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Cardio I - ECG > Dysrhythmias Below The AV Node > Flashcards

Dysrhythmias Below The AV Node Flashcards

1
Q

Ectopic focus from ventricle (cell decides to contract early/out of order)
Ventricular depolarization occurs BEFORE SA node fires
WIDE QRS bc stimulation occurs BELOW AV node
NO P wave
COMPENSATORY PAUSE to reorganize SA and AV nodes for impulse conduction

A

PVC

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2
Q

PVC

A

Ectopic focus from a ventricle (cell decides to contract early/out of order)
Ventricular depolarization occurs BEFORE SA node fires
WIDE QRS bc stimulation occurs BELOW AV node
NO P wave
COMPENSATORY PAUSE after the PVC to reorganize SA and AV for impulse conduction

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3
Q

Are PVCs abnormal?

A

No

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4
Q

PVC telemetry characteristics…

A 
Compensatory pause ==> beat after PVC feels like a "thump in the chest" bc the ventricles have a lot of time to fill c blood bc of the compensatory pause 
Bigeminy 
Trigeminy 
Couplet 
Unifocal 
Multifocal
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5
Q

Bigeminy

A

Every OTHER beat is PVC

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6
Q

Trigeminy

A

Every THIRD beat PVC

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7
Q

Couplet

A

TWO PVCs paired together

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8
Q

Unifocal

A

PVCs all the same –> same irritated area in Vs causing the early contraction

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9
Q

Multifocal

A

PVCs appear different –> more than one area irritated and they all contribute to early contraction

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10
Q

PVC potential causes…

A 
Caffeine/energy drinks
Nicotine
Stress
Overexertion
Hypo- or hyperkalemia
Ischemia
Cardiomyopathy
Cardiac irritation
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11
Q

PVC characteristics

A

Increased frequency ==> decreased filling time ==> DECREASED PRELOAD ==> decreased SV ==> decreased CO

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12
Q

Decreased CO is dangerous c PVCs when…

A 
Couplet
Multifocal
> 6/min.
Triplets 
*termination points for activity ==> can degrade to life-threatening rhythm*

May progress to V-tach or V-fib
Anti-arrhythmia

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13
Q

It is important to note if PVCs…

A

Increase c exercise
Decrease c exercise
Stay the same c exercise

monitor BP and sx for termination points

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14
Q

Should premature beats be taken into consideration when calculating HR?

A

No - HR should be calculated on a part of the strip that does not contain the PVCs

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15
Q

3 or more consecutive PVCs
NO P wave
WIDE QRS (bc impulse BELOW AV node)
V rate 100-250bpm

A

V-tach

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16
Q

When is the QRS wide?

A

When the impulse comes from BELOW the AV node

17
Q

V-tach

A

3 or more consecutive PVCs
NO P wave
WIDE QRS (bc impulse comes from BELOW AV node)
V rate 100-250bpm

18
Q

V-tach V rate…

A

100-250bpm

19
Q

V-TACH =

A

EMERGENCY

20
Q

V-tach possible causes…

A 
Ischemia/infarction
CAD
HTN
Digoxin
Electrolyte imbalance
21
Q

V-tach management

A

Cardioversion (time c QRS)

Defibrillation (increased Joules of energy to reset the rhythm)

22
Q

V-tach characteristics

A 
CO greatly affected ==> decreased HR, decreased filling time, NO atrial contraction
Lightheadedness
Syncope
Angina
Weak, thready pulse
Disorientation
23
Q

V-tach telemetry characteristics…

A

NO P wave

WIDE QRS

24
Q

“Twisting of the points”

A

Torsades de Pointes

25
Q

Torsades is a characteristic of…

A

V-tach

26
Q

Torsades occurs when…

A

V-tach changes axis ==> bad prognostic factor that makes the V-tach harder to defibrillate

27
Q

Characteristics of torsades

A

Twisting around the isoelectric line
Occurs during V-tach
Significant drop in CO
Cardioversion

28
Q

Quivering of ventricles, so no real contraction, and the atria do not really contract much
NO CO
Multiple ectopic foci –> contractions not synchronous
Zig-zag pattern
Progression of V-tach

A

V-fib

29
Q

V-fib

A

Quivering of ventricles, so no real contraction, and the atria don’t really contract much
NO CO
Multiple ectopic foci c no synchronous contraction
Zig-zag pattern
Progression of V-tach

30
Q

V-FIB =

A

EMERGENCY

31
Q

V-fib possible causes…

A

Progression of V-tach
Infarction/ischemia
HTN
Digoxin toxicity

32
Q

V-fib management

A

Defibrillation
CPR
O2
Meds

33
Q

Altered electrical conduction during angina
T wave inversion
T wave flattened or peaked
Changes in ST segment at least 1mm (elevation is STEMI; depression if NSTEMI)

A

MI

34
Q

The zone of ischemia in an MI looks like what on a telemetry strip?

A

T wave inversion or flattening

35
Q

The zone of infarction in an MI looks like what on a telemetry strip?

A

Q wave/STEMI (elevated) (transmural MI) –> > 0.04 sec; at least 1/4 the heigh of R wave in same QRS
Non Q-wave/NSTEMI (depressed) (sub-endocardial MI) –> area of myocardium can re-infarct if not managed
Bundle branch blocks

Cardio I - ECG (7 decks)

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