ALL EXAMS: EKGs Flashcards
what is this
what interventions
normal sinus rhythm
none
what is this
what interventions
Sinus bradycardia
Assess patient’s BP and for symptoms
- Atropine or pacemaker if symptomatic
what is this
what interventions
sinus tachycardia
treat underlying cause
what is this
what interventions
premature atrial complexes (PAC)
occasional = normal
Assess patient and check electrolytes
treat underlying cause (may be an early sign of HF, a-tach, or a-fib)
what is this
what interventions
Paroxysmal atrial tachycardia (PAT)
(multiple PACs)
Assess patient
treat underlying cause
- Digoxin (cardiac glycoside)
- cardizem (calcium channel blocker)
- beta-blockers (end in -lol)
- amiodarone (class III antiarrhythmic)
- adenosine (call V antiarrhythmic)
- oxygen
what is this
what interventions
Atrial Flutter
Assess patient, check for SOB or chest pain
- digoxin (cardiac glycoside)
- cardizem (calcium channel blockers)
- beta-blockers
- adenosine (class V antiarrhythmic)
- CARDIOVERSION
what is this
what interventions
Atrial fibrillation
Assess patient and count HR for 1 minute
<48 hours/unstable
- digoxin (cardiac glycoside)
- cardizem (calcium channel blocker)
- beta-blocker
- amiodarone (class III antiarrhythmic)
- CARDIOVERSION
> 48 hours/stable
- anticoagulants for 2-3 weeks, then cardioversion
what is this
what interventions
Premature ventricular contraction (PVC)
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
couplet
- two PVCs in a row
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
triplet
- three PVCs in a row
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
Ventricular tachycardia
Assess patient; check pulse, vitals, and LOC
Pulse and stable
- amiodarone (class III antiarrhythmic)
- cardizem (calcium channel blocker)
- Beta-blocker
- digoxin (cardiac glycoside)
- CARDIOVERSION
No pulse
- Defibrillation
- CPR
what is this
what interventions
Wolfe-parkinson white
- swooping Q-R
what is this
what interventions
Torsades de pointes
Assess patient
- IV magnesium
- may need cardioversion
what is this
what interventions
Ventricular fibrillation
Assess patient (pulse, vitals, LOC)
- DEFIBRILLATE
- CPR
what is this
what interventions
supraventricular tachycardia
Assess patient (vitals, LOC)
Lie patient flat in bed; call Dr. and stay with pt
If stable:
- vagal maneuvers (bear down, ice cold washcloths on face, deep cough)
If unstable:
- adenosine (class V antiarrhythmic)
- amiodarone (class III antiarrhythmic)
- cardizem (calcium channel blocker)
- verapamil (calcium channel blocker)
- CARDIOVERSION (if meds don’t work)
what is this
what interventions
Idioventricular rhythm
- slow rate
- regular rhythm
- no P wave
- inverted T wave
what is this
what interventions
Asystole
Assess patient (check pulse, LOC, and other leads on tele monitor)
Begin CPR
- epinephrine (alpha/beta-adrenergic agonist)
what is this
what interventions
bundle branch block
- double Q waves
what is this
what interventions
1st degree heart block (p waves farther than 0.2 from QRS)
Assess patient
May not need interventions
what is this
what interventions
Second degree type I (going, going…gone)
Assess patient
If symptomatic:
- atropine (anticholinergic)
- transcutaneous pacing
what is this
what interventions
Second degree type II
Assess patient
Immediate transcutaneous pacing
- oxygen
- atropine (anticholinergic) [usually doesn’t work] or epinephrine (alpha/beta-adrenergic agonist)
what is this
what interventions
Third degree (complete) heart block
Assess Patient
initiate transcutaneous pacing (if symptomatic)
- atropine (anticholinergic), epinephrine (alpha/beta-adrenergic agonist), or dopamine (+ inotrope)
- oxygen
what is this
what interventions
Sinus bradycardia
Assess patient’s BP and for symptoms
- Atropine or pacemaker if symptomatic
what is this
what interventions
supraventricular tachycardia
Assess patient (vitals, LOC)
Lie patient flat in bed; call Dr. and stay with pt
If stable:
- vagal maneuvers (bear down, ice cold washcloths on face, deep cough)
If unstable:
- adenosine (class V antiarrhythmic)
- amiodarone (class III antiarrhythmic)
- cardizem (calcium channel blocker)
- verapamil (calcium channel blocker)
- CARDIOVERSION (if meds don’t work)
what is this
what interventions
Atrial fibrillation
Assess patient and count HR for 1 minute
<48 hours/unstable
- digoxin (cardiac glycoside)
- cardizem (calcium channel blocker)
- beta-blocker
- amiodarone (class III antiarrhythmic)
- CARDIOVERSION
> 48 hours/stable
- anticoagulants for 2-3 weeks, then cardioversion
what is this
what interventions
sinus tachycardia
treat underlying cause
what is this
what interventions
Premature ventricular contraction (PVC)
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
Ventricular fibrillation
Assess patient (pulse, vitals, LOC)
- DEFIBRILLATE
- CPR
what is this
what interventions
PVC (bigeminy)
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
Third degree (complete) heart block
Assess Patient
initiate transcutaneous pacing (if symptomatic)
- atropine (anticholinergic), epinephrine (alpha/beta-adrenergic agonist), or dopamine (+ inotrope)
- oxygen
what is this
what interventions
premature atrial complexes (PAC)
occasional = normal
Assess patient and check electrolytes
treat underlying cause (may be an early sign of HF, a-tach, or a-fib)
what is this
what interventions
STEMI
what is this
what interventions
Ventricular tachycardia
Assess patient; check pulse, vitals, and LOC
Pulse and stable
- amiodarone (class III antiarrhythmic)
- cardizem (calcium channel blocker)
- Beta-blocker
- digoxin (cardiac glycoside)
- CARDIOVERSION
No pulse
- Defibrillation
- CPR
what is this
what interventions
Atrial fibrillation
Assess patient and count HR for 1 minute
<48 hours/unstable
- digoxin (cardiac glycoside)
- cardizem (calcium channel blocker)
- beta-blocker
- amiodarone (class III antiarrhythmic)
- CARDIOVERSION
> 48 hours/stable
- anticoagulants for 2-3 weeks, then cardioversion
what is this
what interventions
Atrial Flutter
Assess patient, check for SOB or chest pain
- digoxin (cardiac glycoside)
- cardizem (calcium channel blockers)
- beta-blockers
- adenosine (class V antiarrhythmic)
- CARDIOVERSION
what is this
what interventions
premature atrial complexes (PAC)
occasional = normal
Assess patient and check electrolytes
treat underlying cause (may be an early sign of HF, a-tach, or a-fib)
what is this
what interventions
PVCs
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
Torsades de pointes
Assess patient
- IV magnesium
- may need cardioversion
what is this
what interventions
Ventricular paced
none
what is this
what interventions
short run of PVCs
Assess patient and monitor; correct underlying cause/electrolyte imbalance
occasional = okay
more than 6/min or close to T wave = bad
Drugs
- amiodarone (class III antiarrhythmic)
- oxygen
what is this
what interventions
idioventricular
(notice inverted T waves)
what is this
what interventions
Ventricular fibrillation
Assess patient (pulse, vitals, LOC)
- DEFIBRILLATE
- CPR
what is this
what interventions
Asystole
Assess patient (check pulse, LOC, and other leads on tele monitor)
Begin CPR
- epinephrine (alpha/beta-adrenergic agonist)
what is this
what interventions
1st degree heart block
(p waves farther than 0.2 from QRS)
Assess patient
May not need interventions
what is this
what interventions
Paroxysmal atrial tachycardia (PAT)
(multiple PACs)
Assess patient
treat underlying cause
- Digoxin (cardiac glycoside)
- cardizem (calcium channel blocker)
- beta-blockers (end in -lol)
- amiodarone (class III antiarrhythmic)
- adenosine (call V antiarrhythmic)
- oxygen
what is this
what interventions
Second degree type II
Assess patient
Immediate transcutaneous pacing
- oxygen
- atropine (anticholinergic) [usually doesn’t work] or epinephrine (alpha/beta-adrenergic agonist)
what is this
what interventions
AV paced
none
what is this
what interventions
Second degree type I (going, going…gone)
Assess patient
If symptomatic:
- atropine (anticholinergic)
- transcutaneous pacing
what is this
what interventions
Third degree (complete) heart block
Assess Patient
initiate transcutaneous pacing (if symptomatic)
- atropine (anticholinergic), epinephrine (alpha/beta-adrenergic agonist), or dopamine (+ inotrope)
- oxygen
