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EKG > dysrhythmias > Flashcards

dysrhythmias Flashcards

1
Q

rapid dysrhythmia with HR of 150-250

rate so fast that it overrides SA node

P wave lost in preceding T wave- making it hard to determine where the impulse originates

A

supraventricular tachycardia

arises from above the ventricles but can’t tell if it’s from the atria or junction

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2
Q

SA node transiently stops firing and 3+ beats are dropped

A

sinus arrest

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3
Q

complete heart block

A

3rd degree AV heart block

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4
Q

dysrhythmia with a rhythm of 40 to 100 bpm (___ the inherent rate of the ventricles)

wide and bizarre QRS

T wave in the opposite direction of the R wave

absent P wave (hidden in the QRS)

A

accelerated idioventricular rhythm

(exceeds the inherent rate of the ventricles)

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5
Q

PVCs that all look the same

A

unifocal

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6
Q

complete block of conduction at or below the AV node, the impulses do not reach the ventricles

A

3rd degree AV heart block

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7
Q

sinus tachycardia is HR b/w

A

100 to 160

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8
Q

early ectopic beats that interrupt the normal rhythm

originate from an irritable focus in the ventricular conduction system or myocardium

retrugrade impulse inhibits the firing of a normally fired SA node impulse; SA node timing unaffected

A

PVC

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9
Q

PR intervals that are longer than 0.20 secs and constant

everything else pretty normal

A

1st degree AV heart block

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10
Q

SA node transiently stop firing and 1-2 beats are dropped

A

sinus pause

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11
Q

normal sinus rhythm for 4 y/o

A

75 to 115

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12
Q

periods of brady, tachy, prolonged pauses, or alternating brady and tachycardia that cause cardiac insufficiency and hypoperfusion

usually happens in elderly due to degenerative SA node

A

sinus node dysfunction

aka

sick sinus syndrome

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13
Q

PVCs that look different from each other

A

multifocal

these are more concerning b/c it means the ventricles are irritable and that the early beats are arising from more than one location

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14
Q

what makes it impossible to differentiate b/w mobitz 1 and mobitz 2

what is this called

A

if every other P wave is conducted

b/c you cannot assess for progressive prolongation or fixation

called a 2:1 AV block

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15
Q

which heart blocks are emergent

A

2nd degree AV block, type 2

and

3rd degree AV heart block (life threatening)

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16
Q

(3 or more) P waves that change appearance (absent/ inverted/ abnormal) because pacemaker site shifts b/w SA node and or AV junction

A

wandering atrial pacemaker

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17
Q

INTERMITTENT block at the level of the bundle of His or bundle branches

this results in atrial impulses NOT ALWAYS being conducted to the ventricles

A

2nd degree AV block, type 2

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18
Q

sustained VT

A

peristant PVCs for more than 30 seconds

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19
Q

run VT

aka

burst VT

aka salvo VT

A

a brief episode of 3 or more PVCs in a row

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20
Q

wide ( > 0.12 secs) bizarre QRS complexes

T wave in the opposite direction of the R wave

no P wave

A

ventricular dysrhythmia

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21
Q

varient of polymorphic ventricular tachycardia

associated wprolonged QT interval

drug induced or from electrolyte abnormalities

A

torsades de pointes

“twisting of points”

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22
Q

common rhythm after a cardiac arrest

A

junctional tachycardia

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23
Q

PVCs that occur on or near a previous T wave are called ____ and may precipitate ___

A

PVCs that occur on or near a previous T wave are called R-on-T PVCs and may precipitate ventricular tachycardia/ fibrillation

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24
Q

difference b/w PAC with aberrant ventricular conduction and PVC

A

PAC does not have a compensatory pause

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25
Q

wenckebach

A

2nd degree AV heart block, type 1

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26
Q

noncompensatory pause is associate with

A

PACs

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27
Q

VT w/ each QRS looking the same

A

monomorphic

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28
Q

atrial dysrhythmias are thought to be caused by what 3 mechanisms

A
  • disorders of impulse formation
    • automaticity
    • triggered activity
  • disorder of impulse conduction
    • reentry
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29
Q

tx for pt with torsades de pointe in cardiac arrest

A

defibrillation

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30
Q

tx for pt with torsades de pointe, NOT in cardiac arrest

A

magnesium sulfate

don’t let them brady down

(FYI- Mag mediates K influx during phase 4 of the action potential, during hypomagnesemia, K influx is partially inhibited… this causes delayed ventricular depolarization)

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31
Q

PR interval is prolonged and the same duration for every beat

intermittently a P wave occurs and is not follwed by a QRS complex

A

2nd degree AV block, type 2

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32
Q

dysrhythmia that arises from the ventricles with 100 to 250 bpm

wide ( >0.12 secs) and bizarre QRS

T wave in the opposite direction of the R wave

absent P wave (hidden in the QRS)

present when there are 3+ PVCs in a row

A

ventricular tachycardia

33
Q

upright and round P waves seem to march right through the QRS complexes

immeasurable PR intervals

A

3rd degree AV heart block

34
Q

early ectopic beats that originate outside the SA node and produce an irregular rhythm

followed by a noncompensatory pause

A

PAC

35
Q

w/ atrial Flutter, what determines the ventricular rate

A

the number of impulses conducted through the AV node

(ex: 3:1 conduction ratio)

36
Q

dysrhythmia with HR of 120-150 that arises from atria

P waves that change morphology

rhythm is irregular due to multiple foci

A

multifocal atrial tachycardia

37
Q

a partial delay or complete interruption in the conduction b/w the atria and ventricles that disrupts ventricular filling

A

heart block

38
Q

patterned irregularity

HR increases during inspiration and decreases during expiration

occurs naturally in: athletes, kids, geris

also occurs in: inferior wall MI, CVD, digitalis, morphine, intracranial pressure

