Medical-surgical Nursing Demystified

(Michael S) #1

(^56) Medical-Surgical Nursing Demystified



  • Proper care and restrictions if the patient has a pacemaker—frequent
    monitoring of the pacemaker battery, who will follow up with the cardi-
    ologist, and so on. Frequency depends on the type of pacemaker and the
    cardiologist.


Asystole


WHAT WENT WRONG?


Asystole is defined as no cardiac electrical activity. This causes ventricles to stop
contractions, leading to no cardiac output and no blood flow. Cardiac standstill is a
medical emergency. Treatment must be started immediately, while simultaneously
attempting to understand the etiology of a non-beating heart. Asystole is a criterion
for certifying that the patient is dead. Asystole may be caused by disruption in the
electrical conduction system, causing life-threatening arrhythmias, sudden cardiac
death, hypovolemia, cardiac tamponade, massive pulmonary embolism, acute
myocardial infarction, metabolic disorder, or drug overdoses. In case of a drug
overdose—usually PEA (pulseless electrical activity)—reverse overdose or treat.

PROGNOSIS


Prognosis is poor unless the heart can be started. The longer asystole continues,
the more tissue is lost.

HALLMARK SIGNS AND SYMPTOMS



  • No pulse

  • Cyanosis

  • Apnea

  • No palpable blood pressure


INTERPRETING TEST RESULTS



  • Electrocardiogram—P-, QRS–, T-waves are barely noticeable or absent.

  • Arterial blood gases.


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