Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Acute - EKG strips (Exam 2) > Acute - EKG strips > Flashcards

Acute - EKG strips Flashcards

1
Q

QRS complex represents which period of time

A

ventricular depolarizaion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

EKG - ischemia

A
  • lack of oxygenation
  • „ ST segment depression or T wave inversion
  • REVERSIBLE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

EKG - injury

A

-„ prolonged ischemia
„- ST segment elevation
- REVERSIBLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

EKG - infarction

A
  • death of tissue IRREVERSIBLE
    Earliest stage: T wave (tall & narrow); symmetrical T wave inversion

Next stage: ST segment elevation; ST segment depression

Last stage: may or may not show a Q wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

depolarization

A

spread of electrical impulse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

repolarization

A

returning to resting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

length of PR interval

A

0.12 - 0.20 sec (3 -5 boxes)

atrial depolarization and spread of impulse to AV node, Bundle of His, RBB and LBB, and Purkinje fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

QRS complex

A

< 0.12 sec (3 squares)

ventricular depolarization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ST segment

A

end of ventricular depolarization
beginning of ventricular repolarization
normally - flat line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ST segment - elevated

A

> 1-2 mm elevation

–> myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ST segment - depressed

A

> 0.5 mm depression

  • -> mycardial ischemia
  • -> if a “dip” – digoxin toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

T wave

A

ventricular repolarization

- normal is slightly asymmetrical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

abnormal T wave - inverted

A

myocardial ischemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

abnormal T wave - peaked

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

U wave

A
  • sometimes follow T wave

- prominent U waves (> 2 mm) = hypokalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

sinus tachycardia (100-160) - causes

A
  1. increased sympathetic stimulation
    - stress, anxiety, fever, exercise, pain, sepsis, hyperthyroidism, drugs
  2. drugs that increase sympathetic tone:
    - epinephrine, atropine, caffeine, alcohol, nicotine, cocaine, aminophylline, thyroid meds
  3. low cardiac output states - cardiac arrest, shock, hypovolemia
  4. low oxygen states - COPD, asthma, PE, MI
  5. drugs that decrease parasympathetic tone - see #2
17
Q

sinus bradycardia (40-60 bpm) - causes

A
  1. decreased sympathetic tone
  2. increased parasympathetic tone
  3. drugs - beta adrenergic agents, CCB, digitalis
  4. other causes - Lyme disease, hypothyroidism

⇡↓

18
Q

sinus brady - treatment

A 
only treat if symptomatic (↓ BP, ⇡ cap refill, 
↓ LOC)
1. atropine
2. pacemaker (transcutaneous/transvenous = temporary)
3. D/C meds that cause rhythm
4. Dopamine (if hypotensive)
5. O2
6. Chronic = permanent pacemaker
19
Q

premature atrial contraction - causes

A
  • excess stimulation (caffeine, nicotine, alcohol)
  • electrolyte imbalance
  • heart disease (MI, atrial stretch)
  • sypathomimetic drugs (epinephrine, amphetamines, digitalis)
  • others (stress, fatigue, anxiety, inflammation, infection)
20
Q

PACs - treatment

A

no treatment - eliminate or treat cause
monitor pt - 3 or more consecutive = atrial tach
can be a precursor to A. Fib, A. Flutter of PSVT (aka atrial tachycardia)

21
Q

paroxysmal atrial tachycardia

A

rate: 150-250 bpm
starts and/or ends abruptly

treatment: adenosine (Initial dose: 6 mg given as a rapid intravenous bolus (administered over a 1-2 second period).

Repeat administration: If the first dose does not result in elimination of the supraventricular tachycardia within 1-2 minutes, 12 mg should be given as a rapid intravenous bolus

22
Q

atrial tachycardia - treatment

A

STABLE:

  1. vagal maneuvers - will stim baroreceptors to stim parasym system (carotid massage, bear down (Caution - can cause “rebound” tachycardia or severe bradycardia)
  2. adenosine IV
  3. CCB, BB, digtalis (but don’t combine)
  4. cardioversion
  5. antiarrhythmics

UNSTABLE:
- require immediate synchonized cardioversion

23
Q

atrial flutter

A 
sawtooth
rhythm: reg or irreg
rate: 250-400
can be in 2:1, 3:1, 4:1 ratio
PR interval - not measurable

Risk for: stasis of blood –> mural thrombi (formed in atria)

