Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EKG > ECG Rules > Flashcards

ECG Rules Flashcards

1
Q

Tall, peaked T wave

A

K+ is too high or myocardial ischemia is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

U wave may represent

A
  • low K+
  • abnormal Mg+ levels
  • normal repolarization of purkinje fibers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Slowed conduction (>0.20) in the PR interval is indicative of…

A

1st degree AVB (AV block)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

QRS complex >0.12 represents

A

-R or L bundle branch block and a slowing of normal conduction through the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a deep Q wave signifies…

A

myocardial infarct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what creates a slight variance in normal RR intervals?

A

respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Normal QT interval

A

less than one-half the RR interval and should not vary from one complex to another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

problem with a long QT interval

A

it presents an extended opportunity for stray irritable impulses to excite the muscle and may trigger dangerous ventricular rhythms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

medications that prolong the QT interval

A

quinidine and pronestyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

elevated ST segment

A
  • more than 1mm above baseline

- indicates myocardial ischemia: lack of oxygen to cardiac muscle (STEMI)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

normal sinus rhythm (NSR)

A
  • regular rhythm
  • 60-100 bpm
  • each complex is complete
  • intervals are within normal limits
  • nothing looks off
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

treatment of sinus bradycardia if pt is symptomatic

A

atropine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

significance of sinus tachycardia

A
  • depends on pt’s tolerance of increased HR- some have dizziness and hypotension
  • increased HR = increased myocardial O2 consumption
  • MI pts with consistent tachy have increased risk for angina and increased infarct size
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

treatment of sinus tachycardia

A
  • treat underlying cause

- beta blockers (Inderal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

sinus arrhythmia

A
  • RR intervals vary; rate changes with respirations

- usually no significance and no treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Premature atrial contractions (PAC)

A
  • early complex
  • atrial because it still has a p-wave
  • t-wave might be bigger because p-wave is sitting on top of it
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

PAC associations

A
  • usually from stress, caffeine, tobacco, alcohol
  • could be infection, inflammation, hyperthyroidism, COPD, heart disease, valvular disease
  • enlarged atrium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

treatment of PAC

A
  • start with getting rid of caffeine, tobacco, alcohol

- meds: dig, quinidine, procainamide, beta-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

atrial flutter

A
  • p-waves have saw-tooth appearance
  • SA node constantly firing
  • if >100 bpm, significantly decreased CO and could go into HF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

problems with atrial flutter

A
  • decreased CO because atria can’t refill with blood (decreased preload)
  • at risk for clots because of sitting blood… they’ll be on an anticoagulant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

treatment of atrial flutter

A
  • cardioversion: reads QRS so it shocks when its supposed to

- meds: verapamil, diltizem, dig, quinidine, procainamide, beta-blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

atrial fibrillation

A
  • *hallmark sign is regularly irregular QRS complexes

- syncope is often caused by an otherwise healthy person going into AFib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

significance of AFib

A
  • decreased CO because lose “atrial kick”
  • thrombi
  • stroke
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

treatment of AFib

A
  • will need to be on anticoagulants
  • if fast: digoxin
  • if slow: pacemaker
  • emergency situations: cardioversion
  • other meds: verapamil, diltizem, quinidine, beta-blockers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

atrial tachycardia

A
  • R-R is constant and rate is regular
  • rate is 150-250 bpm
  • patient will say “my heart is racing” or “pounding out of my chest”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

atrial tachycardia associations

A
  • overexertion and emotional stress
  • DIG TOXICITY
  • changes in position, deep insporation, caffeine and tobacco
  • Will Parkinson Wright
  • RDH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

treatment of atrial tachycardia

A
  • Adenosine doesn’t treat, just slows HR so you can see rhythm and have paddles ready
  • vagal stimulation
  • Meds: adenosine, verapamil, diltiazem, digitalis, propanolol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

premature junctional contraction (PJC)

A
  • premature beat (irregular rhythm)
  • no p-wave
  • fired from the AV node
  • QRS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment of PJC

A
  • rarely causes s/s

- MAY medicate with procainamide or quinidine

30
Q

treatment of junctional escape rhythm

A
  • only medicate if symptomatic

- if symptomatic, give atropine

31
Q

associations of accelerated junctional rhythm

A
  • acute inferior MI
  • Dig toxicity
  • acute rheumatic fever
  • open heart surgery
32
Q

treatment of accelerated junctional rhythm

A
  • if Dig tox: hold Dig

- atrial pacemaker

33
Q

junctional tachycardia

A
  • no p-wave
  • regular rate and rhythm
  • rate >100 bpm (usually 100-180)
  • QRS
34
Q

junctional tachycardia associations

A

-*ACUTE INFERIOR MI
-Dig tix
acute rheumatic fever
-open heart surgery
(rapid HR can cause s/s of low CO)

35
Q

treatment of junctional tachycardia

A
  • vagal stimulation
  • verapamil
  • cardioversion
36
Q

premature ventricular contractions (PVC)

