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HLTH 1141-Intro to Electrocardiography > Chapter 5-Rhythm Strip Interpretation and Sinus Rhythm > Flashcards

Chapter 5-Rhythm Strip Interpretation and Sinus Rhythm Flashcards

1
Q

Identify the components of the rhythm

A

1-rhythm (regularity)
2-rate
3-P wave morphology
4-PR interval
5-QRS duration and morphology

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2
Q

What is evaluated and classified when determining dysrhythmias?

A

Waves, segments, and intervals.

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3
Q

P waves represent:

A

Atrial depolarization

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4
Q

QRS complex represents:

A

Ventricular depolarization

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5
Q

How do you calculate a regular rate

A

Either the 300 or 1500 method

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6
Q

How do you calculate an irregular rate

A

With the 6-second method

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7
Q

Explain the 6 second method

A

Multiply the number of P waves and QRS complexes in a 6 second strip by 10

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8
Q

When identifying the P wave morphology what two questions need to be answered

A
  1. Are the shapes and waveforms all the same?
  2. Does each P wave have a QRS complex following it?
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9
Q

How do you measure the PR interval

A

Measure from beginning of P wave to beginning of QRS complex

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10
Q

What is a normal PR interval

A

0.12-0.20

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11
Q

What is the normal limits for a QRS complex

A

0.06-0.10 seconds

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12
Q

How do you measure the QRS complex

A

Measure from where QRS complex starts to the J joint

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13
Q

Describe the J joint

A

Point where S wave stops and ST segment begins

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14
Q

What are the several questions that need to be answered when determine the QRS measurement and morphology

A
  1. Are all QRS complexes equal duration (width)
  2. What is the actual measurement, and is it within normal limits
  3. Do all QRS complexes look alike? If no are the unusual complexes associated with premature or ectopic complex?
  4. Do all QRS complexes follow a P wave
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15
Q

Describe the pathway of sinus node

A

Starts in SA node, travels to AV node, continues through Bundle of His and bundle branches to ventricles

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16
Q

Describe the classification for Normal Sinus Rhythm

A

Rhythm - regular
Rate - 60-100
P wave morphology - P waves are same shape, upright deflection, appears in front of QRS complex
PR Interval - between 0.12-0.20 second, same appearance, no variations
QRS duration & morphology - between 0.06-0.10 second, same with no deflections

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17
Q

What is this ECG strip representing

A

Normal Sinus Rhythm

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18
Q

Describe low cardiac output

A

Patient experiences symptoms due to the heart not pumping adequately

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19
Q

What are the symptoms of low cardiac output that are considered neurological

A

-change in mental state
-light headedness
-dizziness
-confusion
-loss of consciousness

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20
Q

What are the symptoms of low cardiac output that are considered cardiac

A

-chest pain
-palpitations
-chest discomfort
-enlarged cardiac size
-congestive heart failure

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21
Q

What are the symptoms of low cardiac output that are considered respiratory

A

-difficulty breathing
-shortness of breath
-frothy sputum
-fluid present in lungs
-lung congestion

22
Q

What are the symptoms of low cardiac output that are considered urinary

A

-decreased urinary output of less then 30ml in one hour

23
Q

What are the symptoms of low cardiac output that are considered peripheral

A

-hypotension
-pale skin
-skin cool and clammy to the touch

24
Q

Describe the key difference in criteria for Sinus Bradycardia

A

All criteria are same as normal sinus rhythm except the rate is less than 60 bpm

25
Q

What is this ECG strip representing

A

Sinus Bradycardia

26
Q

How might the patient be affected by Sinus Bradycardia

A

May or may not experience or display symptoms

27
Q

What is the main difference in criteria for Sinus Tachycardia

A

All criteria same as Normal Sinus Rhythm except the rate is between 100-150 bpm

28
Q

How might the patient be affected by Sinus Tachycardia

A

Depends on the rate of tachycardia above patients normal resting rate, may experience symptoms of low cardiac output, and complaints such as heart racing

29
Q

What is this ECG strip representing

A

Sinus Tachycardia

30
Q

Describe the key difference in criteria for Sinus Dysrhythmia

A

All criteria same as Normal Sinus Rhythm except the rhythm interval between the P-P and R-R waves occurs at irregular periods.

31
Q

Describe vagal tone

A

Constant tension on vagus nerve that causes heart to beat more slowly

32
Q

Describe Sinus Dysrhythmia

A

Condition in which heart rate remains within normal limits but is influence by the respiratory cycle and variations of vagal tone

33
Q

How might the patient be affected by Sinus Disrhythmia

A

Usually shows no signs or symptoms, but if serious enough and the heart rate decreases to 40-50 bpm patient may complain of palpitations or dizziness

34
Q

What is this ECG strip representing

A

Sinus Dysrhythmia

35
Q

Describe Sinus Arrest

A

Occurs when SA node stops firing causing a pause in electrical activity

36
Q

What is the key difference in criteria for Sinus Arrest

A

All criteria same as Normal Sinus Rhythm but the rhythm is regular before and after the sinus arrest period (pause), rhythm is considered irregular due to absence in electrical activity during pause

37
Q

What is this ECG strip representing

A

Sinus Arrest

38
Q

When classifying Sinus Arrest what is the 6th criteria you need to calculate, and what is the calculation

A

Length of pause - must be determined to see how long heart had no rhythm

Measure the R-R interval around the pause and multiple number of boxes by 0.04

39
Q

How may the patient be affected by Sinus Arrest

A

Will experience signs and symptoms of decreased cardiac output if pause is longer than 2 seconds and occurs on frequent basis.

May also experience periods of ischemia, hypotension, dizziness and syncope

40
Q

Define ischemia

A

Sudden loss or reduction in blood supply (oxygen) to region of heart tissue

41
Q

Define syncope

A

Loss of consciousness

42
Q

Define hypotension

A

Lower than normal blood pressure that can cause reduction of blood flow to vital organs

43
Q

Describe Sinus Exit Block

A

Occurs when SA node initiates electrical impulse that is blocked and not conducted to atria, atria and ventricles do no depolarize, P wave will not be seen until next conducted complex

44
Q

What other Rhythm is similar to Sinus Exit Block

A

Sinus arrest

45
Q

What is the key difference in criteria when classifying a Sinus Exit Block

A

All criteria is same as Normal Sinus Rhythm except the rhythm is irregular due to pauses and the rate will vary depending on electrical activity

*measure the length of pause

46
Q

What is this ECG strip representing

A

Sinus Exit Block

47
Q

How may the patient be affected by Sinus Exit Block

A

Seriousness depends on length and frequency of the pause, if pauses are accompanied by low heart rate the patient may expedience signs and symptoms of low cardiac output including hypotension, chest pain, shortness of breath or changes in mental status

48
Q

Which rhythm shows an irregularity during inspiration and expiration

A

Sinus Dysrhythmia

49
Q

A QRS complex measuring 0.12 second or wider indicates what?

A

Delayed ventricular conduction

50
Q

What might cause Sinus Exit Block

A

Acute myocardial infarction, ischemia, or drugs such as digitalis or quinidine

HLTH 1141-Intro to Electrocardiography (9 decks)

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