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Complex DMR > ECG & Dysrhythmias > Flashcards

ECG & Dysrhythmias Flashcards

1
Q

Sinus arrhythmia characteristics

A 
Rate
80
Regularity
Irregular
P wave?
Yes
P:QRS ratio
1:1
PR interval
.14
QRS width
.06
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2
Q

Bradycardia & potential causes

A 
<60 BPM 
 Hypoxia
 Hypothermia
 Medications
Sleep
Normal in athletes
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3
Q

Bradycardia treatment & symptoms

A

Symptomatic
Syncope, chest pain, hypotension, shortness of breath, diaphoresis
Atropine .5mg IVP

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4
Q

Tachycardia & potential causes

A

100+ BPM

Fever
Anemia
Hypovolemia
Hypotension
Pulmonary embolism
Myocardial infarction
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5
Q

Before treating tachycardia, what do you want to know?

A

Is pt symptomatic/compensating?

Treat the cause (blood products, fluid, etc)

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6
Q

tachycardia treatment

A

BB CCB

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7
Q

A-fib characteristics

Rate/rhythm/pwave?/P:QRS ratio/ PR interval

A

Slow:50
Fast: 170
Irregular
No Pwave , P:QRS, PR interval

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8
Q

Complications of Afib

A

Decreased CO & Clots

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9
Q

Treatment of Afib

A

Anticoagulation
• Heparin gtt (inpatient) • Oral anticoagulants
Rate control
• Digoxin, beta blockers, calcium channel blockers Rhythm control
• Antiarrhythmics, cardiac ablation, cardioversion (need TEE first!)

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10
Q

A flutter Characteristics Rate/rhythm/pwave?/P:QRS ratio/ PR interval

A 
rate 100/50
irregular 
No P wave--F wave present
P:QRS ratio n/a
PR interval n/a
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11
Q

Possible a flutter causes

A 
Acute MI
• Mitral valve disease
• Thyrotoxicosis (↑T4)
• COPD
• Chest surgery
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12
Q

A-flutter treatment

A

Rate control until SA node takes over again • Beta blockers, calcium channel blockers
► Antiarrhythmics or cardioversion if needed

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13
Q

SVT

Characteristics Rate/rhythm/pwave?/P:QRS ratio/ PR interval

A 
Rate 100-167 
Regular
P wave present but can be hidden in t wave(?)
P:QRS: 1:1
PR: w/in range
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14
Q

SVT treatment:

A

Determine underlying rhythm

Slow heart rate (BB/CCB)

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15
Q

give name & rate of 3 Junctional Rhythms

A

rate 40-60 junctional
rate 61-100 accelerated junctional
rate 100+ junctional tachy

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16
Q

Junctional wave characteristics Rate/rhythm/pwave?/P:QRS ratio/ PR interval

A

40-100+ depending on rhythm
regular
Inverted P wave/buried p wave/ no pwave
PR/P:QRS ratio depends on if pwave is present

17
Q

Causes of Junctional rhythm

A

Digoxin toxicity
Acute MI
Heart Surgery

18
Q

Treatment of Junctional rhythm

A 
Supportive care (pacing)
Treat the cause
19
Q

Defibrillation

A

• Not synchronized
– Deliveredanytimeincardiaccycle
• Higher energy (electricity)

20
Q

Debribrillation rhythms

A

Ventricular fibrillation

Ventricular tachycardia without a pulse

21
Q

Cardioversion

A
  • Synchronized

* Delivered on the R wave • Lower energy (electricity)

22
Q

Cardioversion rhythms

A

̶ Atrial fibrillation (after
anticoagulation!)
̶ Unstable tachyarrhythmias

23
Q

Epinephrine

A
  • First line for pulseless rhythms • 1mg q 3-5 minutes

* PEA = Push Epi Always

24
Q

Amiodarone

A
  • Antiarrhythmic
  • Reduces heart rate
  • Drip used in tachyarrhythmias
25
Q

Atropine

A
  • Antimuscarinic anticholinergic • Increases heart rate
  • Used in bradycardias
  • .5mg IVP (“.5 alive”)
26
Q

Adenosine

A

• Converts, stops or slows rhythms • 6mg IVP, then 12mg IVP if needed

27
Q

types of pacemaker

A

Transcutaneous
Transvenous
Transthoracic (epicardial)
Internal

28
Q

Types of pacing

A

Atrial, venticular, biventricular, dual chamber

29
Q

Atrial Pacer spike

A

► Atrial

• Pacer spike prior to P wave

30
Q

Ventricular pacer spike

A

• Pacer spike prior to QRS

31
Q

Biventricular

A

• Two spikes prior to QRS (lead

in each ventricle)

32
Q

Dual chamber

A

• Spike prior to P wave and QRS

33
Q

Failure to fire

A

No pacer spikes where they should have been

34
Q

Loss of capture

A

Pacer spikes not followed by P or QRS complex

35
Q

Undersensing

A

Pace beats or spikes too close to previous beats results in spikes in T waves or Qrs

36
Q

Assessing PM function

A

is the chamber being paced capturing? • P wave or QRS after a spike
► Is the pacemaker sensing the patient’s inherent rhythm? • Pacer spike when appropriate – not too many or too little
► Is there a pulse with each the pacer rhythm? • Palpate!

Complex DMR (12 decks)

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