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Chapter: Medical Surgical Nursing: Management of Patients With Dysrhythmias and Conduction Problems

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Adjunctive Modalities and Management

a. Pacemaker Therapy b. Nursing Process: The Patient With a Pacemaker c. Cardioversion and Defibrillation d. Electrophysiologic Studies e. Cardiac Conduction Surgery

Adjunctive Modalities and Management

Dysrhythmia treatments depend on whether the disorder is acute or chronic as well as on the cause of the dysrhythmia and its actual or potential hemodynamic effects.

 

Acute dysrhythmias may be treated with medications or with external electrical therapy. Many antiarrhythmic medications are used to treat atrial and ventricular tachydysrhythmias. These medications are summarized in Table 27-1. The choice of med-ication depends on the specific dysrhythmia, presence of cardiac failure and other diseases, and the patient’s response to previous treatment. The nurse is responsible for monitoring and docu-menting the patient’s responses to the medication and for mak-ing sure that the patient has the knowledge and ability to manage the medication regimen.


 

If medications alone are ineffective in eradicating or decreas-ing the dysrhythmia, certain adjunctive mechanical therapies are available. The most common are pacemakers for bradycardias and tachycardias, elective cardioversion and defibrillation for acute tachydysrhythmia, and implantable devices for chronic tachy-dysrhythmia. Surgical treatments, although less common, are also available.

 

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