Dysrhythmia

Definition

A dysrhythmia (or arrhythmia) is any deviation from the normal sinus rhythm of the heart. Dysrhythmias range from benign (premature atrial contractions) to life-threatening (ventricular fibrillation).

Common Dysrhythmias

• Atrial fibrillation: Irregularly irregular; stroke risk; anticoagulate.
• Ventricular tachycardia: Wide QRS, rapid; treat with cardioversion (stable) or defibrillation (pulseless).
• Ventricular fibrillation: Chaotic, no perfusion; CPR and defibrillation.
• PVCs: Premature wide complexes; usually benign unless frequent or in MI.
• Heart blocks: 1°, 2° type I/II, 3° (complete).
• Asystole/PEA: CPR; no defibrillation.

Nursing Interventions

Continuous cardiac monitoring, 12-lead ECG, IV access, assess for symptoms (chest pain, syncope, SOB), administer anti-arrhythmics, prepare for cardioversion/defibrillation/pacing as indicated, correct electrolyte imbalances (especially K+ and Mg).

NCLEX Relevance

Identify V-fib, V-tach, A-fib, and heart blocks. Match rhythm with appropriate intervention.