Ventricular Fibrillation (V Fib)

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Maria Stewart
BSN,RN,CCRN, CMSRN
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Included In This Lesson

Study Tools For Ventricular Fibrillation (V Fib)

Parts of EKG waveform (Image)
Ventricular Fibrillation (Image)
10 Common EKG Heart Rhythms (Cheatsheet)
EKG Chart (Cheatsheet)
EKG Electrical Activity Worksheet (Cheatsheet)
Heart Rhythms Signs and Symptoms (Cheatsheet)
Heart Rhythm Identification (Cheatsheet)
Hs and Ts of ACLS (Cheatsheet)
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Outline

Overview

  1. Ventricular Fibrillation
    1. Multiple unorganized electrical signals in the ventricles
      1. Causing the ventricles to quiver
        1. Wavy lines
      2. Heart not able to pump blood out
        1. Zero cardiac output
      3. Life threatening emergency
        1. Cardiac arrest

Nursing Points

General

  1. Characteristics of Ventricular fibrillation
    1. Rhythm
      1. Irregular
    2. Rate
      1. Not measurable
    3. P:QRS ratio
      1. Not measurable
    4. PR interval
      1. Not measurable
    5. QRS complex
      1. Not measurable

Assessment

  1. Patient Presentation
    1. Cardiac arrest
    2. Will NEVER have a pulse!

Therapeutic Management

  1. Nursing Interventions
    1. CPR
  2. Follow ACLS guidelines
    1. CPR
    2. Defibrillate
    3. Epinephrine
    4. Amiodarone

Nursing Concepts

  1. EKG Rhythms
  2. Perfusion

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Transcript

So in this lesson we are going to talk about ventricular Fibrillation or V-Fib. It is a very important rhythm to understand because patients in V-fib are in cardiac arrest and we need to do something immediately or they will die! When you see this rhythm, they will go asystole if we don’t treat it. So let’s talk about V-fib.

So in ventricular fibrillation the ventricles are quivering and absolutely no cardiac output there is usually no pulse. So since the ventricles are just sitting there quivering, they are not contracting, there is absolutely no cardiac output and no pulse. So CPR must be initiated immediately. This rhythm is very common in patients that are having a heart attack or have severe coronary artery disease. If left untreated, people will go into asystole and just die. Let’s talk about the characteristics for v-fib.

It’s pretty simple to do cause there is not much to it! The rhythm is irregular, remember the heart is erratically quivering, there is no way to measure a heart rate, there are no P waves so there is not a P to QRS ratio, the PR interval is not measurable and you cannot really count the QRS complex. There is no QRS complex since the heart is just quivering it is not measurable. In step 6, it is obviously V-fib. It is one of those rhythms that you need to make a jump for it and you need to prepare to start CPR, bring the defibrillator and call a code.

So people in V-fib have no cardiac output they are in cardiac arrest, they are dying! The priority nursing interventions are to follow the ACLS guidelines, confirm there is not a pulse and start CPR right away. Defibrillate as soon as possible, it is the only chance they have of going into a normal sinus rhythm. Epinephrine every 3-5 minutes and then Amiodarone bolus and drip. However early defibrillation is the best treatment. So as soon as you see this rhythm, you start CPR, call a code, defibrillate them and give meds and hopefully you will bring the patients back.

So the key points to remember from this lesson are the abnormalities regarding Ventricular fibrillation. The ventricles are quivering and fibrillating, there is no cardiac output so the patients in V-fib are in cardiac arrest. Nursing interventions are to follow the ACLS guidelines immediately and start CPR, defibrillate asap and administer medications. This cycle is repeated every 2 minutes or until the code is called and CPR is terminated or hopefully the patient has regained a pulse. V-fib is not one of those rhythms that you wait to see if this is really happening, you need to take action right away!

I hope you guys have enjoyed this quick lesson regarding V-Fib and feel more comfortable knowing what to do when you see this rhythm. Make sure you check out all of the resources attached to this lesson. Now, go out and be your best self today! And, as always, happy nursing!

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NCLEX Prep A

Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
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  • Disorders of the Adrenal Gland
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
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  • Childhood Growth and Development
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  • Labor Complications
  • Disorders of the Thyroid & Parathyroid Glands
  • Pregnancy Risks
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  • Basic
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  • Fundamentals of Emergency Nursing
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  • Circulatory System
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  • Emergency Care of the Cardiac Patient
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  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
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  • Newborn Complications
  • Neurologic and Cognitive Disorders
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Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Addisons Disease
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Nursing Care and Pathophysiology for Cushings Syndrome
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Disseminated Intravascular Coagulation (DIC)
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Thrombocytopenia
Blood Transfusions (Administration)
Growth & Development – Preschoolers
Nursing Care and Pathophysiology for Hyperthyroidism
Preload and Afterload
Growth & Development – School Age- Adolescent
Nursing Care and Pathophysiology for Hypothyroidism
Legal Considerations
Performing Cardiac (Heart) Monitoring
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Gestation & Nägele’s Rule: Estimating Due Dates
Nursing Care and Pathophysiology of Angina
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Leukemia
Diabetes Management
Lymphoma
Nursing Care and Pathophysiology of Myocardial Infarction (MI)
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Fundal Height Assessment for Nurses
Injectable Medications
Oncology Important Points
Somatoform
Nursing Care and Pathophysiology of Coronary Artery Disease (CAD)
Fall and Injury Prevention
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Normal Sinus Rhythm
Physiological Changes
Sickle Cell Anemia
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Discomforts of Pregnancy
Nursing Care and Pathophysiology for Heart Failure (CHF)
Sinus Bradycardia
Nursing Care and Pathophysiology for Anaphylaxis
Antepartum Testing
Hemophilia
Sinus Tachycardia
Nutrition in Pregnancy
Pacemakers
Atrial Fibrillation (A Fib)
Premature Ventricular Contraction (PVC)
Ventricular Tachycardia (V-tach)
Ventricular Fibrillation (V Fib)
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nursing Care and Pathophysiology of Hypertension (HTN)
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
Nursing Care and Pathophysiology for Cardiomyopathy
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Nursing Care and Pathophysiology for Thrombophlebitis (clot)
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Overview of the Nursing Process
Dehydration
Fetal Development
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Cardiogenic Shock
Fetal Environment
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Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
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Defense Mechanisms
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Overview of Developmental Theories
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Bronchiolitis and Respiratory Syncytial Virus (RSV)
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Hemodynamics
Proton Pump Inhibitors
Schizophrenia
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)