Clin Lab: Rhythms Part 1-4

Question 1

Normal sinus rhythm rate

Answer 1

60 -100 bpm

Question 2

How many big boxes is a normal sinus rhythm? (R-R)

Answer 2

3-5

Question 3

Sinus Bradycardia rate

Answer 3

< 60 bpm

(normal, but slow)

Question 4

How many boxes is a sinus bradycardia? (R-R)

Answer 4

> 5 big boxes

Question 5

Sinus tachycardia rate

Answer 5

100 - ~150 bpm

(normal but fast)

Question 6

How many big boxes is one second?

Answer 6

5 big boxes

Question 7

How many big boxes is 3 seconds?

Answer 7

15 big boxes

Question 8

Sinus Tachycardia: Rate

Answer 8

100 - 150bpm

Question 9

How many big boxes is Sinus tachycardia?

Answer 9

< 3 big boxes

Question 10

Atrial Escape Rhythm: Rate

Answer 10

60 - 80 bpm

Question 11

Ectopic Atrial Tachycardia (EAT): Rate

Answer 11

> 110 up to 250 bpm

Question 12

Wandering Atrial Pacemaker: Rate

Answer 12

Normal: 60-100

Question 13

What is Multi-focal Atrial Tachy?

Answer 13

when a wandering pacemaker goes from normal rate to a tachy rate

Question 14

Paroxysmal Supraventricular Tachy: Rate

Answer 14

150 - 250

Question 15

Atrial Flutter: Rate

Answer 15

~300 (250 - 350)

Question 16

Junctional Escape Rhythm: Rate

Answer 16

40 - 60bpm

Question 17

Accelerated junctional: Rate

Answer 17

> 60bpm

Question 18

Ventricular Escape (idioventricular) Rhythm: Rate

Answer 18

20 - 40bpm

Question 19

Accelerated Ventricular Escape (Idiopathic) Rhythm: Rate

Answer 19

> 40

Question 20

Ventricular Tachy: Rate

Answer 20

150 - 250

Question 21

Ventricular Flutter: Rate

Answer 21

250 - 350

Question 22

Ventricular Fibrillation: Rate

Answer 22

350 - 450

Question 23

SA pause occurs when…

Answer 23

there is an extended period of time b/t sinus beats & no other pacemaker foci take over

Question 24

Causes of SA pause

Answer 24

• meds/drugs (inotropes/chronotropes)
• Ischemia
• Damage to SA node (sarcoidosis)

Question 25

When to be concerned w/ SA pause

Answer 25

• pause is 3 secs or more OR
• multiple frequent pauses OR
• Pt is symptomatic

Question 26

SA pause Tx

Answer 26

pacemaker

Question 27

Sick Sinus Syndrome Tx

Answer 27

pacemaker

Question 28

Causes of Rhythm Disturbances

Answer 28

• Ischemia
• Drugs
• Sympathetic stimulation
• Sick sinus syndrome
• Electrolyte disturbances
• Incr stretch (volume overload)

Question 29

What electrolytes can cause disturbances in the heart?

Answer 29

• Ca++
• K+
• Mg++

Question 30

What can cause incr stretch?

Answer 30

CHF
Cirrhosis

Question 31

Premature beats: Atrial & junctional irritants

Answer 31

• usually sympathetic stimulation for any #of reasons

not as concerning

Question 32

Premature beats: ventricular irritants

Answer 32

• hypoxia/ischemia ***
• electrolyte imbalance
• Stretch

Question 33

Describe 1st degree heart block

Answer 33

PR interval is greater than I big box (the same going throughout)
MUST SAY THE UNDERLYING RHYTHM

Question 34

Describe 2nd degree Type I heart block

Answer 34

aka Wenckebach
- progressively longer PR interval
—>long, long, long then dropped QRS complex

Question 35

Describe 2nd degree Type II heart block

Answer 35

PR interval doesn’t change, but you do have hanging P waves

Question 36

Describe 3rd degree heart block

Answer 36

No relationship w/ the pacing of atria vs pacing of ventricles