Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Oxygen delivery (DO2) to the tissues is determined by cardiac output and the arterial oxygen content, which in turn is determined by the hemoglobin concentration and its oxygen saturation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Sinus node dysfunction can manifest with sinus bradycardia, sinus pauses or tachycardia-bradycardia syndrome. Asymptomatic sinus bradycardia has not been associated with adverse outcomes and treatment is not recommended.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Abnormalities of the sinus node, atrial tissue, AV nodal tissue or conduction system can cause bradyarrhythmias. Bradyarrhythmias are more common in older patients because of age-related degeneration and fibrosis of the conduction system.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Treatment of torsades de pointes includes discontinuing QT-prolonging agents, correcting electrolyte derangements, administering magnesium and increasing the ventricular rate with isoproterenol or temporary pacing.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Polymorphic ventricular tachycardia can occur in the setting of a normal (< 460 ms) or prolonged (> 460 ms) QT interval. Unstable patients with normal QT interval-associated polymorphic VT require immediate defibrillation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In addition to antiarrhythmic administration for the treatment of ventricular tachycardia, correction of electrolyte abnormalities and discontinuation of offending agents should be performed concurrently.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
In patients with stable monomorphic ventricular tachycardia, administration of IV procainamide, amiodarone or sotalol can be used to terminate the rhythm. Amiodarone is often better tolerated in patients with systolic dysfunction.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ventricular tachycardia is classified as sustained when it lasts > 30 seconds or requires termination. Conversely, nonsustained ventricular tachycardia has a duration of < 30 seconds and terminates spontaneously.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ventricular tachycardia is characterized by ≥ 3 consecutive complexes originating in the ventricles at a rate greater than 100 beats per minute. It is the most common cause of wide QRS complex tachycardia.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Typical atrial flutter is a macroreentrant, narrow complex atrial tachycardia that is characterized by a regular sawtooth pattern on the ECG. Atrial rates usually range from 250 to 330 beats per minute.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Hemodynamically unstable patients with atrial fibrillation should be treated with synchronized direct current cardioversion. The reported success rates for electrical cardioversion of atrial fibrillation during critical illness range from 30% to 37%.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Amiodarone is an effective rhythm control agent in the treatment of atrial fibrillation and it offers the additional benefit of rate control if both beta-receptor antagonists and calcium channel blockers are contraindicated.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Nondihydropyridine calcium channel blockers may be used for rate control in patients with atrial fibrillation that are intolerant of beta-receptor antagonists and digoxin can be considered as third-line therapy.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Management of the hemodynamically stable patient with atrial fibrillation involves three treatment principles: rate control, rhythm control/cardioversion and anticoagulation. Beta-receptor antagonists are effective for rate control.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
New-onset atrial fibrillation in critical illness is often reversible. The majority of patients will spontaneously convert to sinus rhythm within 72 hours of treatment of the underlying causes or removal of the offending agent.