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4093 6 Flashcards

1
Q

What are 3 of the ways we evaluate an ECG

A

P wave shape
P R interval
QRS complex duration and shape

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2
Q

Where do you find the PR interval on the strip

A

from the beginning of the P to the beginning of the Q

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3
Q

The size of the PR interval reflects the

A

amount of time from the start of atrial depolarization to the start of ventricular depolarization

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4
Q

The normal time for PR interval is:

A

0.12 – 0.20 seconds (3 to 5 small boxes)

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5
Q

or the most part, Sinus dysrhythmias either effect the

A

rate or rhythm. The other stuff will be normal. So sinus dysrhythmias look similar to NSR

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6
Q

Sinus Rhythm is the only rhythm when

A

each of the five steps of rhythm analysis are “normal”

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7
Q

1500 method

A

count the little boxes between the peaks and divide into 1500

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8
Q

If Sinus tachycardia gets really fast, which one of the measurements are you unable to do

A

you can’t do the PR interval because the P is overtaken by the preceding T

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9
Q

Sinus Dysrhythmia often occurs as a

A

normal variant (can be in young people, athletes)

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10
Q

Sinus Dysrhythmia is frequently related to ____ and

A

breathing and pressure on the vagas nerve

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11
Q

Sinus Arrest occurs when

A

there’s sudden absence of electrical activity starting in the SA node

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12
Q

Sinus Arrest: A pause of ___-seconds is considered a medical emergency

A

six-seconds

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13
Q

Sinus Exit Block looks very much the same as

A

Sinus Arrest with one important distinction: with Sinus Exit Block the pause is a direct multiple of the R to R interval of the underlying rhythm. So it’s more orderly

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14
Q

PAC’s occur when

A

an early electrical impulse occurs from a location in the atria other than the SA node

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15
Q

PAC’s occur when an early electrical impulse occurs

A

from a location in the atria other than the SA node

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16
Q

PAC: because the signal is being fired from somewhere unusual, it results in a change in the shape of the

A

P wave (the shape might be fine, but it could be bisphasic)

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17
Q

The P wave with PAC’s will always be

A

upright

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18
Q

PAC: the R to R intervals could be

A

irregular

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19
Q

Atrial Flutter occurs when there is an obstruction within the

A

atrial electrical conduction system

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20
Q

Atrial Flutter occurs when there is an obstruction within the atrial electrical conduction system. Due to this impediment a series of

A

rapid depolarizations occur.

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21
Q

Atrial Fibrillation: P waves

A

are absent

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22
Q

What measurement can you not do in Atrial Fibrillation

A

PR interval (because there’s no P wave)

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23
Q

Atrial Fibrillation: rapid electrical activity overwhelms the AV node causing impulses to

A

enter the ventricular conduction system at irregular points. This results in irregular R to R intervals.

24
Q

Many times when a patient has “new onset” Atrial Fibrillation the patient will report with a heart rate of

A

160 bpm or more

25
Q

Atrial Fibrillation: When we say “Not all fibrillatory waves are created equal” what does that mean

A

some are coarse (big) and some are fine (small)

26
Q

Atrial Fibrillation: This absence of contraction of the atria can result in a loss of cardiac output anywhere from 15 - 30% due to the absence of

A

atrial kick

27
Q

Atrial Fibrillation: its impossible to determine the ___ rate on the ECG

A

atrial rate (because it’s just quivering)

28
Q

Atrial Fibrillation with a ventricular response in excess of 100 bpm is commonly referred to as Atrial Fibrillation with “rapid ventricular response” or

A

uncontrolled A-fib

29
Q

When analyzing a rhythm strip, it qualifies as being regular when

A

the PR interval measures the same

30
Q

besides Asystole and Ventricular Fibrillation, the remaining ventricular rhythms typically have 2 key features

A

no P wave

will display a wide, bizarre QRS complex (measuring 0.12 seconds or greater)

31
Q

Unifocal – abnormal complexes are of the same shape

A

all of the abnormalities have only ONE shape

32
Q

Multifocal

A

the abnormalities have more than one shape

33
Q

Bigeminy

A

abnormal complexes occur every second complex

34
Q

PVC’s occur when

A

an early electrical impulse occurs from a location in either ventricle

35
Q

PVC: The locus of stimulation being different, results in

A

a change in the morphology of the cardiac complex.

36
Q

Ventricular Tachycardia: P wave

A

absent

37
Q

Ventricular Tachycardia: QRS

A

wide, bizzare

38
Q

at the onset of ventricular tachycardia, approximately 50% of patients

A

become unconscious

39
Q

Although patients in V Tach may be treated with a defibrillator,

A

not all patients in Ventricular Tachycardia require this level of treatment

40
Q

Ventricular Tachycardia: Depending upon their level of consciousness and blood pressure, the patient may be treated with

A

medications, synchronized cardioversion

or in the worst case scenario a defibrillator and BLS/ACLS response.

41
Q

V fib: QRS

A

absent

42
Q

V fib: Fibrillatory waves may be

A

coarse or very fine

43
Q

The longer V Fib occurs, the smaller

A

the waveforms are likely to be

44
Q

First degree heart block is actually a

A

delay rather than a block

45
Q

First degree heart block finding

A

PR Interval will be longer than normal (over 0.20 sec)

46
Q

With second degree heart block, Type I, some impulses

A

are blocked but not all

47
Q

Second Degree Heart Block Type II (both of the main traits)

A

the impulse is blocked in the bundle of His.

Every few beats there will be a missing beat but the PR Interval will not lengthen

48
Q

Second Degree Heart Block Type II: the impulse is

A

blocked in the bundle of His.

49
Q

Second Degree Heart Block Type II: For every few beats there will be

A

a missing beat but the PR Interval will not lengthen

50
Q

Second Degree Heart Block Type 1: More P waves can be observed vs

A

QRS Complexes (which makes sense because eventually a p wave impulse doesn’t go through so you’re missing a QRS)

51
Q

Second Degree Heart Block Type 1: Each successive impulse undergoes

A

a longer delay

52
Q

Second Degree Heart Block Type 1: the next impulse is blocked after

A

3 or 4 beats the next impulse is blocked

53
Q

Second Degree Heart Block Type 1: PR Intervals will lengthen progressively with each beat until

A

a QRS Complex is missing

54
Q

Third Degree Heart Block

A

no atrial impulses are transmitted to the ventricles

55
Q

Third Degree Heart Block: no atrial impulses are transmitted to the ventricles. As a result

A

the ventricules generate an escape impulse, which is independent of the atrial beat.

56
Q

In most cases the atria will beat at 60-100 bpm while the ventricles asynchronously beat at 30-45 bpm.

A

Third Degree Heart Block

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