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G270 MS Exam #1 > ECG Bootcamp > Flashcards

ECG Bootcamp Flashcards

1
Q

What is plan A?

A

SA node

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2
Q

What is plan B?

A

AV node

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3
Q

What is Plan C?

A

AV bundle

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4
Q

What is plan D?

A

Purkinje Fibers

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5
Q

SA node inherent rate

A

60-100bpm

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6
Q

AV node inherent rate

A

40-60 bpm

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7
Q

Bundle of HIS inherent rate

A

20-40 bpm

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8
Q

Cardiac Monitoring where leads go

A

“White over Right”
“Clouds over grass”
“Smoke over Fire”
“Chocolate close to the heart”

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9
Q

Small box seconds

A

0.04 seconds

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10
Q

Large box seconds

A

0.2 seconds

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11
Q

Large box=___small boxes

A

5

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12
Q

PR interval length

A

0.12-0.20 seconds

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13
Q

QRS complex length

A

0.06-0.12 seconds

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14
Q

ST segment length

A

0.08-0.12 seconds

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15
Q

Q length

A

< 0.04 seconds

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16
Q

Normal Sinus rhythm rate

A

60-100 bpm

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17
Q

P-wave in NSR

A

Normal

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18
Q

Sinus Tachycardia rate

A

100-150 bpm

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19
Q

Causes of sinus tachycardia (9)

A
  • hyperthyroidism
  • hypovolemia
  • HF
  • anemia
  • exercise
  • use of stimulants
  • fever
  • pain
  • anxiety
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20
Q

What to assess for in sinus tachycardia?

A

Low cardiac output

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21
Q

Treatment for sinus tachycardia (4)

A

Treat cause—> pain med, antipyretics, hydration, etc

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22
Q

Sinus Bradycardia rate

A

Bpm less than 60

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23
Q

Causes of sinus bradycardia (7)

A
  • vagal response
  • drugs
  • ischemia
  • disease of the nodes
  • ICP
  • hypoxemia
  • athletes
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24
Q

Difference between asymptomatic and symptomatic sinus Brady

A

Symptomatic —> decreased CO

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25
Q

What to do for symptomatic Brady

A

Assess and tx cause

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26
Q

Interventions for sinus brady

A
  • atropine
  • transcutaneous pacing
  • dopamine or epinephrine infusion
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27
Q

When to not use atropine to tx sinus bradycardia

A

When the bradycardia is associated with hypothermia

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28
Q

What is sinus arrhythmia?

A

Sinus rhythm but the rate varies with inspirations

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29
Q

Rate changes with sinus arrhythmias

A

Inspire=increase in rate

Expire=decrease in rate

30
Q

Does sinus arrythmia affect hemodynamics status?

A

Very rarely

31
Q

What happens in sinus arrest/pause?

A

SA node fails to fire —> no PQRST complex

32
Q

Causes of sinus arrest (5)

A
  • MI
  • hyperkalemia
  • digoxin
  • OD
  • physiological response to increased vagal tone
33
Q

For atrial dysrhythmias, where is it seen on the EKG?

A

Changes in the p wave

34
Q

Premature Atrial Contraction —> what is seen in the EKG?

A

Early p wave..may be seen in the t wave

35
Q

Rate of Supraventricular tachycardia or paroxysmal SVT

A

150-250 bpm and regular

36
Q

Rate of atrial tachycardia

A

150-250 bpm

37
Q

Main difference between SVT and AT

A

1:1 conduction for AT —> ventricle responds to every atrial impulse……SVT —> abrupt onset and cessation

38
Q

Pattern of atrial flutter

A

Sawtooth pattern

39
Q

Causes of atrial flutter (6) and intervention

A
  • lung disease
  • ischemic heart disease
  • Hyperthyroidism
  • hypoxemia
  • HF
  • alcoholism

Intervention —> address cause

40
Q

A fib characteristics (3)

A
  • no discernible p wave
  • irregular ventricular rate
  • results in loss of atrial kick
41
Q

What is someone with a fib at risk for

A

Pulmonary or systemic emboli

42
Q

What are junctional rhythms?