24
Q

adenosine

A
  • antiarrhythmic
  • given for PSVT when vagal maneuvers don’t work
  • administered over a 1-2 second period, followed by saline flush
25
Q

atrial flutter – treatment

A
  1. Control the ventricular rate - (if ventr rate is <100 = controlled) CCB (diltiazem), BB, Digitalis
  2. If A. flutter < 48 hrs = cardioversion
  3. if A. flutter > 48 hrs = chance of thrombi formed, so TEE first to check, then cardioversion
    - anticoags
  4. If hemodynamically unstable = (if ventr. rate >100) = cardioversion
26
Q

atrial fibrillation

A

rhythm: irregular/chaotic
rate: > 400 (atria quivers); ventri rate varies

ventricular rate:
< 100 = controlled
> 100 = uncontrolled A. fib or A. fib w/rapid ventricular response

27
Q

A. fib treatment

A

SAME TREATMENT AS A. FLUTTER W/EXCEPTION OF AMIODARONE

  1. Control rate = Digoxin, CCB (diltiazem), BB
  2. Amiodarone = if < 48 hour onset
  3. A. fib < 48 hours = cardioversion
  4. A. fib > 48 hours = TEE to r/o mural thrombi, then cardioversion
  5. if hemodynamically unstable = cardioversion

Chronic A. fib = control ventricular rate; anticoags

28
Q

amiodarone (Cordarone)

A

antiarrhythmic

treatment for ventricular arrhythmias

29
Q

premature ventricular tachycardia

A

QRS = wide, distorted, bizarre, notched
Can be:
1. single
2. bigeminal - every other
3. trigeminal - every 3rd
4. quadrigeminal - every 4th
5. pairs - 2 in a row
6. runs - many in a row = > 3 = ventri. tachycardia
7. unifocal - comes from one area/same pattern
8. multifocal - different look/comes from different area of ventricle

30
Q

causes of ventricular dysrhythmias

A
  1. age = ⇡
  2. sympathetic stimulation = infection, surgery, stress, nicotine, caffeine, alcohol
  3. certain drugs = anesthesia, sympathomimetic agents
  4. heart disease = chronic HF, COPD
  5. anemia, hypokalemia, hypomagnesemia
31
Q

PVC treatment

A

asymptomatic - no treatment

symptomatic - treat underlying cause
= electrolyte imbalance/acid-base/O2

Treat if any/several are present:

  • more than 5-6 PVC/min
  • multifocal PVCs
  • paired PVCs (couplet)
  • R on T phenom
  • short bursts of V. Tach (run of 3
32
Q

V. Tach

A

lethal dysrhythmia

QRS = wide, bizarre

33
Q

V. Tach treatment

A

No pulse = DEFIBRILLATE

Stable and pulse =

  1. Codarone (amiodarone)
  2. Lidocaine
  3. Procainamide
  4. Cardioversion = to get back good rhythm

Unstable w/a pulse (⇡ RR, ↓ PO2, chest pain, seizures, cool/clammy skin, hyperventilation, change in LOC = shock symptoms)

  1. Cardioversion (sedate if possible)
  2. Lidocaine or Cordarone (to prevent recurrence)
34
Q

V. fibrillation

A

Lethal dysrhythmia / #1 cause of cardiac arrest w/acute MI

35
Q

V. fibrillation treatment

A

1st = check another lead/check pulse

No pulse/unconscious

  1. V. fib = defib
  2. CPR, IV line, intubate
  3. Medications = epinephrine, vasopressin, cordarone, lidocaine, procainimide, Magnesium
36
Q

ventricular standstill (asystole) treatment

A

Always: CHECK PULSE

DO NOT defibrillation - there’s no electrical activity

CPR 
IV
intubate
Transcutaneous pacing
epinephrine
atropine
37
Q

cardioversion - when?

A

SYNCHRONIZED: delivers shock during ventricular DEpolarization (on R wave)

When:

  1. supraventricular tachy
  2. A. fib
  3. A. flutter
  4. unstable V. tach w/a pulse
38
Q

defibrillation - when?

A
  1. pulseless V. tach
  2. V. fib
  3. sustained Torsades de Pointes (unstable V. tach w/ a pulse)
39
Q

defibrillation - patient safety issues

A
  1. correct ID dysrhythmia
  2. remove transdermal med patches - can cause burns
  3. don’t use too much gel - burns
  4. paddles cleaned after each use

Acute - EKG strips (Exam 2) (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions