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Med Surg > Cardiac Rhythms > Flashcards

Cardiac Rhythms Flashcards

1
Q

An irregularity or disturbance of the normal electrical activity of the heart
abnormal rhythm

A

dysrhythmia

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2
Q

taking a breath causes what type of pressure

A

negative

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3
Q

steps in the cardiac conduction system

A

1) SA node initiates rate
2) AV node relays atrial impulse to ventricles
3) bundles of His
4) Purkinje fibers- ventricular myocardium

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4
Q

one square on EKG paper is how many seconds

A

0.04 sec and 1 mm

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5
Q

needed for the diagnosis of heart muscle damage, enlargement of a cardiac chamber, and interruption of some portions of the cardiac conduction system

A

12 Lead EKG

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6
Q

describe a 12 lead EKG

A

looks at heart from 12 different angles

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7
Q

a print-out of a single lead or view

A

rhythm strip

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8
Q

single lead usually is sufficient for identifying basic

A

dysrhythmias

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9
Q

used for constant 24-hour monitoring in intensive care situations

A

single leads

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10
Q

how do you calculate the rate on an EKG

A

count R complex in 6 sec strip and multiply by 10

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11
Q

easy way to remember telemetry

A

White on Right, Clouds over Grass; Smoke over Fire and Christmas Tree on the bottom

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12
Q

every 15 large blocks is how many seconds

A

3 sec

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13
Q

simple way to estimate rate

A

from one R to the next how far apart? Each large square

300, 150, 75, 60, 50, 43

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14
Q

are small pauses in heart rate normal

A

yes

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15
Q

Dubin’s method can only be used if

A

the rhythm is regular

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16
Q

depolarization of the chambers _____ their contraction

A

provokes

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17
Q

When the heart is resting between “beats”, the EKG machine draws a straight line on the paper

A

isoelectric line

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18
Q

first deflection in the normal cardiac cycle

A

p wave

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19
Q

what does the p wave represent

A

depolarization of the atria

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20
Q

why does the depolarization of the SA node appear on EKG

A

does not generate enough voltage to be seen on the EKG, we assume it occurred to initiate the cycle

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21
Q

After the p wave…

A

there is a brief return to the isoelectric line, then the QRS complex

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22
Q

what does QRS complex represent

A

depolarization of ventricles

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23
Q

does the QRS normally point upwards or downwards

A

could be either, but all the QRS complexes should be pointed in the same direction

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24
Q

what is the duration of the QRS complex

A

0.04- 0.12 sec or about 1-3 blocks

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25
Q

what does the T wave represent

A

reploarization of ventricles

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26
Q

is atrial repolarization seen on an EKG

A

no because the voltage is so low, however it occurd during the QRS complex

27
Q

what occurs during the PR interval

A

atria contract/depolarization

(0.12-0.20) or about 3-5 blocks

28
Q

what organs are nourished by blood first in circulation

A

heart and brain

29
Q

what three things do you look at when diagnosing heart dysrthythmias

A

rate, rhythm, complex

30
Q

a small increase in what electrolyte will cause the heart to stop

A

potassium (K)

31
Q

what are some typical causes of dysrhythmias

A

Hypoxia
Ischemia
Sympathetic stimulation- stress, trauma, CHF, hyperthyroidism
Medications-antiarrhythmics, bronchodilators, cardiac glycosides, etc.
Electrolyte disturbances- K, Ca and Mg
Stretch or hypertrophy

32
Q

describe a normal sinus rhythm

A

rate: 60-100 or about 75
rhythm: regular
PR: upright (0.16)
QRS: 0.06

33
Q

describe sinus bradycardia

A 
SLOW
rate: 23 or < 60
rhythm: regular
PR: 0.24
QRS: 0.12
34
Q

how do you treat sinus bradycardia

A

atropine or pacemaker

35
Q

describe sinus tachycardia

A 
FAST, poor fill time
rate: 150
rhythm: regular
PR: 0.16
QRS: 0.04
36
Q

describe premature atrial contraction (PACs)

A

not super concerning, just keep an eye on
*they are usually evident in atrial dysrthymias
P wave comes early
rhythm is irregular
PR: 0.16
QRS: 0.06

37
Q

describe atrial tachycardia

A

eventually if left untreated, lungs will fill with fluid
fast rate, cells are overriding the AV node
rate: 150-300
P wave: differs in shape
PR: short, < 0.12

38
Q

treatment for atrial tachycardia

A

beta blockers and calcium channel blockers

39
Q

describe supraventricular tachycardia (SVT)

A

rate: rapid about 160
cause SOB, chest pain
coming from atria

40
Q

what is SVT treated with

A

Metoprolol or *adenosine (slows heart)

41
Q

describe atrial flutter

A

hypertrophy of the heart
*all blood is not emptied out of heart
atrial rate: 250-300
*P waves look like FLUTTERS or SAW TOOTH

42
Q

what is used as treatment for many dysrhthmias if other measures don’t work

A

cardioversion therapy

43
Q

describe atrial fibrillation

A 
*most common dysrhythmia*
low blood pressure, SOB
"quivering", not kicking heart beat
no discernible Ps
rhythm: always IRREGULAR
rate: about 70
wavy baseline
44
Q

initial drug treatment for atrial fibrillation

A

Amiodarone

Dilitiazem

45
Q

broadly describe what heart block is

A

longer period from SV to AV

ALL types are slow (brady)

46
Q

describe first degree AV block

A

don’t do anything, just monitor
PR interval is prolonged (0.36)
rate is regular
bradycardic: 60

47
Q

another name for second degree Heart Block Mobitz type 1

A

Wenkebach

48
Q

describe 2nd degree Wenkebach

A

rate is slow, progressive*
rhythm is irregular
PR gets longer then drops a beat
(0.2 then 0.24 then 0.26 then drops beat)

49
Q

describe 2nd degree mobitz type 2

A

bundle branch delay

drops every other beat

50
Q

treatment for 2nd degree heart block

A

atropine: to speed up heart and trigger nerves

ONLY give 3 doses max

51
Q

treatment for dysrhythmias if pt has pulse

A

MEDICATION

52
Q

treatment for dysrhythmias if pt has NO pulse

A

*dead

compressions (30:2) THEN defib.

53
Q

describe 3rd degree heart block

A
  • NO coordination between atria and ventricles (INDEPENDENT of eachother)
    rhythm: 40-60
  • BAD: SOB, chest pain, dizziness
54
Q

treatment for 3rd degree heart block

A

pacemaker or atropine(sometimes)

55
Q

describe premature ventricular contraction (PVC)

A 
no P  wave preceding PVC
feels like a skipped beat
not very concerning unless couplet
weird looking beat
occur due to pain, fever or low O2
56
Q

describe couplet PVC

A

PVC occurring in pairs due to inadequate CO2

this is a problem when they occur in pairs

57
Q

describe ventricular tachycardia

A

rapid rate: 150
no Ps or QRS
cardiac output is decreased
heart is irritated

58
Q

treatment for ventricular tachycardia

A

if there is a pulse, then amiodarone

59
Q

what do you always do first BEFORE treatment of dysrhythmias

A

assess patient

60
Q

describe polymorphic

A

no P waves associated with QRS
poor cardiac output
QRS complexes occuring from different foci

61
Q

what is the procedure for V-fib if no pulse

A

1)epi 2) compressions 3) amiodarone 4) compressions

62
Q

describe V-fib

A

ALWAYS SHOCK- defib
no contraction of heart muscle
only twitching
no cardiac output/sudden death

63
Q

describe idioventricular

A

slow rhythm
no P or QRS waves
poor output

Med Surg (23 decks)

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