DYSRHYTHMIAS-1.pptx

PRE TEST 1.A client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the: A. Vagus nerve to slow the heart rate B. Vagus nerve to increase the heart rate; overdriving the rhythm. C. Diaphra...

PRE TEST 1.A client with rapid rate atrial fibrillation asks a nurse why the physician is going to perform carotid massage. The nurse responds that this procedure may stimulate the: A. Vagus nerve to slow the heart rate B. Vagus nerve to increase the heart rate; overdriving the rhythm. C. Diaphragmatic nerve to slow the heart rate D. Diaphragmatic nerve to overdrive the rhythm 2. A client has developed Afib, which a ventricular rate of 150 beats per minute. A nurse assesses the client for: A.Hypertension and headache B.Nausea and Vomiting C.Hypotension and Dizziness D.Flat neck veins 3.A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate? A. Make certain that your bath water is warm. B. Avoid straining while having a bowel movement. C. Limit your intake of caffeinated drinks to one a day. D. Avoid strenuous exercise such as running. 4. A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as: A. Normal Sinus Rhythm B. Sinus Bradycardia C. Sick Sinus Syndrome D. First-degree heart block 5.A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: A. Premature ventricular contractions B. Ventricular tachycardia C. Ventricular fibrillation D. Sinus tachycardia 6. When ventricular fibrillation occurs in a CCU, the first person reaching the client should: A. Administer oxygen B. Defibrillate the client C. Initiate CPR D. Administer sodium bicarbonate intravenously 7.A nurse notices frequent artifact on the ECG monitor for a client whose leads are connected by cable to a console at the bedside. The nurse examines the client to determine the cause. Which of the following items is unlikely to be responsible for the artifact? A.Frequent movement of the client B. Tightly secured cable connections C. Leads applied over hairy areas D. Leads applied to the limbs. 8.A nurse is caring for a client with unstable ventricular tachycardia. The nurse instructs the client to do which of the following, if prescribed, during an episode of ventricular tachycardia? A. Breathe deeply, regularly, and easily B. Inhale deeply and cough forcefully every 1 to 3 seconds C. Lie down flat in bed D. Remove any metal jewelry 9.A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as: A. Sinus tachycardia B. Atrial fibrillation C. Ventricular tachycardia D. Ventricular fibrillation 10.When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by: A. The presence of occasional coupled beats B. Long pauses in an otherwise regular rhythm C. A continuous and totally unpredictable irregularity D. Slow but Strong and regular Beats 11.A client with a bundle branch block is on a cardiac monitor. The nurse should expect to observe: A. Sagging ST segments B. Absence of P wave configurations C. Inverted T waves following each QRS complex D. Widening of QRS complexes to 0.12 second or greater 12.The adaptations of a client with complete heart block would most likely include: A. Nausea and vertigo B. Flushing and slurred speech C. Cephalalgia and blurred vision D. Syncope and slow ventricular rate 13.The nurse is caring for a client with atrial fibrillation. In addition to an antidysrhythmic, what medication does the nurse plan to administer? a. Heparin b. Atropine c. Dobutamine d. Magnesium sulfate. 14. The nurse is caring for a client with unstable angina whose cardiac monitor shows ventricular tachycardia. Which action is appropriate to implement first? a. Defibrillate the client at 200 J. b. Check the client for a pulse. c. Cardiovert the client at 50 J. d. Give the client IV lidocaine. 15.In teaching clients at risk for bradydysrhythmias, what information does the nurse include? a. "Avoid potassium-containing foods." b. "Stop smoking and avoid caffeine." c. "Take nitroglycerin for a slow heartbeat." d. "Use a stool softener." DYSRHYTHMIAS PRESENTED BY: NILLAMA, LADY TREXIE OTADOY, KENNE  DYSRHYTHMIA S of the formation Dysrhythmias are disorders or conduction (or both) of the electrical impulse within the heart. These disorder can cause disturbance of the heart rate, the heart rhythm, or both. Named according to the site of origin of the impulse and the mechanism of formation or conduction involved. CAUSES OF DYSRHYTHMIAS Electrolyte Imbalances Ischemia or Myocardial Infarction (Heart Attack) Heart Failure Structural Heart Disease Medications and Drugs Stress and Stimulants Hyperthyroidism Conduction System