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CH 1 > ECG Rhythms (Module 4) > Flashcards

ECG Rhythms (Module 4) Flashcards

1
Q

To Treat or Not to Treat

A

assess/treat the pt and not the monitor

is pt symptomatic?
give O2 and monitor saturation
monitor BP and HR
start IV if not already established
notify MD

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2
Q

Five Steps to Identify HR

A

rate?
rhythm? irregular (varies more than 0.08 s)
P wave before each QRS? Are P waves upright and uniform in lead II
what is length of PR interval? 0.12-.2 s (3-5 small squares)
do all QRS complexes look alike? 0.06-.12s (1.5-3 small squares)

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3
Q

P wave

A

atrial depolarization

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4
Q

PRI

A

the time it takes for the impulse to reach the ventricles

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5
Q

QRS complex

A

ventricular depolarization and atrial repolarization (masked by QRS)

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6
Q

T wave

A

ventricular repolarization

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7
Q

U wave

A

Purkinje fiber repolarization (if visible)

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8
Q

PLEASE REVIEW ECG STRIPS OF ARRHYTHMIAS

A

PLEASE REVIEW ECG STRIPS OF ARRHYTHMIAS

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9
Q

Sinus Bradycardia

A

normal in some athletes
response to carotid massage, Valsalva, hypothermia, parasympathetic drugs, increased ICP, hypothyroidism, inferior wall MI

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10
Q

Sinus Bradycardia ECG Characteristics

A

HR less than 60

normal and inverted QRS??

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11
Q

Sinus Bradycardia Significance and Treatment

A

pale
cool skin
hypotension
angina
dizziness/syncope
SOB
confusion
disorientation

pacing, atropine

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12
Q

Sinus Tachycardia

A

SNS stimulation
anxiety
pain
fever
caffeine
alcohol
nicotine
dehydration

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13
Q

Sinus Tachycardia ECG Characteristics

A

HR >100 but <180

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14
Q

Sinus Tachycardia Significance and Treatment

A

SPB
dizziness
low BP

beta blockers, anxiety meds

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15
Q

SVT

A

may occur in healthy person and stop on its own
angina
HF
cardiogenic shock

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16
Q

SVT ECG Characteristics

A

atrial rate 100-280 BPM (>150)
regular rhythm
P waves not visible
PR interval and QRS normal

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17
Q

SVT Significance and Treatment

A

palpitations
hypotension
dizziness
anxiety
CP
weakness

ablation, vagal, adenosine, CCBs, cardioversion

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18
Q

A Fib/A Flutter

A

atrial fibrosis; loss of muscle mass
HTN
HF
CAD
ETOH

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19
Q

A Fib ECG Characteristics

A

atrial rate as high as 350-600
ventricular rate 50-180
p wave indiscernible
irregular

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20
Q

A Fib/A Flutter Significance and Treatment

A

loss of atrial kick=loss of CO

decrease ventricular rate, CCB, BB, Dig, Amio, Cardioversion, heparin

21
Q

A Flutter ECG Characteristics

A

atrial rate 2:1,3:1, etc.
ventricular rate 50-180
p wave methodic and saw tooth

22
Q

First Degree AV Block

A

MI
CAD
hypothyroid
vagal stimulation drugs (digoxin, BB, CCBs)

23
Q

First Degree AV Block ECG Characteristics

A

HR normal
reg rhythm
p wave normal
PR interval >.20 s and constant
QRS normal

24
Q

First Degree AV Block Significance and Treatment

A

precursor to lethal HBs

watch/monitor, med changes

25
Q

Second Degree AV Block Type I (Wenckebach or Mobitz 1)

26
Q

Second Degree AV Block Type I (Wenckebach or Mobitz 1) ECG Characteristics

A

progressive prolonged
PRI until P wave is blocked
normal QRS

27
Q

Second Degree AV Block Type I (Wenckebach or Mobitz 1) Treatment

A

may not need treatment but may progress

28
Q

Second Degree AV Block Type 2 (Mobitz 2)

A

ischemia
myocarditis
post cardiac surgery
CCBs
dig

29
Q

Second Degree AV Block Type 2 (Mobitz 2) ECG Characteristics

A

blocked P wave

30
Q

Second Degree AV Block Type 2 (Mobitz 2) Significance and Treatment

A

may progress to complete block

PPM

31
Q

Third Degree AV Block (AV Dissociation)

A

ischemia
MI
fibrosis
cardiomyopathy

32
Q

Third Degree AV Block (AV Dissociation) ECG Characteristics

A

P wave no relation to QRS
atrial rate higher than ventricular rate

33
Q

Third Degree AV Block (AV Dissociation) Treatment

34
Q

PVC

A

stimulants
electrolyte imbalances (K, Mg)
emotional distress
exercise, hypoxia

35
Q

PVC ECG Characteristics

A

HR varies, regular rhythm
P wave absent
QRS wide/bizarre, distorted, >.12s, bigeminy/trigeminy/quageminy

36
Q

PVC Significance and Treatment

A

nonperfusing beats, no pulse

K, amio

37
Q

Ventricular Tachycardia (monomorphic)

A

almost always in diseased hearts
MI
ischemic heart disease
HF
cocaine

38
Q

Ventricular Tachycardia ECG Characteristics

A

ventric rate 100-200
QRS > .12s

39
Q

Ventricular Tachycardia Significance and Treatment

A

slower rates may be tolerated better

check pt, start CPR, pulse less v tach, defibrillate cardioversion if pulse, epi/vasopressin, amiodarone

40
Q

Torsade de Pontes (Polymorphic V-Tach)

A

review ECG strip but looks like a bunch of squiggles

41
Q

V Fib

A

CAD
MI
hypokalemia
hypomagnesemia
hemorrhage
drug therapy
shock

42
Q

V Fib ECG Characteristics

A

ventric rate >300
fibrillary waves noted

43
Q

V Fib Significance and Treatment

A

no coordinated atrial or ventricular contraction

check pt, start CPR, pulse less v tach, defibrillate cardioversion if pulse, epi/vasopressin, amiodarone

44
Q

Asystole

A

myocardial hypoxia
advanced HF
severe hyperkalemia and acidosis
PM failure

45
Q

Asystole ECG Characteristics

46
Q

Asystole Significance and Treatment

A

cardiac arrest than respiratory arrest

epi, CPR

47
Q

Pulseless Electrical Activity

A

hypovolemia #1 cause

hypoxia
acidosis
hypo/hyperkalemia
hypothermia
MI
toxins
tamponade
tens pneumo
thrombosis trauma
overdose of tricyclic antidepressants

48
Q

Pulseless Electrical Activity ECG Characteristics

49
Q

Pulseless Electrical Activity Significance and Treatment

A

no pulse; loss of consciousness; no BP

CPR

CH 1 (24 decks)

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