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Sinus Dysrhythmia • Same as NSR except for slight irregularity of the heart rhythm • Rate of impulse formation in SA node may vary with respirations • P-to-P and R-to-R intervals change with respirations • Increases with inspiration and decreases with expiration Sinus Dysrhythmia • Should be a difference of at least 0.8 seconds between shortest and longest RR intervals • Common and normal finding – Causes may include MI, Sick Sinus Syndrome, and administration of certain drugs, i.e., digitalis – Varies with respirations Sinus Dysrhythmia Sinus Dysrhythmia Sinus Arrest Rhythm • SA node fails to initiate an impulse • Absence of a PQRST complex is noted on rhythm strip • Causes a slight period of cardiac standstill • Lasts until sinus node continues its normal function Sinus Arrest Rhythm • Causes include hypoxia, ischemia, damage to the SA node, or administration of certain drugs such as digitalis or salicylates • Also occurs as result of acute MI • These occurrences are infrequent • Patient assessment is imperative Sinus Arrest Rhythm Sinus Arrest Rhythm Clinical Significance of Sinus Rhythms • Associated with assessment of patients • If patient is experiencing chest pains, dizziness, weakness, fainting, markedly decreased blood pressure, or altered level of consciousness = symptomatic or medically unstable Sinus Bradycardia • If heart rate falls significantly, cardiac compromise may occur • Symptomatic – Signs of decreased cardiac output • Treatment – Oxygen, IV access line, administration of drugs (atropine), or TCP Sinus Tachycardia • Cardiac output may fall < 150 due to inadequate ventricular filling time • Myocardial oxygen demand increases • Can precipitate myocardial ischemia or infarct • Treatment – Aimed at finding and treating cause Sinus Dysrhythmia • Considered a normal alteration in heart rhythm, especially in young children and elderly adults • Usually does not require emergency treatment Sinus Arrest • If patient is asymptomatic (medically stable) episodes occurring occasionally, observation may be done • If patient is bradycardic and symptomatic (medically unstable) may need oxygen, IV, drug therapy, and/or TCP Chapter 7 Review Strips Pg 81 Strip 1 Chapter 7 Review Strips Pg 82 Strip 2 Chapter 7 Review Strips Pg 82 Strip 3 Chapter 7 Review Strips Pg 82 Strip 4 Chapter 7 Review Strips Pg 83 Strip 5 Chapter 7 Review Strips Pg 83 Strip 6 Chapter 7 Review Strips Pg 83 Strip 7 Chapter 7 Review Strips Pg 84 Strip 8 Chapter 7 Review Strips Pg 84 Strip 9 Chapter 7 Review Strips Pg 84 Strip 10