Etiology of cardiac arrhythmias in the outline can be caused by:
- Inflammation of the heart, such as rheumatic fever, myocardial inflammation (myocarditis due to infection).
- Disorders of coronary circulation (coronary atherosclerosis or coronary artery spasm), such as myocardial ischemia, myocardial infarction.
- Because the drug (intoxication), among others by digitalis, quinidine and anti-arrhythmia drugs other.
- Electrolyte balance disorders (hyperkalemia, hypokalemia).
- Disorders of the autonomic nervous system settings that affect the work and heart rhythm.
- Ganggguan psychoneurotic and central nervous.
- Metabolic disorders (acidosis, alkalosis).
- Endocrine disorders (hyperthyroidism, hypothyroidism).
- Heart rhythm disorders due to cardiomyopathy or heart tumor.
- Heart rhythm disorders due to degeneration (fibrosis of the conduction system of the heart).
- Change in BP (hypertension or hypotension); The pulse may be irregular; pulse deficit; irregular heart rhythm sound, extra sound, pulse decreased; pale skin, cyanosis, sweating; edema; Urine output decreases as weight decreases cardiac output.
- Syncope, dizziness, throbbing, headache, disorientation, confusion, lethargy, change in pupil.
- Mild to severe chest pain, may be lost or not with antianginal drugs, anxiety.
- Shortness of breath, cough, change of speed / depth of respiration; additional breath sounds (krekels, crackles, wheezing) may exist indicate respiratory complications such as left heart failure (pulmonary edema) or pulmonary tromboembolitik phenomena; hemoptysis.
- Fever; redness of the skin (adverse drug reactions); inflammation, erythema, edema (thrombosis siperfisial); loss of muscle tone / strength.
Nursing Diagnosis and Intervention for Abnormal Heart Rhythms (Arrhythmias)
Risk for decreased cardiac output related to electrical conduction disturbances, decreased myocardial contractility.
Expected outcomes:
- Maintain / increase cardiac output adequate as evidenced by blood pressure / pulse in the normal range, adequate urine output, palpable pulse same, usual mental status.
- Showed a decrease in the frequency / absence of dysrhythmias.
- Participate in activities that decrease myocardial work.
- Raba pulse (radial, femoral, dorsalis pedis) record the frequency, regularity, amplitude and symmetrical.
- Auscultation of heart sounds, note the frequency, rhythm. Note the extra heart rate, decreased pulse.
- Monitor vital signs and examine the adequacy of cardiac output / tissue perfusion.
- Determine the type of dysrhythmias and note the rhythm: tachycardia; bradycardia; atrial dysrhythmias; ventricular dysrhythmias; heart block.
- Provide quiet environment. Assess the reason for limiting the activity during the acute phase.
- Demonstrate / encourage use of behavioral stress management ie deep breathing relaxation, guided imagery.
- Investigate reports of pain, note the location, duration, intensity and relieving factors / ballast.
- Note the non-verbal instructions pain, for example; facial frown, cry, change in BP
- Prepare / do cardiopulmonary resuscitation as indicated.
- Monitor laboratory tests, for example; electrolyte.
- Give supplemental oxygen as indicated.
- Give the drug as indicated: potassium, anti-dysrhythmia.
- Prepare for elective cardioversion aids.
- Help installation / maintain pacemaker function.
- Enter / maintain input IV.
- Prepare for invasive diagnostic procedures.
- Prepare for the installation of automatic cardioverter or defibrillator.