Orris

Heart block For 2 nd year nursing student

Reading File
Heart block is a delay or failure of electrical impulses traveling from the atria to the ventricles, usually through the AV node or His-Purkinje system. It can cause slow pulse, dizziness, fainting, and in severe cases reduced cardiac output.
For a 2nd-year nursing student, study it in this order:
  1. Normal cardiac conduction system
    • SA node, AV node, bundle of His, bundle branches, Purkinje fibers
    • Normal ECG components: P wave, PR interval, QRS complex
  2. Causes and risk factors
    • Ischemic heart disease or myocardial infarction
    • Age-related conduction-system fibrosis
    • Drugs such as beta-blockers, digoxin, verapamil/diltiazem
    • Electrolyte abnormalities, especially hyperkalemia
    • Myocarditis, congenital heart disease, post-cardiac surgery
  3. Types of heart block
    • First-degree AV block
    • Second-degree AV block: Mobitz type I (Wenckebach) and Mobitz type II
    • Third-degree, or complete, heart block
    • Bundle branch blocks
  4. ECG recognition
    • PR interval changes
    • Dropped QRS complexes
    • AV dissociation in complete heart block
  5. Clinical manifestations
    • May be asymptomatic
    • Bradycardia, fatigue, dizziness, syncope, hypotension, chest discomfort, dyspnea
  6. Diagnosis and management
    • ECG, cardiac monitoring, electrolyte tests, medication review
    • Treat reversible causes
    • Atropine and temporary pacing for unstable symptomatic bradycardia
    • Permanent pacemaker for many cases of Mobitz II or complete heart block
  7. Nursing care
    • Assess pulse, BP, consciousness, chest pain, oxygen saturation
    • Continuous ECG monitoring
    • Keep emergency pacing/defibrillation equipment available when indicated
    • Prepare and educate patients receiving a pacemaker
Key exam point:
  • Mobitz I: PR interval gradually lengthens, then a QRS complex is dropped.
  • Mobitz II: PR interval stays constant, but QRS complexes are suddenly dropped. It is more dangerous.
  • Third-degree block: P waves and QRS complexes occur independently. It is an emergency if symptomatic.
Which topic would you like in detailed nursing-note format?
  1. ECG patterns and differences
  2. Causes, signs, and complications
  3. Emergency management and nursing care
  4. Pacemaker care and patient education
This is a shared conversation. Sign in to Orris to start your own chat.