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NUR251 - Medical Surgical III > Chapter 39: Dysrhythmias > Flashcards

Chapter 39: Dysrhythmias Flashcards

intro to ECG

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USMLE® Step 1 flashcards
1
Q

abnormal heart rhythms

A

dysrhythmias

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2
Q

T/F

Dysrhythmias can directly decrease cardiac output (CO) by changing stroke volume and heart rate.

A

true

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3
Q

Name the parts of the autonomic nervous system (ANS) that affect the heart.

A
  • vagus nerve fibers of the parasympathetic nervous system (PNS)
  • nerve fibers of the sympathetic nervous system (SNS)
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4
Q

Stimulation of the __________ nerve slows firing of the sinoatrial (SA) node and slows impulse conduction of the AV node, this __________ heart rate.

A

vagus ; decreases

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5
Q

Stimulation of the __________ nerves increases sinoatrial (SA) node firing, AV node impulse conduction, and cardiac contractility. This __________ heart rate.

A

sympathetic ; increases

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6
Q

a graphic tracing of the electrical impulses in the heart

A

electrocardiogram (ECG)

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7
Q

What do the waveforms on the electrocardiogram (ECG) represent?

A

the electrical activity of depolarization and repolarization produced by the movement of ions across the membranes of heart cells

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8
Q

T/F

The membrane of a heart cell is semipermeable.

A

true

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9
Q

the inside of the cell is positively charged compared with the outside

A

depolarization

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10
Q

a slower movement of ions across the membrane restores the cell to the polarized state

A

repolarization

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11
Q

T/F

A 6-lead electrocardiogram (ECG) view of the heart is helpful in assessing dysrhythmias.

A

false; 12-lead

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12
Q

ability to initiate an impulse spontaneously and continuously

a. contractility
b. automaticity
c. excitability
d. conductivity

A

b. automaticity

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13
Q

ability to be electrically stimulated

a. contractility
b. automaticity
c. excitability
d. conductivity

A

c. excitability

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14
Q

ability to transmit an impulse along a membrane in an orderly manner

a. contractility
b. automaticity
c. excitability
d. conductivity

A

d. conductivity

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15
Q

ability to respond mechanically to an impulse

a. contractility
b. automaticity
c. excitability
d. conductivity

A

a. contractility

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16
Q

What are the most common leads in an electrocardiogram (ECG)?

A

leads II and V

17
Q

What is the most accurate way to calculate the heart rate from an electrocardiogram (ECG)?

A

count the number of QRS complexes in 1 minute

18
Q

a distortion of the baseline and waveforms seen on the electrocardiogram (ECG)

A

artifact

19
Q

Match the correct wavelength to the description.

represents time for the passage of the electrical impulse through the atrium causing atrial depolarization (contraction, should be upright

a. P wave

b. PR interval

c. QRS complex

d. QRS interval

A

a. P wave

20
Q

Match the correct wavelength to the description.

  • measured from beginning of P wave to beginning of QRS complex
  • represents time taken for impulse to spread through the atria, AV node and bundle of His, bundle branches, and Purkinje fibers to a point immediately before ventricular contraction

a. ST segment

b. PR interval

c. T wave

d. P wave

A

b. PR interval

21
Q

Match the correct wavelength to the description.

Q, R, and S wave

a. QRS interval

b. QT interval

c. ST segment

d. QRS complex

A

d. QRS complex

22
Q

Q, R, or S wave?

first negative (downward) deflection after the P wave, short and narrow, not present in several leads

A

Q wave

23
Q

Q, R, or S wave?

first positive (upward) deflection in the QRS complex

A

R wave

24
Q

Q, R, or S wave?

first negative (downward) deflection after the R wave

A

S wave

25
Q

Match the correct wavelength to the description.

  • measured from beginning to end of QRS complex
  • represents time taken for depolarization (contraction) of both ventricles (systole)

a. QRS interval

b. ST segment

c. P wave

d. QRS complex

A

a. QRS interval

26
Q

Match the correct wavelength to the description.

  • measured from the S wave of the QRS complex to the beginning of the T wave
  • represents the time between ventricular depolarization and repolarization (diastole)
  • should be flat

a. QT interval

b. Q wave

c. ST segment

d. R wave

A

c. ST segment

27
Q

Match the correct wavelength to the description.

  • represents time for ventricular repolarization
  • should be upright

a. Q wave

b. R wave

c. S wave

d. T wave

A

d. T wave

28
Q

Match the correct wavelength to the description.

  • measured from beginning of QRS complex to end of T wave
  • represents time taken for entire electrical depolarization and repolarization of the ventricles

a. QRS complex

b. QT interval

c. QRS interval

d. ST segment

A

b. QT interval

29
Q

T/F

Adult men have slightly longer QT intervals than women.

A

false; women have longer QT intervals

30
Q

the observation of a patient’s heart rate and rhythm at a side distant from the patient

A

telemetry monitoring

31
Q

T/F

Dysrhythmias result from disorders of impulse formation, impulse conduction, or both.

A

true

32
Q

natural pacemaker of the heart

A

sinoatrial (SA) node

33
Q

the recovery period after stimulation

a. refractory phase

b. absolute refractory phase

c. relative refractory period

d. full excitability

A

a. refractory phase

34
Q

occurs when excitability is zero, and the heart cannot be stimulated

a. refractory phase

b. absolute refractory phase

c. relative refractory period

d. full excitability

A

b. absolute refractory phase

35
Q

occurs slightly later in the cycle, and excitability is more likely

a. refractory phase

b. absolute refractory phase

c. relative refractory period

d. full excitability

A

c. relative refractory period

36
Q

heart is completely recovered

a. refractory phase

b. absolute refractory phase

c. relative refractory period

d. full excitability

A

d. full excitability

37
Q

What would the nurse measure to determine whether there is a delay in electrical impulse conduction through the patient‘s ventricles?

a. P wave

b. Q wave

c. PR interval

d. QRS complex

A

d. QRS complex

38
Q

The nurse needs to measure the heart rate for a patient with an irregular heart rhythm. Which method will be accurate?

a. Count the number of large squares in the R-R interval and divide by 300.

b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.

c. Use the 3-second markers to count the number of QRS complexes in 6 seconds and multiply by 10.

d. Calculate the number of small squares between one QRS complex and the next and divide into 1500.

A

b. Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS complexes.

39
Q

Which action by a registered nurse (RN) who is orienting to the telemetry unit indicates a good understanding of the treatment of heart dysrhythmias?

a. Prepares defibrillator settings at 360 joules for a patient whose monitor shows asystole.

b. Injects IV adenosine over 2 seconds for a patient with supraventricular tachycardia.

c. Turns the synchronizer switch to the “on” position before defibrillating a patient with ventricular fibrillation.

d. Gives the prescribed dose of diltiazem (Cardizem) to a patient with new-onset type II second-degree AV block.

A

b. Injects IV adenosine over 2 seconds for a patient with supraventricular tachycardia.

NUR251 - Medical Surgical III (6 decks)

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