Disorders Infections and Inflammation Genetic Disorders Autonomic Nervous System Imbalances  TYPES OF DYSRHYTHMIAS SINUS TACHYCARDIA The rhythm still originates at the SA node but at an increased rate of greater than 100 beats per minute for both the atria and ventricles. The heart rate is usually between 100 and 120 beats per minutes. CAUSES: medication, exercise, anxiety, fever, anemia, heart failure and hypovolemia MANAGEMENT: Carotid sinus pressure (carotid massage) or Beta-blockers SINUS BRADYCARDIA The rhythm still originates at the SA node but a decreased rate of less than 60 beats per minute for both the atria and ventricles. CAUSES: Medication, vagal stimulation, hypoendocrine states and hypothermia MANAGEMENT: Anticholinergic drugs like atropine sulfate  PREMATURE ATRIAL CONTRACTION Ectopic beats that originates from the atria and they are not rhythms. Cells in the heart starts to fire or go off before the normal heartbeat is supposed to occur. These called heart palpitations. CAUSES: Coronary or valvular heart diseases, atrial ischemia, coronary artery atherosclerosis, heart failure, COPD, electrolyte imbalance and hypoxia. MANAGEMENT: Procainamide and quinidine and carotid sinus massage ATRIAL FLUTTER An abnormal rhythm that occurs in the atria of the heart. Atrial flutter has an atrial rhythm that is regular but has an atrial rate of 250 to 400 beats/min. It has sawtooth appearance. QRS complexes are uniform in shape but often irregular in rate. CAUSES: Heart failure, tricuspid valve or mitral valve disease, pulmonary embolism, inferior wall MI, carditis and digoxin toxicity. MANAGEMENT: Cardioversion, calcium channel blocker, beta-adrenergic blockers and anticoagulant ATRIAL FIBRILLATION Results from abnormal impulse formation that occurs when structural or electrophysiological abnormalities alter the atrial tissue causing a rapid, disorganized, and uncoordinated twitching of the atrial musculature. CAUSES: Atherosclerosis, heart failure, congenital heart disease, chronic obstructive pulmonary disease, hypothyroidism and thyrotoxicosis.  PREMATURE JUNCTIONAL CONTRACTION Occurs when some regions of the heart become excitable than. PR interval less than 0.12 seconds if P wave precedes QRS complex QRS complex configuration and duration is normal P wave is inverted Atrial and ventricular rhythms irregular CAUSES: Myocardial infarction, digoxin toxicity, excessive caffeien or amphetamine use.  ATRIOVENTRICULAR BLOCKS Av blocks are conduction defects within the AV junction that impairs conduction of atrial impulses to ventricular pathways First Degree AV Block The electrical impulses from the atria are delayed as they pass through the AV node, but eventually all impulses reach the ventricles. This is the mildest form of AV block. Prolonged PR interval (>0.20 seconds) CAUSES: MI, hyperkalemia, hypokalemia, digoxin toxicity, calcium channel blockers, amiodarone and use of antidysrhythmic Second Degree AV Block There are two subtypes of second-degree AV block: Mobitz Type I (Wenckebach Block) Progressive delay in AV node conduction until one impulse fails to pass through, resulting in a dropped QRS complex. Progressive lengthening of the PR interval until a P wave is not followed by a QRS complex (dropped beat). After the dropped beat, the cycle repeats. Mobitz Type II Some of the atrial impulses fail to conduct to the ventricles, without a progressive lengthening of the PR interval. It is more dangerous than Type I and can progress to a complete block. Intermittent dropped QRS complexes without PR interval lengthening. PR intervals remain constant when the conduction occurs. Third Degree Block Complete failure of the electrical impulses to pass from the atria to the ventricles. The atria and ventricles beat independently of each other, causing severe disruption of the heart’s function. Atrial rhythm regular Ventricular rhythm regular and rate slower than atrial rate No relation between P waves and QRS complexes NO constant PR interval PREMATURE VENTRICULAR CONTRACTIONS Early heartbeats that originate in the ventricles rather than from the sinoatrial (SA) node, which is the normal pacemaker of the heart. PVCs are a type of ventricular arrhythmia. CAUSES: Myocardial infarction (heart attack), heart failure, electrolyte imbalances, and drug toxicity. MANAGEMENT: Beta-blockers (metoprolol) and Calcium Channel Blockers: (verapamil)  VENTRICULAR TACHYCARDIA A type of ventricular arrhythmia where the ventricles (the lower chambers of the heart) beat very fast, usually at a rate of 100 to 250 beats per minute. It is considered a medical emergency because cardiac output cannot be maintained because of decreased diastolic filling (preload). CAUSES: MI, aneurysm, CAD, rheumatic heart diseases, mitral valve prolapse, hypokalemia, hyperkalemia, pulmonary embolism and anxiety.  