Counting out the boxes (EKGs like a boss)

Question 1

Counting out rate, the big boxes go

Answer 1

300, 150, 100, 75, 60, 50

Question 2

Normal PR interval =

Answer 2

.12 -.20 seconds
or
3 to 5 boxes

Question 3

if PR interval is >.20 seconds =

Answer 3

1st degree AV block

Question 4

if you see ST elevation think……

Answer 4

injury to cardiac muscle

Question 5

if you see ST depression think…..

Answer 5

ischemia to cardiac muscle

Question 6

ST elevation/depression in II, III, AVF……

Answer 6

Inferior MI

Question 7

ST elevation/depression in V1, V2, V3

Answer 7

Anterior MI

Question 8

ST elevation/depression in V4, V5, V6

Answer 8

Anterior Lateral MI

Question 9

ST elevation/depression in I and AVL

Answer 9

Lateral MI

Question 10

Right atrial hypertrophy looks like….

Answer 10

Look at V1, if p-wave >.12 (3 small squares)

look for a large, di-phasic wave with a tall initial component

Question 11

Left atrial hypertrophy looks like…..

Answer 11

Look at V1, if p-wave >.12 (3 small squares)

look for a large, di-phasic wave with a wide terminal component

Question 12

Right ventricular hypertrophy looks like…..

Answer 12

• R-wave is > S-wave in V1
• R-wave gets progressively smaller from V1 to V6
• S-wave persists in V5 & V6
• Wide QRS

Question 13

Left ventricular hypertrophy looks like……

Answer 13

• S-wave in V1 and R-wave in V5 add up to >35mm
• left axis deviation
• Wide QRS
• T-wave slants down slowly (is inverted) and returns to baseline rapidly

Question 14

Electrolyte imbalances seen on EKG….

• T-wave flat
• St segment depressed
• U-wave

Answer 14

Hypokalemia

S/sx = muscle weakness, fatigue, hypotension, dizziness, headache, N/V, increased myocardial irritability, confusion, abdominal distention, polyuria

Question 15

Electrolyte imbalances seen on EKG….

• P-wave is flat and wide
• T-wave is tall and peaked

Answer 15

Hyperkalemia

s/sx = bradycardia, asystole, muscle weakness, confusion

Question 16

Electrolyte imbalances seen on EKG….

• QT interval is long

Answer 16

Hypocalcemia

s/sx = bronchospasm, muscle cramps and tremors, tetany, seizures, decreased Cardiac Output

Question 17

Electrolyte imbalances seen on EKG….

• QT interval is short

Answer 17

Hypercalcemia

s/sx = HTN, anorexia, N/V, abdominal pain, headache, confusion, polydipsia, polyuria

Question 18

Electrolyte imbalances seen on EKG….

• T-wave is flat
• ST is possibly depressed
• QT is long

Answer 18

Hypomagnesia

s/sx = dysrhythmias, enhanced digtoxin effect, confusion, lethargy, coma, facial twitches, seizures

Question 19

Electrolyte imbalances seen on EKG….

• T-wave tall, peaked

Answer 19

Hypermagnesia

s/sx = bradycardia, hypotension, apnea, lethargy, muscle weakness

Question 20

S/sx you may see w/ Hyponatremia

Answer 20

orthostatic hypotension, tachycardia, headache, lethargy, seizures, N/V, dry mucous membranes

Question 21

S/sx you may see w/ Hypernatremia

Answer 21

HTN, tachycardia, rales, oligouria, flushed skin, lethargy, irritability, tremors

Question 22

Intrinsic rate of the SA node pacemaker

Answer 22

60-100 bpm

Question 23

Intrinsic rate of the AV node pacemaker

Answer 23

45-60 bpm

Question 24

Intrinsic rate of the bundle of his

Answer 24

40-45 bpm

Question 25

Intrinsic rate of the right and left bundle branches

Answer 25

40-45 bpm

Question 26

Intrinsic rate of the Purkinje fibers

Answer 26

20-40 bpm

Question 27

Standard limb leads

Answer 27

I, II, III

Question 28

Augmented limb leads

Answer 28

AVR, AVL, AVF

Question 29

Precordial leads

Answer 29

V1-V6

Question 30

Anteroseptal leads

Answer 30

V1, V2, V3, with or without involvement of V4

Question 31

Anterior leads

Answer 31

V1-V4

Question 32

Anterolateral leads

Answer 32

V4-V6, I and aVL

Question 33

Lateral Leads

Answer 33

I and aVL

Question 34

Inferior leads

Answer 34

II, III, and aVF

Question 35

Inferolateral leads

Answer 35

II, III, aVF, V5 and V6

Question 36

quick! everything you know about a P-Wave!!

Answer 36

• is caused by Atrial depolarization
• normal is up to 0.12 seconds
• V1 and V2 are the best leads to see the P wave

Question 37

Quick! everything you know about the PR interval!!

Answer 37

• time from the beginning of P-wave to the start of the QRS normal = 0.12 -0.20 seconds
• Atrial contraction begins in the middle of the P-wave and continues throughout the PR interval

Question 38

slide 31

Answer 38

start there