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critical care exam 2 but better > conduction disorders > Flashcards

conduction disorders Flashcards

1
Q

what is the primary pacemaker of the heart

A

SA node

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2
Q

what is the position of V1

A

4th intercostal space to the right of the sternun

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3
Q

what is the position of V2

A

4th intercostal space to the left of the sternum

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4
Q

What is the position of v3

A

middle of 2 and 4

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5
Q

what is the position of V4

A

5th intercostal space midclavicular

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6
Q

what is the position of V5

A

middle of 4 and 6

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7
Q

What is the position of V6

A

5th intercostal space mid axillary

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8
Q

what are the limb leads

A

RA, RL, LA, LL
These four are the frontal plane that adds 6 views of the heart so that’s I, II, III, aVR, aVF, aVL

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9
Q

what are standard limb leads

A

I, II, III

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10
Q

what are the augmented limb leads

A

aVR, aVL, aVF

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11
Q

which leads view the heart from the frontal plane

A

I, II, III, aVR, aVL, aVF

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12
Q

which leads have an inferior view

A

II, III, aVF

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13
Q

which leads have a septal view

A

V1, V2

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14
Q

Which leads have an anterior view

A

V3, V4

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15
Q

Which leads have a lateral view

A

I, aVL, V5, V6

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16
Q

what leads may be used in right sided heart failure?

A

right sided precordial leads

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17
Q

what are the three pacemakers of the heart and their rates

A

SA node 60-100
AV node 40-60
ventricular pacemaker 30-40

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18
Q

what does the p wave indicate

A

atrial depolarization

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19
Q

where is the p wave always positive

A

leads I and II

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20
Q

where is the p wave always negative

A

aVR

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21
Q

where is the p wave biphasic

A

V1

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22
Q

What does the QRS wave indicate?

A

Ventricular depolarization
Atrial repolarization

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23
Q

What is the Q wave?

A

The first negative deflection after the P wave

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24
Q

What is the R wave?

A

The first positive deflection after the P wave

25
Q

What is the S wave?

A

The first negative deflection after the R wave

26
Q

What does the T wave indicate?

A

Ventricular repolarization

27
Q

What does the QT indicate?

A

The depolarization and repolarization phase

28
Q

What does the PR indicate

A

AV conduction time
PP =RR

29
Q

what can cause a prominent U wave

A

hypokalemia

30
Q

what are the symptoms of hemodynamic instability?

A

altered mental status
chest discomfort
hypotension

31
Q

treatment for symptomatic brady

A

Atropine 0.5mg given rapidly as an IV bolus every 3-5 minutes to a max dose of 3mg
Make sure they’re taking stool softener to decrease risk of vasovagal reaction

32
Q

what is the POTS criteria

A

Greater than 30 bpm increase changing position without hypotension

33
Q

What is the treatment for POTS

A

Increase salt and fluid
Limit triggers: caffeine, big meals, prolonged standing

34
Q

treatment for symptomatic tachy?

A

Synchronized cardioversion if there’s hemodynamic instability
Vagal maneuvers
Narrow QRS: adenosine
Wide QRS: procainamide, amiodarone, and sotalol

35
Q

what is the pattern of sinus arrhythmia

A

regularly irregular

36
Q

what is the precursor to a fib?

37
Q

treatment of artrial flutter

38
Q

what is the most common heart dysrythmia

39
Q

what is the pattern of afib?

A

irregular irregular

40
Q

what is the treatment for afib

A
  • antithrombolytics
  • heart rate control
  • amiodarone as pharmocologic cardioversion
  • electrical cardioversion if there is hemodynamic instability
41
Q

junctional rhythm pacemaker

42
Q

what is the treatment for junctional rhythm?

A

atropine, dopamine, epi

43
Q

What rhythms are SVT?

A

A fib, a flutter, junctional tachy

44
Q

What is the treatment for SVT?

A

Adenosine if stable 6mg rapidly with fluid bolus
Warn patient of chest pressure
Synchronized cardioversion if unstable

45
Q

What is a PVC initiated by

A

purkinje fibers

46
Q

How is v tach defined?

A

Three of more PVC’s in a row

47
Q

What is the treatment for v tach

A

Stable monomorphic → monitor
Symptomatic monomorphic → cardioversion
Pulseless → defibrillation
EF <35% → implantable cardioverter defibrillator (ICD)
EF >35% → amiodarone

48
Q

what is the most common dysrhythmia in patients with cardiac arrest?

49
Q

what is the treatment for v fib

A

early defibrillation

50
Q

what is the treatment for asystole

A

high quality CPR

51
Q

What is the rhythm of a 2nd degree type 1 heart block

A

regularly irregular

52
Q

What is the initial treatment of choice for heart block

A

atropine
emergency defibrillation, cardioversion, or pacing
pacemaker for Bradycardia
ICDs for tachycardia

53
Q

which medication do you withhold before cardioversion

54
Q

What medications do you give after defibrillation

A

epinephrine or vasopressin

55
Q

What do you give before trans cutaneous pacing

A

sedative for pain

56
Q

When would you do pacemaker therapy

A

symptomatic bradycardia and symptomatic heart block

57
Q

During what part of heart rhythm would cardioversion be done?

A

During R wave

58
Q

What is performed before cardioversion?

A

TEE to check for blood clots, may put patient on anticoagulants beforehand

59
Q

What heart blocks does atropine not work for?

A

Second degree type 2 and third degree

critical care exam 2 but better (8 decks)

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