ECG Dysrhythmias

Question 1

Normal Sinus Rhythm

Answer 1

HR: 60-100
Regular Rhythm
P wave before every QRS
PR Interval: 0.12-0.20 seconds
QRS Duration: 0.06-0.12
Treatment: None-normal rhythm

Question 2

Sinus Bradycardia

Answer 2

HR: Less than 60
Regular Rhythm
P waves and QRS present
Assess: Dizziness, low BP
Treatment: IV fluids, oxygen or atropine.

Question 3

Sinus Tachycardia

Answer 3

HR: Greater than 100
Regular Rhythm
P waves and QRS Present
Treatment: Assess and treat underlying cause.

Question 4

Atrial Fibrillation

Answer 4

Irregular Rhythm
Lots of tiny indiscernible P waves
QRS present but irregular
Assess: Fatigue, weakness, SOB, anxiety, syncope, palpitations, chest pain, hypotension.
Treatment: Drug therapy
Common in clients with Hypertension, HF, CAD.

Question 5

Ventricular Fibrillation

Answer 5

Electrical chaos
No discernible P waves, T waves, or QRS
Blood not being pumped out of heart and brain not receiving blood.
Treatment: Defibrillate, CPR, Airway Management, ACLS Protocol.

Question 6

Ventricular Tachycardia

Answer 6

HR: 140-180
No P or T waves
Wide frequent QRS is present
Treatment: Need 12-lead ECG to determine stable or unstable VT, both must be defibrillated.
Stable VT: Oxygen, amiodarone, lidocaine, or magnesium.
Unstable VT: Treat as VF.

Question 7

Ventricular Asystole

Answer 7

Absence of any rhythm.
Appears as flat line but may occasionally have QRS.
Full cardiac arrest
Treatment: DO NOT DEFIB!!! There’s no electrical activity. Manage airway and CPR.

Question 8

Cardiac Markers

Answer 8

*Troponin: Myocardial muscle protein - diagnostic for MI.

*Creatine Kinase: Enzyme of myocardium, brain, skeletal muscle - indicates tissue necrosis/injury.

*Creatine Kinase-MB (CK-MB): Myocardial muscle.

*Myoglobin: Cardiac and skeletal muscle.