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Adult Health II > ECG and Dysrhythmias > Flashcards

ECG and Dysrhythmias Flashcards

1
Q

What is the P wave?

A

atrial depolarization (contraction)

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2
Q

What is the PR interval?

A

the time it takes from the start of atrial depolarization for an impulse to travel through the atrial tissue, AV node, bundle of His, bundle branches, and purkinje fibers (just before ventricular depolarization)

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3
Q

How long is the PR interval?

A

0.12-0.20 seconds or 3-5 small blocks

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4
Q

What is the QRS complex?

A

ventricular depolarization

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5
Q

How long is the QRS complex?

A

0.04-0.10 seconds or 1-2.5 small blocks

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6
Q

What is the ST segment?

A

early ventricular repolarization

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7
Q

How much ST segment displacement is significant?

A

elevation/depression by 1 mm or one small block up and down

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8
Q

What is the QT interval?

A

the total time for ventricular depolarization and repolarization

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9
Q

How long is the QT interval?

A

0.30-0.44 seconds or 7.5-11 small blocks

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10
Q

Causes of sinus bradycardia

A

vagal stimulation, valsalva (bearing down), carotid massage, vomiting, medications (BB, CCB, Digoxin)

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11
Q

Treatment of sinus bradycardia

A

atropine (only treat if pt is symptomatic), IV fluids, O2

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12
Q

Causes of sinus tachycardia

A

stress and dehydration

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13
Q

Pathophysiology of sinus tachycardia

A

increased CO & BP, increased myocardial O2 demand, decreased coronary artery perfusion time, decreased diastolic filling time

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14
Q

Treatment of sinus tachycardia

A

Treat the cause (doesn’t always require treatment bc stress can cause it), valsalva, carotid massage, medications (BB, CCB, Digoxin)

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15
Q

Atrial tissue becomes irritable and fires an impulse before the next sinus impulse is due

A

Premature atrial contraction

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16
Q

Rapid stimulation of atrial tissue
Rate: 150-250 bpm
Clinical Manifestations: palpitations, chest pain, SOB, anxiety, hypotension

A

Supraventricular Tachycardia (SVT)

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17
Q

Prolonged/untreated SVT leads to this

A

inability to maintain BP, HF, and cardiogenic shock

18
Q

Interventions for SVT

A

From least to most invasive:
Valsalva, carotid massage, bearing down
Adenosine: medication that resets electrical conduction
Cardioversion
Cardiac Ablation (if Pt experiences continuing episodes of SVT)

19
Q

Most common dysrhythmia seen in practice

A

atrial fibrillation

20
Q

Rapid impulses from many atrial foci depolarize the atria in a disorganized manner
Atrial rate: 300-600 bpm
Ventricular rate: 120-200 bpm

21
Q

Etiology of A fib

A

age, valve disorders, cardiomyopathy

22
Q

Complications of A fib

A

CO decreases by 20-30%, increased risk for blood clots

23
Q

Medications for A fib

A

Amiodarone (antidysrhythmic) - can cause worsening dysrhythmias so tell Pt to report worsening symptoms

CCB (Diltiazem), BB, Digoxin - these work for most tachydysrhythmias

Anticoagulation therapy - warfarin (educate to avoid foods high in Vit K), Heparin, Enoxaparin (Lovenox)

24
Q

Interventions for A fib (if medications don’t work)

A

Synchronized cardioversion - turn off O2, make sure everyone is clear, press synchronize button on crash cart

Cardiac ablation - used as a long-term tx if patient frequently goes into dysrhythmias

25
Q

Repetitive firing of irritable ventricular tissue
Rate: usually 140-180 bpm
Wide and Bizarre QRS

A

Ventricular Tachycardia

26
Q

Causes of V tach

A

cardiomyopathy, hypomagnesemia, drug toxicity, hypokalemia, ischemic heart disease, MI

27
Q

Tx for V tach w/ pulse

A

they are stable - monitor closely & prepare for cardioversion

28
Q

Tx for pulseless V tach

A

CPR & defibrillate

29
Q

Electrical chaos in the ventricles
Ventricles quiver
NO CARDIAC OUPUT = NO PULSE

A

Ventricular Fibrillation

30
Q

Etiology of V fib

A

same as V tach, surgical manipulation of the heart, failed cardioversion

31
Q

Tx for V fib

A

Immediately defibrillate x 3 & CPR

32
Q 
Complete absence of ventricular rhythm 
No QRS complex
No contraction 
No CO
No pulse 
No perfusion
A

Ventricular Asystole

33
Q

Etiology of Ventricular Asystole

A

trauma, overdose, MI

34
Q

Tx for asystole

A

CPR and ACLS - trying to get a shockable rhythm

35
Q

Waves forms on the monitor

No pulse

A

Pulseless Electrical Activity (PEA)

36
Q

Tx for PEA

A

CPR and ACLS - trying to get a shockable rhythm

37
Q

Shockable Rhythms

A

V fib and pulseless V tach

38
Q

Non-shockable rhythms (treat with CPR and ACLS - goal is to get a shockable rhythm)

A

PEA and asystole

39
Q

One small block represents ____ seconds on an ECG

A

0.04 seconds

40
Q

One large block represents ____ seconds on an ECG

A

0.20 seconds

Adult Health II (19 decks)

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