VENTRICULAR FIBRILLATION Ventricular fibrillation is rapid, ineffective quivering of ventricles that may be rapidly fatal. CAUSES: Myocardial ischemia, electrolyte imbalances, digoxin toxicity or hypothermia  SIGNS AND SYMPTOMS Chest pain or tightness Dizziness or lightheadedness Fainting Palpitations – a feeling of skipped heartbeats or fluttering Pounding in the chest Shortness of breath Weakness or fatigue PATHOPHYSIOLO GY MEDICAL MANAGEMENT Electrocardiogram (ECG or EKG) A diagnostic tool that records the electrical activity of the heart over a period of time using electrodes placed on the skin. It provides a visual representation of the heart's electrical impulses, which are crucial in regulating the heart's contractions. Holter Monitor A portable device used to continuously record the heart's electrical activity over 24 to 48 hours or longer, depending on the prescription. Holter monitor tracks heart rhythms for a longer period while the person goes about their daily activities. MEDICAL MANAGEMENT Echocardiogram A non-invasive imaging technique that uses ultrasound waves to create real-time images of the heart. It provides valuable information about the heart's structure and function, including its chambers, valves, and blood flow. Tilt Table Test A diagnostic procedure used to evaluate the cause of unexplained fainting and assess how a person's heart and blood pressure respond to changes in body position. MEDICAL MANAGEMENT Stress Test (Exercise ECG) A diagnostic procedure that evaluates how the heart responds to physical stress or exercise. The test typically involves monitoring the heart's electrical activity while the patient exercises on a treadmill or stationary bike. Blood Tests A medical diagnostic procedure that involves analyzing a sample of blood to provide information about a person's health. Check for conditions like electrolyte imbalances or thyroid dysfunction that may cause arrhythmias.  PHARMACOLOGICAL MANAGEMENT Sodium Channel Blockers (Class I) These medications work by blocking sodium channels in the heart, which helps to slow down electrical conduction and reduce abnormal impulses. Beta-Blockers (Class II) These medications block the effects of adrenaline and reduce the heart's workload, slowing the heart rate and decreasing the force of contraction. Potassium Channel Blockers (Class III) These medications prolong the repolarization phase of the heart’s electrical cycle by blocking potassium channels, which stabilizes the  PHARMACOLOGICAL MANAGEMENT Calcium Channel Blockers (Class IV) These medications slow down the conduction through the atrioventricular (AV) node by blocking calcium channels, helping to control heart rate. Anticoagulants Prevent blood clots and reduce stroke risk in patients with atrial fibrillation, especially those with other risk factors like heart failure, hypertension, or diabetes. Electrolyte Supplements Low levels of certain electrolytes, particularly potassium and magnesium, can trigger or worsen arrhythmias. Electrolyte  SURGICAL MANAGEMENT Pacemaker Implantation A procedure to put a small battery- operated device called a pacemaker into your chest. The pacemaker sends regular electrical impulses, which help keep your heart beating regularly. Maze Procedure A surgical technique used primarily to treat atrial fibrillation (AFib). The procedure involves creating a series of precise incisions (or "maze") in the atrial tissue to disrupt the abnormal electrical pathways that cause AFib.  SURGICAL MANAGEMENT Coronary Artery Bypass Grafting (CABG) This surgery improves blood flow to your heart by creating a bypass around your narrowed coronary arteries using arteries or veins taken from other parts of your body.  