Why did I call the Dr?

[Holly27]

Ok Here I go. My RN told me to call the dr about a pt. She handed the strip from telemetry and said "call dr.soandso and tell him ms.blank has had 3 pauses at 1.72 and tell him she has had several since that strip and what does he want you to do?" I said sure. I called. Dr calls back.I tell him. He ask hasn't she been in afib? I look at my report. I say yes. He said well don't worry unless it is at 3. I said ok and thank you and told my rn. She said that's fine.

Question......"reminder ive only been on floor out of orientation for a week"

What in the heck did I just talk to this dr and nurse about? I know a little about it but more not.

[RazorbackRN, BSN, RN]

Ok Here I go. My RN told me to call the dr about a pt. She handed the strip from telemetry and said "call dr.soandso and tell him ms.blank has had 3 pauses at 1.72 and tell him she has had several since that strip and what does he want you to do?" I said sure. I called. Dr calls back.I tell him. He ask hasn't she been in afib? I look at my report. I say yes. He said well don't worry unless it is at 3. I said ok and thank you and told my rn. She said that's fine.

Question......"reminder ive only been on floor out of orientation for a week"

What in the heck did I just talk to this dr and nurse about? I know a little about it but more not.

PVC's, I think. Something about if they occur after depolarization, they can be deadly.

Someone correct, I'm sure I'm wrong somewhere.

[km5v6r, EdD, RN]

Ok Here I go. My RN told me to call the dr about a pt. She handed the strip from telemetry and said "call dr.soandso and tell him ms.blank has had 3 pauses at 1.72 and tell him she has had several since that strip and what does he want you to do?" I said sure. I called. Dr calls back.I tell him. He ask hasn't she been in afib? I look at my report. I say yes. He said well don't worry unless it is at 3. I said ok and thank you and told my rn. She said that's fine.

Question......"reminder ive only been on floor out of orientation for a week"

What in the heck did I just talk to this dr and nurse about? I know a little about it but more not.

The pt is having periods of 1.72 seconds between QRS complexes. If they happen frequently it can cause symptomatic bradycardia. The heart rate could slow so much it could cause the b/p to drop. The nature of AFib is that the QRS complexs are irregular. The doc is recognizing that the QRS's are irregular and a longer period of time is occuring between some of them. He is telling you he is not concerned unless the ventricular response or QRS's slow down to point of it being 3 seconds between complexes. Once in a while the ventricular response of a pt in Afib will slow so much they have to have pacer placed.

[Holly27]

Cool! Thanks! Gawd I wish you had been an instructor in my class. lol You really helped me understand. Thanks again!

[km5v6r, EdD, RN]

Glad to help. Any other questions?

[Tweety, BSN, RN]

Good answer from above.

Remember we are responsible for reporting changes and patient condition, even if the patient is asymptomic, especially changes that has the potential for further changes.

Suppose the patient crashed that evening and the MD found out there was a change that he/she wasn't aware of?

It's good that you're asking questions and gaining understanding. Good luck!