Introduction: Advancing Telemetry Skills for Complex Patients (08:29)
Marcia Gamaly polls participants on nursing fields, outlines lecture topics, and discusses her professional background.
Telemetry Nursing Overview (11:33)
Gamaly presents a scenario in which an alcoholic and atrial fibrillation patient expires due to aspiration and nursing oversight. Hear examples of arrthythmias. Gamaly discusses the importance of learning from mistakes.
Cardiology Basics (28:28)
Gamaly discusses heart anatomy and function; hear the origin of "coronary circulation." She reviews EKG wave forms, heart rate calculations and rhythm interpretations. Hear tips on placing telemetry pack leads and learn about normal sinus conduction and automaticity.
Sinus Rhythms (19:27)
Gamaly discusses assessing and monitoring sinus bradycardia, tachycardia and arrhythmia from different EKG leads and treating underlying conditions. View a video on placing cardioversion pads.
Atrial Rhythms (18:34)
Gamaly discusses how to identify and manage ectopic beats and pacemakers, including PACs, WAPs, multi-focal atrial tachycardia and atrial flutter. Hear how to distinguish sinus from atrial tachycardia on an EKG. View a video on cardioverting an atrial tachycardia patient.
Atrial Fibrillation (10:15)
Gamaly explains how to identify and manage the atrial dysrhythmia, including distinguishing controlled from uncontrolled states. Learn about causes and complications. Hear a cardioversion patient scenario.
Junctional Rhythms (08:25)
Gamaly explains how to identify and manage junctional dysrhythmias including PJCs, junctional escape complexes, and junctional tachycardia.
Ventricular Rhythms (26:34)
Gamaly discusses when and how to treat PVCs. Learn about identifying and managing accelerated idioventricular rhythm, ventricular tachycardia, and torsade. Hear ways to improve EKG reading quality and view a video on shocking pulseless patients.
ST Segment Patterns (06:18)
Gamaly explains how to read isoelectric ST segments, segment depression, and inverted and elevated T waves.
Heart Blocks (20:14)
Learn about identifying and managing first degree AV, second degree type 1, second degree type 2, and complete heart blocks. Complete heart blocks are often confused with bradyarrhythmia or slow atrial fibrillation. View a video on using a Lifepak to shock, cardiovert or pace patients.
Gamaly discusses temporary transcutaneous, temporary transvenous, permanent transvenous, and epicardial pacemaker indications and types. Learn about chamber sensing, pacer overriding, and AICD interaction. Gamaly explains how to use a pacer and walks through reporting from sample rhythm strips.
Neck Surgery Misassessment Cases (08:30)
Gamaly discusses a scenario in which an anterior cervical discectomy patient died suddenly of a hematoma occluding his airway. A nurse ordered a cough suppressant for a thyroidectomy patient, missing her hematoma signs.
Prepping Patients (12:23)
Gamaly describes a scenario for preparing for a downgraded hemothorax ICU patient. She discusses flushing IV lines, finding veins and ABCDE assessments. View a video on oxygen modalities in titration and weaning of oxygen.
Assessing and Reassessing (07:52)
Gamaly discusses assessing patients while walking by their room. She discusses a scenario in which a coronary artery disease patient develops ventricular tachycardia and walks through an ACLS protocol.
Chest Pain Pathophysiology (16:55)
Gamaly explains atherosclerosis, coronary artery disease, and acute coronary syndrome causes and risk factors. Learn about unstable angina, non-STEMI, and STEMI wave form changes.
Chest Pain Assessment (12:41)
Learn about typical and atypical MI clinical presentation signs. Angina is a CAD symptom due to ischemia; types include Prinzmetal's, stable, and unstable. Gamaly discusses assessing a chest tube patient draining 200 ccs of blood.
Diagnostic Testing (12:03)
Unstable angina patients require an EKG and may require diagnostic catherization; acute MI patients require cardiac enzymes. Gamaly discusses interventions and heart failure caused by fluid-overloading post-op patients. Learn about preventing complications and reducing pain.
Angina Code and Cardiac Markers (21:05)
Obese children are requiring statins. Gamaly discusses a scenario in which a patient stops breathing; learn about proper bagging techniques during CPR. Learn about collateral circulation in reoccurring MIs, cardiac enzyme timing in cell membrane leakage, and using cardiac markers diagnostically.
Acute Coronary Syndrome Treatment (08:17)
Cardiac catheterization visualizes artery anatomy and architecture. Gamaly explains PCIs, including intracoronary stents and balloon angioplasties, and discusses outpatient care.
Vascular Access Site Complications (31:38)
Learn about identifying and managing hematomas, retroperitoneal hemorrhages, pseudoaneurysms, AV fistulas, and infections following PCIs. See videos on applying femoral puncture site pressure bands and radial management systems to maintain homeostasis. Gamaly discusses the vasovagal response when releasing pressure.
Heart Failure (15:11)
Gamaly explains heart failure phases and symptoms, including fluid overload. Diagnostic tests include x-rays, EKG, CBC, urinalysis, and BNP, an acute CHF marker. Learn about management, monitoring, and patient education.
Coronary Artery Disease Medications (30:52)
Learn about uses, side effects, and monitoring measures for antiplatelets, anticoagulants, beta blockers, nitrates, morphine, end-tidal CO2, ACE inhibitors, adenosine, atropine, epinephrine, dofetilide/Tikosyn, amiodarone, Cardizem, ARBs, diuretics, digoxin, vasodilators, and serum magnesium. Hear GI bleed and morphine metabolite toxicity scenarios.
Patient Management Trends (19:53)
See videos on wearable defibrillators, left ventricular assist devices, and left atrial appendage closure devices. Gamaly discusses patients with positive and negative LVAD reviews. Hear a brief summary of caring for heart disease patients.
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