A
  • ectopic beat
  • no p-wave
  • wide QRS >.12
  • associated with irregular pulse
37
Q

bigeminy

A

every other beat is early

38
Q

trigeminy

A

every 3rd beat is early

39
Q

couplet vs run

A
  • couplet is a PVC that comes in pairs

- run is a PVC that is 3 or more in a row

40
Q

clinical associations of PVCs

A
  • **HYPOKALEMIA
  • hypoxia (could happen during suctioning)
  • stimulants
  • MI, mitral valve prolapse, CHF, CAD
41
Q

significance of PVCs

A
  • could cause Vtach
  • usually benign is pts with normal hearts
  • may reduce CO- angina and HF (heart will enlarge to compensate and cause hypertrophy)
42
Q

indications for treatment of PVCs

A
  • six or more in one minute
  • ventricular couplets or triplets
  • multifocal PVCs
  • R on T phenomenon
43
Q

treatment of PVCs

A
  • amiodarone is drug of choice
  • lidocaine: initial bolus - 0.5-1.5 mg/kg and continuous infusion of 2-4 mg/min
  • procainamide
44
Q

ventricular tachycardia

A
  • regular rate/rhythm
  • rate of 150-250 bpm
  • QRS >.12
45
Q

treatment of ventricular tachycardia

A
  • if pulseless: defibrillate
  • if they have a pulse: drug of choice is amiodarone
  • also lidocaine, pronestyl
46
Q

torsades de pointes

A
  • type of vtach - “twisting of the points”

- crescendo-decrescendo

47
Q

treatment of torsades de pointes

A

-magnesium sulfate

48
Q

ventricular fibrillation and treatment

A
  • no waves or complexes that can be measured or analyzed

- defibrillate immediately, CPR

49
Q

idioventricular rhythm

A
  • 20-40 bpm
  • no p-wave
  • wide QRS and often bizarre looking
50
Q

treatment of idioventrivular rhythm

A
  • atropine, isuprel (DO NOT GIVE LIDOCAINE)

- pacemaker

51
Q

asystole and treatment

A
  • flatline, no pulse
  • always check leads first
  • CPR, ACLS with early intubation and IV epi and atropine
52
Q

pulseless electrical activity (PEA)

A
  • electrical activity can be observed but there is no mechanical activity and NO pulse
  • prognosis is poor unless underlying cause is corrected immediately
53
Q

causes of PEA

A 
PATCHHH
Pulmonary emolus
Acidosis
Tension pneumothorax
Cardiac tamponade
Hypovolemia
Hypoxemia
Hypothermia
54
Q

treatment of PEA

A
  • treat underlying cause

- CPR with early intubation and IV epi

55
Q

first degree heart block

A
  • “if the R is far from the P, then you have first degree”
  • PR interval will be constant but greater than .20
  • AV node is always the one thats blocking it
56
Q

treatment of first degree

A

none

57
Q

wenckebach (second degree heart block type 1)

A
  • “longer, longer, longer, drop, then you have Wenchebach!”

- hallmark: PR is long, next on is longer, longer, then complex is dropped

58
Q

treatment of wenckebach

A

if symptomatic: atropine (always start with .5 mg) or pacemaker

59
Q

classical second degree heart block (Mobitz II)

A
  • “if some p’s don’t get through, then you have Mobitz II”

- some p’s don’t have a QRS, but the ones that do are fixed and regular, they are close to the QRS

60
Q

treatment of classical 2nd degree heart block

A
  • pacing

- can try atropine, epi, dopamine

61
Q

complete or 3rd degree heart block

A
  • “if Ps and Qs don’t agree, then you have 3rd degree”
  • R-R is regular
  • P to P is regular
  • But no relationship between P and QRS… complex is all jacked up
62
Q

treatment of 3rd degree heart block

A
  • priority pt for pacemaker

- may use atropine, epi, dopamine

63
Q

indications for a pacemaker

A
  • symptomatic sinus bradycardia
  • chronic atrial fib with a slow ventricular response
  • idioventricular rhythm
  • 2nd degree heart block type 2
  • 3rd degree heart block
  • sick sinus syndrome
64
Q

failure to pace

A
  • there is no pacemaker spike when there should be one
  • pacemaker fails to initiate an electrical impulse when needed
  • check battery or MD reposition pacing electrode
65
Q

failure to capture

A
  • there is a spike and no immediate p wave or QRS
  • pacemaker initiates a pulse but fails to get a response (contraction)
  • caused by: pacer lead fracture, battery failure, electrode movement, or fibrosis at electrode tip
  • may need to increase coltage
66
Q

failure to sense

A
  • there is a pacemaker pike after a contraction
  • pacemaker fails to sense pts heartbeat and initiates an electrical pulse
  • caused by: pacer lead fracture, battery failure, movement of electrode
  • need to increase the sensitivity of the external pulse generator
67
Q

Atropine

A
  • increases HR

- always start with 0.5 mg; increase and repeat q 3-5 min in ACLS

68
Q

digoxin

A
  • slows ventricular rate, increased CO
  • give in AFib and AFlutter
  • paroxysmal atrial tachycardia
69
Q

amiodarone

A
  • slows the sinus rate, increases PR and QT intervals, causes vasodilation
  • life-threatening ventricular arrhythmias unresponsive to less toxic agents
  • VFib and VTach
  • supraventricular tachyarrhythmias
70
Q

adenosine

A
  • slows conduction through the AV node

- conversion of paroxysmal supraventricular tachycardia to NSR when vagal maneuvers are unsuccessful

71
Q

lidocaine

A
  • suppresses automaticity and spontaneous depolarization of ventricles
  • for ventricular arrhythmias
72
Q

magnesium sulfate

A

-torsades de pointes

EKG (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions