Dysrhythmias Flashcards
What is the intrinsic rate of SA node?
Junctional firing?
Ventricular firing?
60-100
40-60
20-40
Each tiny square on EKG paper represents how much time? (going horizontally)
0.04 seconds
15 of the large squares = 3 seconds
How to quickly get a rate based on a 6 second strip?
Count QRS complexes and multiply x 10
Normal PR interval length?
.12–.20 seconds
Which is 3-5 tiny squares
How to tell the difference between sinus tachycardia and PSVT
PSVT is faster and the P wave will be lost because beats so close together
First line of treatment when trying to slow down a fast HR?
Vagal maneuvers
Bear down like pooping (Valsalva)
Hold breath
Carotid massage
Coughing
What does paroxysmal mean?
Abrupt onset and end
What is patient at high risk for when converting from atrial fib/flutter to NSR?
Throwing a clot
CVA
Characteristic sign of 1st degree AV block?
Prolonged PR interval (greater than 5 squares)
Characteristic sign of 2nd degree type 1 AV block?
Mobitz 1
Wenckenbach
PR interval gets longer each time and eventually the QRS complex drops altogether, then starts over again
Characteristic sign of 2nd degree Type 2 AV block?
Mobitz 2
PR interval constant but will not have all the QRS’s. It will consistently drop one and will have a predictable ratio
Characteristic sign of 3rd degree AV block?
The atria is beating independently of ventricles
Will look like P waves consistent and usually 60-100 BPM
QRS waves consistent and wide and slow
BUT no relationship to each other
Each doing there own thing
How are PVCs named?
Unifocal=they all look the same same
Multifocal=they all look different
Bigeminy=every other beat is PVC
Trigeminy=every 3rd beat is PVC
Couplet=a pair together
3 or more in a row is considered a run of VTach
Will we get a pulse with a PVC?
Not generally
They usually don’t generate enough force to get a peripheral pulse
–If runs of VTach are fast enough they can generate a little perfusion but not sustainable to continue.–
What is torsades de points?
V tach that gets bigger and smaller
Only 2 shockable rhythms?
Pulseless V Tach
V Fib
Tx of asystole?
CPR
ACLS meds
Difference between defibrillation and sync cardioversion?
Defib in v fib and pulseless VTach
Cardioversion in Vtach with pulse and supraventricular tachycardias
Cardioversion starts at 50-100 joules
Defib starts at 120-200 joules
Cardioversion shocks at R wave
Sync button must be turned on in cardioversion
What meds can cause a 1st degree AV block?
Calcium channel blockers
Beta blockers
Flecainide