LABORATORIES Complete Blood Count (CBC): Check for anemia or signs of infection (elevated white blood cell count). normal range : Hemoglobin: Men: 13.5–17.5 g/dL Women: 12.0–15.5 g/dL Hematocrit: Men: 38.8%–50.0% Women: 34.9%–44.5% White Blood Cell Count (WBC): 4,500–11,000 cells/mcL  LABORATORIES Thyroid function tests to check for hyperthyroidism TSH -.35 to.50 TT4- 6-12 ug/d FTI- 4.6-10.9 mg/dl FT4- 0.7-1.53 ng/dL Resin T3 Uptake- 24-39 md/dl FT3- 260-480 pg/mL  LABORATORIES Basic metabolic panel (BMP) to look for Kidney function to access for electrolyte abnormalities kidney injury Electrolytes: Monitor levels of sodium, Renal Function Tests: serum potassium, calcium, and magnesium, as creatinine and blood urea imbalances can affect cardiac function. nitrogen (BUN) to assess kidney Normal range : function. Sodium (Na): 135–145 mEq/L Normal range: Potassium (K): 3.5–5.0 mEq/L Serum Creatinine: 0.6–1.2 Calcium (Ca): 8.5–10.2 mg/dL mg/dL Magnesium (Mg): 1.5–2.5 mEq/L Blood Urea Nitrogen (BUN): 7– 20 mg/dL  LABORATORIES Cardiac biomarkers and B-type natriuretic peptide (BNP) assess for B-type Natriuretic Peptide underlying heart disease (BNP): Elevated levels Troponin I and T: Elevated levels suggest heart failure and can indicate myocardial injury or infarction. help assess the severity of normal Troponin I = 0 - 0.04 ng/mL. heart dysfunction. normal normal Troponin T = 0 - 0.01 ng/mL. BNP= (less than 100 pg/ Creatine Kinase-MB (CK-MB): Another mL) marker for myocardial damage. normal Creatine Kinase -MB (CK- MB)= 3 to 5% (percentage of total CK) or 5 to 25 IU/L.  NURSING MANAGEMENT - Regularly evaluates the patient's blood pressure, pulse rate and rhythm , rate and depth of respirations and breath sounds to determine the dysrhythmias hemodynamic effect. - Ask patient about episodes of lightheadedness, dizziness or fainting as part of the ongoing assessment - Oxygen is applied with nasal prongs to supplement serum levels. To avoid hypoxia that can lead to further myocardial ischemia and dysrhythmias. -Administer medications as prescribed: Use inotropes to improve heart contractility, vasopressors to maintain blood pressure, and diuretics for fluid management if necessary.  NURSING MANAGEMENT -Offer emotional support - to minimizing anxiety - Obtain a 12-lead ECG to continuously monitor the patient. -Collaborate with the healthcare team: many nurses are trained to defibrillate the client. Including CPR various medications and preparation of the client for pacemaker insertion. NURSING CARE PLAN DYSRHYTHMIAS Subjective " I usually have symptoms like fainting, shortness of breath, chest pain , fatigue and even skipped beats felt in chest " as verbalized by the patient. Objective The patient appears in ER anxious slightly diaphoretic and pale, variations in radial adapical pulse such as bradycardia and tachycardia rhythm changes, hypotension. He is sitting upright, occasionally holding his chest. The patient is placed on a monitor and heart rhythm is monitored by the nurse. Upon closer inspection , the patient having hair loss and skin color temperature changes in the extremities (signs of vascular disease) Eyes appear dull or tired with possible conjunctival pallor due to poor oxygenation. Ears Symmetrical with no discharge. Nose No nasal flaring or discharge. Neck: swelling of the neck (signs of thyroid disease), distended jugular veins (signs of heart failure). Cardiovascular: chaotic irregular pulse, tachycardia, chest pain, adventitious sounds (murmur) upon auscultation. Respiratory: adventitious sounds (rales may be a sign of heart failure; wheezing may be a sign of a lung disorder) upon auscultation. Abdomen: abdominal bruits on auscultation, enlarged liver (hepatomegaly), and abdominal distension (signs of heart failure) Circulatory: irregular, fluttering in peripheral pulses. Lymphatic: signs of edema. ATTACHMENTS PT has peripheral IV line attach in right forearm, Access: 18- gauge peripheral IV in the right antecubital fossa for fluid resuscitation. Patent with no signs of redness or swelling at the insertion site. Patient is receiving supplemental oxygen via nasal cannula at 2 l/min , maintaining Sp02 at 95 Cardiac Monitor: Continuous cardiac monitoring showing atrial fibrillation with rapid ventricular response. Vital signs: T - 37 C BP: 80/50 mmHg HR: 150 bpm (tachycardic with irregular rhythm) RR: 28 breaths/min (tachypneic) O2 Sat: 88% on room air  DIAGNOSIS & PLANNING After performing nursing interventions, the patient will Decreased Cardiac Output R/T manifest blood pressure and pulse alterations in rate and rhythm of the rate within normal limits. heart Patient will be able to tolerate activities without chest pain, dyspnea, or changes in the level of consciousness.  