supraventricular tachycardia. So the memory trick, just think it puts the heart rate down into a den with adenosine. And last case scenario is number three, cardioversion.
We have a controlled shock. And we always push sync before any type of cardioversion. So Kaplan mentions, which medication should be held 48 hours prior to an elective cardioversion for SVT? Digoxin, due to the increased ventricular irritability.
Remember, digoxin digs for a deeper contraction. and a second question client with svt has the following assessment data a really fast heart rate of 200 a really low blood pressure 78 over 40 and a respiratory rate of 30. the priority action is to a synchronized cardioversion yes for svt number eight is tarsada's de pointes and the memory trick just think of the tornado of points For the NCLEX, you must know what this rhythm looks like. So the cause is post-MI or after a heart attack when the heart is injured hypoxia but really the biggest one here that you should write down is low magnesium so the treatment is magnesium sulfate huge enclex tip so remember the memory trick here magnesium mellows out the heart muscles so with low magnesium we get a crazy tornado inside the heart so we just give more mag to mellow out the heart and the last one to know number nine is a systole the flat line there. So the memory trick, just think you have to assist fully because the patient is flatlined. They're basically dead.
The treatments to know is epinephrine, atropine, and CPR. The most tested here was epinephrine. And a big NCLEX tip here is no defibrillation, no shock.
We cannot shock a systole because technically we need electricity to shock. And with a systole, we have a flat line. We have no electricity to shock.
Now lastly, the NCLEX key terms to know. When you see these key terms next, it typically means that the question is referring to an indicating rhythm. So a P wave is an atrial rhythm.
A QRS is a ventricular rhythm. So if the question states that the lack of QRS complexes, the answer is probably a systole. Or for wide, bizarre QRS complexes, the answer is typically V-tach. Or Or if you see chaotic or unorganized, this is fibrillation.
So if a question states chaotic rhythm with no P waves, the answer is typically atrial fibrillation. Or a chaotic rhythm without QRX complexes, the answer is ventricular fibrillation. Next is the key term bizarre. If you see the word bizarre, just think tachycardia.
So if the question says bizarre rhythm with wide QRS complexes, the answer is typically ventricular tachycardia. And the very last one is sawtooth. You have to think atrial flutter. Just look for the two Ts in sawtooth.
tooth to know that it's atrial flutter. Now the last big NCLEX tip, if you guys know these nine rhythms, then you will pass the NCLEX here. I always have students asking, well what if they show you third degree heart block or 15 other rhythms? Well yes, you don't need to know how to interpret these for the NCLEX, but you do need to know how to treat them.
and how it will harm the patient because the NCLEX is all about safety so loss of life and loss of limb if it will kill the patient you must know how to treat it Alright guys, that wraps it up for this segment. Don't forget to take your quiz and download the study guides. Thanks for watching.
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