A

When the AV node takes over as the conduction system “gate keeper”

43
Q

What is the junctional escape rate

A

40-60 bpm

44
Q

Accelerated junctional rate

A

60-100 bpm

45
Q

Junctional bradycardia rate

A

Less than 40 bpm

46
Q

Since the location of the AV node is in the center of the heart, what happens to the impulses that are generated from it?

A

They may be conducted forward, backward, or both

47
Q

What happens to the EKG in the junctional escape rhythm?

A

P-wave changes —> may be inverted, absent, or may follow QRS

48
Q

Rate and rhythm of junctional escape rhythm

A

Regular (not from SA node) usually 40-60 bpm

49
Q

Accelerated junctional rate

A

60-100bpm

50
Q

Patient response to accelerated junctional

A

Decrease in CO and hemodynamic instability, depending on the rate

51
Q

Causes of accelerated junctional- 6

A
  • SA node disease
  • ischemic heart disease
  • electrolyte imbalances
  • dig. Toxicity
  • acute MI
  • hypoxemia
52
Q

Treatment of accelerated junctional

A

-treat tachycardia if hemodynamically unstable and alert the provider to change the rhythm

53
Q

What happens to EKG in ventricular dysrhythmias?

A

Wide and bizarre QRS

54
Q

Characteristics of premature ventricular contractions-3

A
  • wide irregular QRS
  • QRS complex greater than 0.12 sec
  • absent p waves
55
Q

Types of PVCs-5-and what they are

A
  • pairs (couplets): 2 sequential pvc
  • runs or bursts: 3 or more sequential PVCs (aka vtach)
  • bigeminy PVC: every other beat is a PVC
  • trigeminy PVC: every third beat is a PVC
  • Quadrigeminy PVC: every 4th beat is a PVC
56
Q

WHen are PVCs dangerous?-4

A
  • frequent, multi focal
  • two or more in a row
  • PVC falls into the vulnerable period of the T wave
  • may lead to Vtach (pulse less VT) or ventricular fib.
57
Q

What is Vtach?-5

A
  • 3 or more PVCs in a row
  • greater than 100 bpm (may go up to 300)
  • wide QRS complexes
  • pulse and pulse less VT
  • treatment pulse less same as v fib
58
Q

Causes of VT-10

A
  • hypoxemia
  • acid-base imbalances
  • exacerbation of HF
  • ischemic heart disease
  • cardiomyopathy
  • hypokalemia
  • hypomagnesemia
  • valvular heart disease
  • genetic abnormalities
  • QT prolongation
59
Q

Torsades de Pointes aka…

A

“Twisting about the point”

60
Q

Torsades de pointes is a type of ____ and what needs to be done

A
  • type of VT

- lethal and treated as pulseless VT—> CPR!!!!!!

61
Q

Cause of torsades de pointes

A

Magnesium deficiency

62
Q

V fib characteristics-4

A
  • chaotic pattern
  • no discernible P, Q, R, S or T
  • coarse or fine
  • no CO
63
Q

What to do first for V fib

A

Check pt-make sure not a loose lead

64
Q

What needs to be done after the patient is checked for a loose lead with v fib (if its not a loose lead)?

A

IMMEDIATE CPR AND DEFIBRILLATION

65
Q

What is an idioventricular rhythm?

A

Escape ventricular rhythm from purkinje fibers

66
Q

Rate for idioventricular rhythm

A

15-40 bpm, regular rhythm

67
Q

Characteristics of idioventricular rhythm

A
  • wide QRS

- no p waves

68
Q

Pulseless electrical activity —> what is it?

A

Looks like a normal rhythm, but no pulse

69
Q

Pulseless electrical activity —> what to assess

A
  • apical and carotid pulses

- quick cardio assessment

70
Q

PEA causes 5 H’s

A
  • hypoxia
  • hypovolemia
  • hypothermia
  • H+ ions (acidosis)
  • Hypo or hyperkalemia
71
Q

PEA causes 5 T’s

A
  • Tablets (OD)
  • tamponade (cardiac)
  • tension pneumothorax
  • thrombosis (coronary)
  • Thrombosis (pulmonary

G270 MS Exam #1 (6 decks)

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