Nursing Intervention & Rationale -Assess for cardiovascular status. -Cardiac arrhythmia places the patient at risk for stroke or heart attack. Assess for a history of coronary artery disease. - Monitor the patient’s blood pressure and -With hypotension, tachycardia is a normal pulse compensatory response to decreased cardiac output. -This also allows the patient to breathe easier. -Place the patient in an upright position. -Beta-blockers and calcium channel blockers offer -Administer beta-blocker or calcium-channel quick heart rate control at rest and during activity. blocker as prescribed. -Exercise, support, counseling, and diet education -Refer the patient to cardiac rehabilitation. are all part of cardiac rehabilitation.  EVALUATIO N Patient blood pressure and pulse rate within normal limits. Patient can do activities without chest pain, dyspnea, or changes in the level of consciousness  DIAGNOSIS & PLANNING After performing nursing Ineffective Tissue Perfusion R/T interventions, the patient will Interruption of blood flow as evidence demonstrate increased perfusion as by Chest pain or tightness evidenced by vitals signs within parameters and intact mentation.  Nursing Intervention & Rationale -Assess mental status, level of -Consciousness level, changes in behavior, speech, motor consciousness, speech, and behavior. response, and pupillary response should all be evaluated. -Monitor blood pressure -A lack of appropriate brain perfusion is caused by severe hypotension. -Administer medications as prescrib. -Administration of antihypertensives, antidysrhythmics, fibrinolytics, anticoagulants, and more may be utilized. - Collaborate with the interdisciplinary team. -Collaboration of an interdisciplinary team allows for treatment from different disciplines to create an appropriate and suitable treatment plan that will improve systemic perfusion and organ function of the client. -Closely monitor lab values and tests. -Hemoglobin, ABGs, electrolytes, cardiac enzymes, and kidney function labs provide information on organ perfusion.  EVALUATIO N Patient increased perfusion as evidenced by vitals signs within parameters and intact mentation  DIAGNOSIS & PLANNING Risk for Activity Intolerance R/T After performing nursing interventions, the patient will be able to engage in a Imbalanced oxygen supply and demand conditioning or rehabilitation program to improve performance.  Nursing Intervention & Rationale -Monitor vital signs and mental status. -Monitor for discrepancies in the client’s heart, breathing, and blood pressure rates. -Assess the patient’s perceived and actual -This offers a comparative baseline and details on the restrictions as well as the severity. education or treatments that are necessary to improve quality of life. -Assess the cardiopulmonary response to -Before, during, and after physical activity, evaluate the activity. cardiopulmonary response, including vital signs. -Administer medication and provide oxygen as -Assess the patient’s response to medications and needed. oxygen or the need for increasing supplemental oxygen with activity. -Coordinate with rehab or exercise programs. -Consider the need for cardiac rehab programs, physical therapy, or other exercise programs that instruct on limiting exertion and maintaining activity within the patient’s capabilities  EVALUATION Patient will engage in a conditioning or rehabilitation program to improve performance.  DIAGNOSIS & PLANNING ·Patient will be able to verbalize understanding of atrial fibrillation, Deficient Knowledge r/t Insufficient treatment plan, any potential drug knowledge of atrial fibrillation and adverse effects, and when to contact a its treatment evidence by healthcare provider. Nonadherence with the treatment regimen Patient will be able to demonstrate two behavior and lifestyle modifications to prevent complications  DIAGNOSIS & PLANNING ·Patient will be able to verbalize understanding of atrial fibrillation, Deficient Knowledge r/t Insufficient treatment plan, any potential drug knowledge of atrial fibrillation and adverse effects, and when to contact a its treatment evidence by healthcare provider. Nonadherence with the treatment regimen Patient will be able to demonstrate two behavior and lifestyle modifications to prevent complications  Nursing Intervention & -Determine knowledge level and capabilities. Rationale To encourage informed decision-making, patients’ awareness of the risks, advantages, and characteristics of medical interventions must be understood. - Recognize avoidance cues. A patient who is avoidant or nonadherent to the treatment plan requires further assessment. Reinforcement can be utilized to promote on-task -Encourage using positive reinforcement. -behavior, teach new skills, or promote behavior modification. -Family or other support system involvement may -Involve support systems be necessary to ensure thorough understanding. -The patient may not be psychologically, -Establish the client’s capacity, readiness, emotionally, or physically capable of and learning obstacles. understanding the treatment plan. Provide education resources to best meet their learning needs.  