March 2008 NCLEX support group

[Silverdragon102]

A thread for all those in March who are planning to take the NCLEX offering both support and any hints or tips that help

Good luck to all

[igmirnor]

Hi

could someone explain about heart blocks as simply as they can??? never can tell the difference... also do you guys think its important???..I have trouble with those..

[pinksunRN]

There are four concepts that make learning the blocks easier.

1) The heart has a triple redundancy backup system in case of failure. In other words if the sino-atrial node gives out then the Atrio-ventricular node can take over. If the A-V node fails then the ventricles have an inherent rhythm. Why doesn't the heart get confused? Because it has a simple rule - follow the fastest. The inherent rate of the SA node is 60-100 beats/minute the A-V node is 40 - 60 beats per minute the ventircles are even slower at around 30 -50 beats pe minute.

Here is an ecample of a rhythm originating from the A-V node. This is known as a nodal or junctional rhythm.

actually the site that came from is worth a visit http://www.cyber-nurse.com/veetac/cham5.htm

2) Both the sino-atrial node and the atrio-venticular node are so important to the heart that they have thier own dedicated arterioles. This is why there can be ischemia around the A-V node but it can remain unaffected.

3) The A-V node is not only the pathway allowing impulse conduction from the atria to the ventircles it is the only access point as the atria and the ventricles are divided by a firm sheet of fibrous tissue that is like a sheet of rubber.

4) Ischemia can act to slow conduction of impulses. Infarction causes scar tissue which is non conductive to impulses.

So the blocks include:-

1 st degree block - prolongation of the P-R interval.

http://www.rnceus.com/ekg/ekgframe.html

2nd degree block there are two types called type 1 and type 2.

2nd Degree heart block type 1 also known as mobitz 1 or weinkebach ( confused? join the club)

This is where the conduction of the p wave sets up an increase in the resistance of the tissue so that the next impulse takes longer to go from the SA node to the A-V node. This reistance increases and the P-R interval increases until the p wave cannot get through and there is a p wave without a ventricular response.

http://www.rnceus.com/ekg/ekgframe.html

The mental image I get is of a group of sheep jumping a gate. The first sheep sails over the gate easily but it's back hoof kicks the top bar and makes it higher so the next sheep really struggles to get over and his struggles set the top bar even higher and the poor next sheep can't get through at all and wanders off. In the meantime the top bar drops back down to where it was before the sheep came:)

Second degree heart block type II also known as Mobitz II is where there are unconducted p waves. This can be a pattern of 2 P waves to 1 ventricular response or it could be more as is shown on the example

http://www.rnceus.com/ekg/ekgframe.html

Third degree block is where there is no communication between the atria and the ventricles

http://www.rnceus.com/ekg/ekgframe.html

got this from a post by gwenith

https://allnurses.com/forums/f15/cheaters-shortcuts-rhythm-interpretation-39872-2.html

[igmirnor]

OR2Ca

:thankya:.....thanks..love the sheep idea LOL....nicely explained....revising lead placements in ECG rt now....

[pinksunRN]

OR2Ca

:thankya:.....thanks..love the sheep idea LOL....nicely explained....revising lead placements in ECG rt now....

i was just resourceful hehehe:) by the way, is it alright to do this even without asking permission from the one who posted it???

[halayne]

tpa = [color=#0000cc]tissue plasminogen activator (tpa)

thanks a lot 4 the info.:cheers:

[halayne]

What does DOC mean? What is DM on the webpage you mentioned above? Does anybody know? Thanks

DOC means drug of choice:cheers:

[igmirnor]

I think if something is not right ... the forum moderators will normally either blank it out or send you a pm saying it is not allowed but I think this is allowed as we are just posting what is available to everyone world over... just my take on it..

[ava'smomRN]

hey guys! i am finished my kaplan course. i passed the readiness test!!!! I am now just waiting for my ATT. I drop off my paperwork and my director should mail it off by friday. i already paid o sign up pearson so i hope that will speed things up.

my plan now is to do 100q a day with kaplan. i also have lippincott and saunders. i still have most of my notes from my last semester and will share them if you all like(if its legal). they are powerpoints from class.

i will do my best to sign up for a system to post, but all the good ones are taken. lol

be back later guys

[pinksunRN]

OR2Ca

:thankya:.....thanks..love the sheep idea LOL....nicely explained....revising lead placements in ECG rt now....

Originally Posted by jgwe4e

Re ekg lead placement:

White on the right, smoke (black) over fire (red)

I learned this in a similar manner: Snow(white) over grass (green), Smoke (black) over fire (red), and a big pile of poop(brown) in the middle.

I like your "white on right" thing

the 2 posts were taken from https://allnurses.com/forums/f205/mnemonics-memory-aids-146408-5.html

i hope you find these useful as I did:specs:

[wishiwereanurse, BSN, RN]

Hi guys, are we doing cardio meds today?

Here's a pharma slide I found on the web to help study with cardio drugs...

:w00t:

[gwafuh_rn, BSN, RN]

Hi guys, are we doing cardio meds today?

Here's a pharma slide I found on the web to help study with cardio drugs...

:w00t:

thanks for the info wishiwereanurse

[Parameduck]

got this from a post by gwenith

https://allnurses.com/forums/f15/cheaters-shortcuts-rhythm-interpretation-39872-2.html

OR2CA,

This is good information that you've posted, but how does this knowledge translate to what you would see on a rhythm strip for a patient with an AV block?