AACN Essentials of Critical-Care Nursing Pocket Handbook, by Marianne Chulay

By Marianne Chulay

Crucial information severe Care Nurses needs to comprehend counseled by means of the yank organization of Critical-Care Nurses, this go-anywhere instruction manual gains tables and figures that encapsulate all of the info required to provide secure and potent care to significantly sick sufferers. Contents contain: serious Care Drug Tables • common Values for Laboratory exams and Physiologic Parameters • Lists of evaluate parts • Cardiac Rhythms: ECG features and remedy publications, together with pattern Rhythm Strips • 12-Lead ECG alterations in Acute Myocardial Ischemia and Infarct • Troubleshooting advisor for Hemodynamic tracking gear • symptoms for Mechanical air flow • Weaning overview software • ACLS Algorithms.

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Lead V3 is the best lead for detecting anterior wall ST-segment deviation,c but can only be used if the chest lead is not being used for arrhythmia monitoring in lead V1. a Data compiled from aDrew (2004); bJacobson (2007); and cAACN (2004). 12 ᭤ Cardiac Rhythms, ECG Characteristics, and Treatment Guide Rhythm Normal sinus rhythm (NSR) ECG Characteristics • • • • • Rate: 60-100 beats/min. Rhythm: Regular. P waves: Precede every QRS; consistent shape. 20 second. 10 second. Treatment • None. 12 ᭤ Cardiac Rhythms, ECG Characteristics, and Treatment Guide (continued ) Rhythm Sinus bradycardia ECG Characteristics • • • • • • Rate: Ͻ60 beats/min.

For ventricular escape rhythms, use atropine to increase sinus rate and overdrive ventricular rhythm. • Use ventricular pacing to increase ventricular rate if escape rhythm is too slow. 12 ᭤ Cardiac Rhythms, ECG Characteristics, and Treatment Guide (continued ) Rhythm Ventricular tachycardia ECG Characteristics • Rate: Ventricular rate is faster than 100 beats/min. • Rhythm: Usually regular but may be slightly irregular. • P waves: P waves may be seen but will not be related to QRS complexes (dissociated from QRS complexes).

AACN Clin Issues Crit Care Nurs. 3 ᭤ Twelve-Lead ECG Placement Angle of Louis B A (A) Limb electrodes can be placed anywhere on arms and legs. Standard placement is shown here on wrists and ankles. (B) Chest electrode placement. V1 ϭ fourth intercostal space to right of sternum; V2 ϭ fourth intercostal space to left of sternum; V3 ϭ halfway between V2 and V4 in a straight line; V4 ϭ fifth intercostal space at midclavicular line; V5 ϭ same level as V4 at anterior axillary line; V6 ϭ same level as V4 at midaxillary line.

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