EVALUATIO N ·Patient will be able to verbalize understanding of atrial fibrillation, treatment plan, any potential drug adverse effects, and when to contact a healthcare provider. Patient will be able to demonstrate two behavior and lifestyle modifications to prevent complications  DIAGNOSIS & PLANNING Risk for Activity Intolerance r/t Patient will be able to Imbalanced oxygen supply and engage in a conditioning or demand as evidenced by risk rehabilitation program to diagnosis is not evidenced by improve performance. signs and symptoms as the Patient will be able to problem has not yet occurred recognize two symptoms and the goal of nursing or indications that interventions is aimed at necessitate medical prevention. evaluation.  Nursing Intervention & Rationale -Monitor vital signs and mental status. -Monitor for discrepancies in the client’s heart, breathing, and blood pressure rates. -Administer medication and provide oxygen -Assess the patient’s response to medications as needed. and oxygen or the need for increasing supplemental oxygen with activity. -Balance rest periods with activity. -Gradually increase exercise and activity levels. Teach energy-saving techniques like taking a 3- minute break midway through a 10-minute walk -Assess the patient’s perceived and actual -This offers a comparative baseline and details on restrictions as well as the severity. the education or treatments that are necessary to improve quality of life. - Coordinate with rehab or exercise -Consider the need for cardiac rehab programs, programs. physical therapy, or other exercise programs that instruct on limiting exertion and maintaining activity within the patient’s capabilities.  EVALUATION Patient able to engage in a conditioning or rehabilitation program to improve performance. Patient able to recognize two symptoms or indications that necessitate medical evaluation  DIAGNOSIS & PLANNING Risk for Ineffective Cerebral Tissue Patient will verbalize how atrial Perfusion r/t Decreased oxygenated fibrillation can cause ineffective blood flow to the brain As cerebral tissue perfusion. evidenced by risk diagnosis is not Patient will adhere to lifestyle evidenced by signs and symptoms modifications to prevent the as the problem has not yet recurrence of atrial fibrillation. occurred and the goal of nursing Patient will not experience altered interventions is aimed at mental status, confusion, or prevention. decreased consciousness related to atrial fibrillation.  Nursing Intervention & -Assess neuromuscular status. Rationale Assess the movement in response to simple instructions. -Closely monitor the blood pressure. Monitor BP measurements for changes in orthostatic pressure -Watch out for signs and symptoms of a A stroke is a severe complication of atrial fibrillation stroke. due to the high risk of blood clot formation. -Begin prophylactic anticoagulant therapy. The two cornerstones of atrial fibrillation care are rate control and anticoagulation. -Provide safety when dizziness occurs. Provide advice on how to reduce dizziness caused by decreased oxygenated blood flow when a patient experiences it as a result of orthostatic hypotension  EVALUATIO N Patient verbalize how atrial fibrillation can cause ineffective cerebral tissue perfusion. Patient adhere to lifestyle modifications to prevent the recurrence of atrial fibrillation. Patient not experience altered mental status, confusion, or decreased consciousness related to atrial fibrillation. THANK YOU  POST TEST 1. Disorder of the formation or conduction (or both) of the electrical impulse within the heart. These disorder can cause disturbance of the heart rate, the heart rhythm, or both. 2. A type of dysrhythmias has sawtooth appearance. 3. A type of ventricular arrhythmia where the ventricles (the lower chambers of the heart) beat very fast, usually at a rate of 100 to 250 beats per minute. 4. A portable device used to continuously record the heart's electrical activity over 24 to 48 hours or longer. 5. A diagnostic tool that records the electrical activity of the heart over a period of time using electrodes placed on the skin. 6-10 Give at least 5 Causes of dysrhythmias 11-15 List different types of dysrhythmias 16-20 Give at least 5 sign and symptoms of Dysrhythmias