ch 22 Flashcards
PP interval (measures what about artial?)
the duration between the beginning of one P wave and the beginning of the next P wave; used to calculate atrial rate and rhythm
PR interval (Purring through the SA node all the way to the AV node)
electrical impulse from the sinoatrial node through the atrioventricular node
QRS complex (the QRS code is only for the relaxing vent)
electrical impulse through the ventricles; ventricular depolarization
QT interval (relaxing then excited vents are QTs)
time from ventricular depolarization through repolarization
ST segment (STop the QRS and start the T wave)
the part of an ECG that reflects the end of the QRS complex to the beginning of the T wave
T wave (ventricles back in action on the T wave)
repolarization of the ventricles
U wave (last one)
reflect Purkinje fiber repolarization; usually, it is not seen unless a patient’s serum potassium level is low
TP interval (you need TP at the end of the T wave for the Pee wave)
the part of an ECG that reflects the time between the end of the T wave and the beginning of the next P wave; used to identify the isoelectric line
torsades de pointes. (torsades de lethal)
lethal ventricular arrhythmia
isoelectric line
T wave to next P wave, no electrical activity = line is flat
The RR interval is used to determine ____and the PP interval to determine ____(ventricles need some R and R, the atria just need to pp)
ventricular rhythm
atrial rhythm
RR and PP -
If the intervals are the same or if the difference between the intervals is less than 0.8 seconds throughout the strip, the rhythm is called
regular. If the intervals are different, the rhythm is called irregular.
increase of 10 bpm or more in the resting heart rate…
increases the risk for sudden cardiac death, atrial fibrillation, heart failure, coronary artery disease, stroke, and cardiovascular disease
Sinus bradycardia occurs when (the esay’s sinus is slow)
the SA node creates an impulse at a slower-than-normal rate. Management depends on the cause and symptoms. Resolving the causative factors may be the only treatment needed.
All characteristics of sinus bradycardia are the same as those of normal sinus rhythm, except
for the rate
Sinus tachycardia occurs when the
sinus node creates an impulse at a faster-than-normal rate.
sinus bradycardia causes
lower metabolic needs (e.g., sleep, athletic training, hypothyroidism), vagal stimulation (e.g., from vomiting, suctioning, severe pain), medications (e.g., calcium channel blockers [e.g., nifedipine, amiodarone], beta-blockers [e.g., metoprolol]), idiopathic sinus node dysfunction, increased intracranial pressure, and coronary artery disease, especially myocardial infarction (MI) of the inferior wall.
sinus tachcardia causes
Physiologic or psychological stress (e.g., acute blood loss, anemia, shock, hypervolemia, hypovolemia, heart failure, pain, hypermetabolic states, fever, exercise, anxiety)
Medications that stimulate the sympathetic response (e.g., catecholamines, aminophylline, atropine), stimulants (e.g., caffeine, nicotine), and illicit drugs (e.g., amphetamines, cocaine, ecstasy)
Sinus tachycardia does not start or end (tachy sinus doesn’t happen overnight)
suddenly
Sinus arrhythmia rate increases with inspiration or expiration? (sinus arrthymias inspire me)
the sinus node creates an impulse at an irregular rhythm; the rate usually increases with inspiration and decreases with expiration.
sinus bradycardia
Ventricular and atrial rate: Less than 60 bpm in the adult
Ventricular and atrial rhythm: Regular
QRS shape and duration: Usually normal, but may be regularly abnormal
P wave: Normal and consistent shape; always in front of the QRS
PR interval: Consistent interval between 0.12 and 0.20 seconds
P:QRS ratio: 1:1
sinus tachycardia - BPM (tachy can’t be 120 min)
Ventricular and atrial rate: Greater than 100 bpm in the adult, but usually less than 120 bpm
Ventricular and atrial rhythm: Regular
QRS shape and duration: Usually normal, but may be regularly abnormal
P wave: Normal and consistent shape; always in front of the QRS, but may be buried in the preceding T wave
PR interval: Consistent interval between 0.12 and 0.20 seconds
P:QRS ratio: 1:1
sinus arrhythmia
Ventricular and atrial rate: 60 to 100 bpm in the adult
Ventricular and atrial rhythm: Irregular
QRS shape and duration: Usually normal, but may be regularly abnormal
P wave: Normal and consistent shape; always in front of the QRS
PR interval: Consistent interval between 0.12 and 0.20 seconds
P:QRS ratio: 1:1
premature atrial complex
A PAC is a single ECG complex that occurs when an electrical impulse starts in the atrium before the next normal impulse of the sinus node.
PAC causes
caffeine, alcohol, nicotine, stretched atrial myocardium (e.g., as in hypervolemia), anxiety, hypokalemia (low potassium level), hypermetabolic states (e.g., with pregnancy), or atrial ischemia, injury, or infarction.
PACs often seen with (Jimmy is often seen with tachy)
sinus tachycardia
PAC
Ventricular and atrial rhythm: Irregular due to early P waves, creating a PP interval that is shorter than the others. This is sometimes followed by a longer-than-normal PP interval, but one that is less than twice the normal PP interval. This type of interval is called a noncompensatory pause
QRS shape and duration: The QRS that follows the early P wave is usually normal, but it may be abnormal (aberrantly conducted PAC). It may even be absent (blocked PAC)
P wave: An early and different P wave may be seen or may be hidden in the T wave; other P waves in the strip are consistent
PR interval: The early P wave has a shorter-than-normal PR interval, but still between 0.12 and 0.20 seconds
P:QRS ratio: Usually 1:1
extrinsic and and intrinsic nervous system play a part in
afib
afib
Ventricular and atrial rate: Atrial rate is 300 to 600 bpm; ventricular rate is usually 120 to 200 bpm in untreated atrial fibrillation
Ventricular and atrial rhythm: Highly irregular
QRS shape and duration: Usually normal, but may be abnormal
P wave: No discernible P waves; irregular undulating waves that vary in amplitude and shape are seen and referred to as fibrillatory or f waves
PR interval: Cannot be measured
P:QRS ratio: Many:1
no atrial kick with (Gab can’t kick, of course)
afib
afib may have a (Gabby definitely has a deficit)
pulse deficit
afib treatment
maybe aspirin or anticoagulants, catheter ablasion
atrial flutter
Ventricular and atrial rate: Atrial rate ranges between 250 and 400 bpm; ventricular rate usually ranges between 75 and 150 bpm
Ventricular and atrial rhythm: The atrial rhythm is regular; the ventricular rhythm is usually regular but may be irregular because of a change in the AV conduction
QRS shape and duration: Usually normal, but may be abnormal or absent
P wave: Saw-toothed shape; these waves are referred to as F waves
PR interval: Multiple F waves may make it difficult to determine the PR interval
P:QRS ratio: 2:1, 3:1, or 4:1
Atrial flutter occurs
because of a conduction defect in the atrium and causes a rapid, regular atrial impulse at a rate between 250 and 400 bpm. NOT all impulses are conducted to the ventricle - otherwise it would be life threatening.