Course 1: Identifying and Managing Cardiac Arrhythmias

Course Information

Educational Need

The occurrence of cardiac arrhythmias is common. For example, an estimated 2.7 to 6.1 million Americans suffer from atrial fibrillation, making it the most common sustained cardiac tachyarrhythmia. Each year, the incidence and prevalence of the condition increase and an expected 12.1 million people will be affected in 2030. Atrial fibrillation raises an individual’s risk of stroke by a factor of five and accounts for between 1.5% and 23.5% of strokes, depending upon age, annually. Electrocardiogram (ECG) monitoring is the standard practice for the monitoring of cardiac rhythms in hospitalized patients and, today, most patients with an indication for arrhythmia monitoring are monitored. However, only 62% of nurses in a recent survey indicated that they were somewhat or very comfortable identifying ECG rhythm abnormalities. In addition, only one-half of surveyed nurses indicated that they were knowledgeable about how to apply therapeutic interventions once an arrhythmia was identified.

An educational need has been identified for a continuing education activity on identifying and managing cardiac arrhythmias. Specifically, this activity will review the scope and impact of these conditions, discuss how ECG monitoring is done, detail ECG findings indicative of cardiac arrhythmia, and discuss nursing diagnoses and interventions for identified arrhythmias. This one-hour online continuing education activity is recommended for nurses and telemetry technicians.

Overview

Electrocardiogram (ECG) monitoring is the standard practice for the monitoring of cardiac rhythms in hospitalized patients and, today, most patients with an indication for arrhythmia monitoring are monitored. However, healthcare professionals often indicate that they are not comfortable identifying ECG rhythm abnormalities and are not knowledgeable about how to apply therapeutic interventions once an arrhythmia is identified. This activity will review the scope and impact of cardiac arrhythmia, discuss how ECG monitoring is done, detail ECG findings indicative of cardiac arrhythmia, and discuss nursing diagnoses and interventions for identified arrhythmias.

Learning Outcome / Objectives

After completing this continuing education activity, nurses and telemetry technicians will be able to monitor patients using ECG to identify cardiac arrhythmias. Specifically, they will be able to (1) measure intervals; (2) interpret ECG findings to identify cardiac arrhythmias; and (3) apply interventions on the basis of ECG findings.

Outline

• ECG Monitoring: Why
  • Lethal and non-lethal arrhythmias
  • Cardiac arrhythmia pathophysiology
  • Signs and symptoms
  • Potential of Missing Life-Threatening Arrhythmias
• ECG Monitoring: How
  • The ECG waveform
  • Determining the heart rate
  • Evaluating the ventricular rhythm
  • Identifying the P wave morphology
  • Determining the P-R interval
  • Identifying the QRS complex
• ECG Monitoring: ECG Findings
  • Sinus node arrhythmias
  • Arterial arrhythmias (atrial fibrillation, atrial flutter, PSVT, WPW Syndrome)
  • Ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation)
  • Junctional Arrhythmias
  • Artrioventricular blocks
• Nursing Diagnoses and Interventions for Arrhythmias