Counting out the boxes (EKGs like a boss) Flashcards
No fancy pictures here, just the facts, 'Mam.
Counting out rate, the big boxes go
300, 150, 100, 75, 60, 50
Normal PR interval =
.12 -.20 seconds
or
3 to 5 boxes
if PR interval is >.20 seconds =
1st degree AV block
if you see ST elevation think……
injury to cardiac muscle
if you see ST depression think…..
ischemia to cardiac muscle
ST elevation/depression in II, III, AVF……
Inferior MI
ST elevation/depression in V1, V2, V3
Anterior MI
ST elevation/depression in V4, V5, V6
Anterior Lateral MI
ST elevation/depression in I and AVL
Lateral MI
Right atrial hypertrophy looks like….
Look at V1, if p-wave >.12 (3 small squares)
look for a large, di-phasic wave with a tall initial component
Left atrial hypertrophy looks like…..
Look at V1, if p-wave >.12 (3 small squares)
look for a large, di-phasic wave with a wide terminal component
Right ventricular hypertrophy looks like…..
- R-wave is > S-wave in V1
- R-wave gets progressively smaller from V1 to V6
- S-wave persists in V5 & V6
- Wide QRS
Left ventricular hypertrophy looks like……
- 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
Electrolyte imbalances seen on EKG….
- T-wave flat
- St segment depressed
- U-wave
Hypokalemia
S/sx = muscle weakness, fatigue, hypotension, dizziness, headache, N/V, increased myocardial irritability, confusion, abdominal distention, polyuria
Electrolyte imbalances seen on EKG….
- P-wave is flat and wide
- T-wave is tall and peaked
Hyperkalemia
s/sx = bradycardia, asystole, muscle weakness, confusion
Electrolyte imbalances seen on EKG….
- QT interval is long
Hypocalcemia
s/sx = bronchospasm, muscle cramps and tremors, tetany, seizures, decreased Cardiac Output
Electrolyte imbalances seen on EKG….
- QT interval is short
Hypercalcemia
s/sx = HTN, anorexia, N/V, abdominal pain, headache, confusion, polydipsia, polyuria
Electrolyte imbalances seen on EKG….
- T-wave is flat
- ST is possibly depressed
- QT is long
Hypomagnesia
s/sx = dysrhythmias, enhanced digtoxin effect, confusion, lethargy, coma, facial twitches, seizures
Electrolyte imbalances seen on EKG….
- T-wave tall, peaked
Hypermagnesia
s/sx = bradycardia, hypotension, apnea, lethargy, muscle weakness
S/sx you may see w/ Hyponatremia
orthostatic hypotension, tachycardia, headache, lethargy, seizures, N/V, dry mucous membranes
S/sx you may see w/ Hypernatremia
HTN, tachycardia, rales, oligouria, flushed skin, lethargy, irritability, tremors
Intrinsic rate of the SA node pacemaker
60-100 bpm
Intrinsic rate of the AV node pacemaker
45-60 bpm
Intrinsic rate of the bundle of his
40-45 bpm
Intrinsic rate of the right and left bundle branches
40-45 bpm
Intrinsic rate of the Purkinje fibers
20-40 bpm
Standard limb leads
I, II, III
Augmented limb leads
AVR, AVL, AVF
Precordial leads
V1-V6
Anteroseptal leads
V1, V2, V3, with or without involvement of V4
Anterior leads
V1-V4
Anterolateral leads
V4-V6, I and aVL
Lateral Leads
I and aVL
Inferior leads
II, III, and aVF
Inferolateral leads
II, III, aVF, V5 and V6
quick! everything you know about a P-Wave!!
- is caused by Atrial depolarization
- normal is up to 0.12 seconds
- V1 and V2 are the best leads to see the P wave
Quick! everything you know about the PR interval!!
- 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
slide 31
start there
