Ch. 18 Eagans Test 2

Question 1

An electrocardiogram (ECG)i is a popular

Answer 1

tool b/c it is inexpensive, noninvasive, and easy to obtain

Question 2

What is depolarization

Answer 2

active contraction

Question 3

What is repolarization

Answer 3

relaxtion

Question 4

Atrial depolarization is seen as

Answer 4

P wave

Question 5

How long is the pwave

Answer 5

no more 2.5 mm high and 3 mm long

Question 6

Ventricular depolarization is seen in

Answer 6

QRS complex

Question 7

A normal QRS complex is not wider than

Answer 7

3 mm (0.12 second)

Question 8

How long is the PR interval

Answer 8

no longer than 0.20 seconds

Question 9

ECG large box paper

Answer 9

(5mm x 5mm)= 20 sec

Question 10

ECG small box

Answer 10

( 1mm x 1mm)= 0.04 sec

Question 11

When is an inverted T wave often seen?

Answer 11

Myocardial damage

Question 12

What are the 3 most dangerous arrhythmias

Answer 12

• V-fib
• Atrial fib
• Thrid degree heart block

Question 13

What are the 7 Hs of PEAs

Answer 13

• Hypovolemia
• Hypoxia
• Hyperchloromia
• Hypocholormia
• Hypothermia
• Hypoglycemia
• Hydrogen ions (severe acidotic state)

Question 14

What are the 6 T of PEAs

Answer 14

• Trauma
• Tension pneumothorax
• Toxins
• Tamponade (Cardiac)
• Thrombosis (coronary)
• Thrombosis (pulmonary)

Question 15

What is Sinus Tachycardia

Answer 15

HR exceeds 100/min at rest

Question 16

What are some common findings in pts w sinus tachycardia (5)

Answer 16

• pain
• anxiety
• fever
• hypovolemia
• hypoxia
• certain meds (bronchodilators)

Question 17

How do you treat sinus tachycardia?

Answer 17

treat the underlying cause

Question 18

What is Sinus Bradycardia

Answer 18

HR less than 60/min

Question 19

Common causes of sinus bradycardia? (2)

Answer 19

• hypotension
• syncope

Question 20

How do you treat sinus bradycardia ?

Answer 20

Atropine

Question 21

What is Sinus Arrhythmia?

Answer 21

• A common arrhythmia
• irregular space between QRS complexes
• R-R interval more than 0.12 second

Question 22

Common causes of sinus Arrhythmia? (2)

Answer 22

• may occur w/ effects of breathing on the heart
• side effect of medication (digoxin)

Question 23

How do you treat sinus arrhythmia?

Answer 23

do not need treat

Question 24

What is a First-Degree Heart block?

Answer 24

• P-R interval exceeds 0.20 seconds
• Cardiac impulses from the SA node is delayed in passing through the AV node or bundle of HIS

Question 25

Common causes of First degree heart block? (2)

Answer 25

- common after a MI that damages the AV node - certain meds (digoxin or beta blockers)

Question 26

Second- degree heart block comes in 2 types. What are they?

Answer 26

- Type 1 (Wenckebach or Mobitz type 1) - Type 2 (Mobitz type 2)

Question 27

Type 1 (Wenckebach or Mobitz type 1) block is recognized when the

Answer 27

PR interval gets progressively longer until one does not pass on to the ventricles

Question 28

"Wenckebach: PR interval gets longer, longer, longer DROP, that's why they call it the Wenckebach" (Ventricle contracting is dropping which is the QRS complex)

Answer 28

Important to know

Question 29

Type 2 (Mobitz type 2) is

Answer 29

- less common - seen as a series of non-conducted p waves followed by p waves that conduct to ventricles (No QRS complex for a while)

Question 30

How do you treat Wenckebach ?

Answer 30

They will only treat if CO is affected

Question 31

Common cause of type 2 second- degree ?

Answer 31

MI

Question 32

How do you treat type 2

Answer 32

Medication (Atropine)

Question 33

What is Third degree heart block (complete heart block)?

Answer 33

- one of the most dangerous arrhythmias - Ventricles and atria are not communicating - "Hot- mess"

Question 34

What is the treatment for Third- degree heart block? (2)

Answer 34

- medication - external pacemaker

Question 35

What is Atrial flutter

Answer 35

- Represents rapid depolarization of atria from an ectopic focus (250 to 350) - "sawtooth pattern" - numerous P waves are present for each QRS

Question 36

What causes Atrial flutter? (5)

Answer 36

- rheumatic heart disease - coronary heart disease - renal failure - stress - hypoxemia

Question 37

How do we treat Atrial flutter? (2)

Answer 37

- medication - cardioversion (shock at 50- 200)

Question 38

What is Atrial fibrillation?

Answer 38

- results when atrial muscles quiver in an irregular pattern; no true p waves are seen - Ventricular rate may be slow and irregular

Question 39

Why is Atrial fibrillation dangerous?

Answer 39

Causes cardiac output to drop and may lead to thrombi atria due to blood stagnation (blood clot)

Question 40

What is the treatment for Atrial fibrillation

Answer 40

Cardioversion

Question 41

What are Premature Ventricular Contractions

Answer 41

- Occurs when ectopic beats originate in the ventricles - QRS complexes is wide and has no preceding Pwave (Bizzare widden QRS complex)

Question 42

What are PVCs caused by? (3)

Answer 42

- hypoxia - electrolyte imbalances (potassium and sodium) - acid-base disorders

Question 43

How can we treat PVCs? (2)

Answer 43

- treat the underlying causes - lidocaine can offer temporary solution

Question 44

What is Ventricular Tachycardia?

Answer 44

- A run of 3 or more PVCs in a row - Wide QRS w/ no p wave after - ventricular rate is usually 100 to 250/min - "V-Tach, Witch's Hat"

Question 45

How do we treat V-tach? (2)

Answer 45

- Cardioversion - Medications (widen QRS- Amiodarone) (narrow QRS- Adenosine)

Question 46

What is Ventricular Fibrillation?

Answer 46

- #1 most dangerous arrhythmia - Erratic quivering of ventricular muscle mass - causes cardiac output to drop to zero - "zig-zag" pattern

Question 47

How do you treat Ventricular fibrillation? (4)

Answer 47

- rapid defibrillation - CPR - oxygen - antiarrhythmic meds

Question 48

Pulseless Electrical Activity (PEA)

Answer 48

- very rare but serious - ECG pattern that **DOES NOT** generate a pulse

Question 49

What is the treatment for PEA (2)

Answer 49

- Emergency life support - immediate reversal of causes (7 H’s and 6 T’s)