A

sinus dysrhythmia

39
Q

sinus bradycardia is HR below ___, pts are less tolerant and symptomatic at rates below ___

A

sinus bradycardia is HR below 60, pts are less tolerant and symptomatic at rates below 45

40
Q

two PVCs in a row are called ___ and indicate ___

A

two PVCs in a row are called a couplet and indicate extremely irritable ventricles

41
Q

flat line

A

asystole

42
Q

sawtooth atrial waveforms

A

atrial Flutter (F wave)

43
Q

no association b/w P waves and QRS complexes

A

3rd degree AV heart block

44
Q

normal sinus rhythm for 6 + y/o

A

60 - 100

45
Q

difference b/w multifocal atrial tachycardia and wandering atrial pacemaker

A

MAT is a faster rate

46
Q
  • normal atrial rate
  • ventricular pacemaker is an escaped rhythm
    • if from the AV junction, rate is 40-60
    • if from the ventricles, rate is 20-40 and the QRS will be wide
  • the atrial and ventricular rhythms are not related to one another
A

3rd degree AV heart block

47
Q

fast ectopic rhythm that arises from the bundle of his

100 to 180 bpm

P wave can be inverted, buried in QRS, can come before QRS, or can come after QRS

normal QRS

A

junctional tachycardia

48
Q

where do atrial dysrhythmias originate

A

atrial tissue

or

internodal pathways

49
Q

most common cause of prehospital cardiac arrest in adults

A

V-fib

50
Q

chaotic firing of multiple sites in the ventricles- 300 to 500 unsynchronized impulses per minute)

QRS is a wavy chaotic line

full cardiac arrest, unresponsive, pulseless

A

Ventricular Fibrillation

(mycoardium is quivering but not contracting and there is no perfusion)

51
Q

why is the SA node timing unaffected in PVCs

A

b/c the pause is compensated

52
Q

intermittent block at the level of the AV node

A

2nd degree AV heart block, type 1

53
Q

dysrhythmia w/ HR of 20-40 bpm

wide and bizarre QRS

T wave in the opposite direction of the R wave

absent P wave (hidden in the QRS)

A

idioventricular rhythm

54
Q

organized electrical rhythm on the ECG monitor but the pt is pulseless and apneic

A

pulseless electrical activity

(PEA)

55
Q

a consistent delay of conduction at the level of the AV node

A

1st degree heart block

not a true block

56
Q

what can notching in a T wave be

A

hidden P waves,

like in 3rd degree AV heart block

57
Q

mobitz 2

A

2nd degree AV block, type 2

58
Q

difference b/w multifocal atrial tachycardia and a-fib

A

in MAT, P waves are discernible

59
Q

short bursts of rapid dysrhythmia with HR of 150-250 that arises from atria

rate so fast that it overrides SA node

A

paroxysmal atrial tachycardia (PAT)

60
Q

irregular pattern with no discernible P waves and instead there is a chaotic baseline of weird waves respresenting atrial activity

HR greater than 350

A

atrial fibrillation (f waves)

61
Q

irregular rhythm due to early beat

short PR interval

P wave can be inverted, buried in QRS, can come before QRS, or can come after QRS

normal QRS

A

premature junctional complex (PJC)

62
Q

rapid dysrhythmia with HR of 150-250 that arises from atria

rate so fast that it overrides SA node

A

atrial tachycardia

63
Q

P waves that differ in appearance from normal sinus P waves (P’ waves)

abnormal (short or long) PR interval

normal (and narrow) QRS

A

atrial dysrhythmias

64
Q

what can happen w/ a-fib

A

stroke

loss of atrial kick and decreased CO causes blood to stagnate in atrial chambers causing clots to form

65
Q

rapid depolarization re-entry circut in the atria at a rate of 250-350

A

atrial Flutter (F wave)

66
Q

impulse arises from AV junction

rate is b/w 40 and 60 bpm

P wave can be inverted, buried in QRS, can come before QRS, or can come after QRS

normal QRS

A

junctional escape rhythm

67
Q

what is the regularity in a 2nd degree AV block, type 2

A

regular or irregular

depends on the conduction ratio; if the conduction ratio is the constant then it will be regular

68
Q

not a true heart block and of little or no clinical significance b/c impulses are conducted to the ventricles

A

1st degree AV heart block

69
Q

VT w/ varying morphology of QRS’s

A

polymorphic VT

aka

torsades to pointes

70
Q

mobitz 1

A

2nd degree AV heart block, type 1

71
Q

PR interval progressively increases until a QRS is dropped, then the next PR interval is shorter

this means not all P waves are follwed by a QRS complex

patterned irregularity

A

2nd degree AV block type 1

72
Q

normal sinus rhythm for 2 y/o

A

85 to 125

73
Q

normal sinus rhythm for newborn

A

110 to 150

74
Q

impulse arises from AV junction at 60 to 100 bpm

P wave can be inverted, buried in QRS, can come before QRS, or can come after QRS

normal QRS

A

accelerated junctional rhythm

75
Q

early ectopic beats that originate outside the SA node and produce an irregular rhythm

followed by a noncompensatory pause

wide QRS complexes

A

PAC with aberrant ventricular conduction

76
Q

can affect ventricular filling time and diminish the strength of the atrial contraction

which causes decreased CO and decreased perfusion

A

atrial dysrhythmias

77
Q

can occur w/ or w/out pulses

pt may or may not be stable

A

ventricular tachycardia

78
Q

what is a PVC that falls in between 2 normal complexes and doesn’t disturb the normal cycle

there will be no compensatory pause because the SA node was not inhibited by retrograde PVC conduction

more common w/ brady

A

interpolated PVCs

EKG (8 decks)

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