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critical care > EKG > Flashcards

EKG Flashcards

1
Q

ability of cardiac cells to generate their own impulse

A

automaticity

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2
Q

how “ready” cells are

A

excitability

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3
Q

conduction of cardiac cell info from one cell to the next

A

conductivity

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4
Q

squeeze of cardiac muscle in response to impulse

A

contractility

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5
Q

electrical conduction of this node is 60-100bpm

A

SA node

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6
Q

electrical conduction of this node is 40-60bpm

A

AV node

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7
Q

electrical conduction of this is 20-40bpm

A

purkinje fibers

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8
Q

important ions to consider with the heart:

A

potassium, sodium, calcium, magnesium

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9
Q

lead 1 on a 12-lead shows

A

atrial disturbances

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10
Q

lead 2 on a 12-lead shows

A

ventricular disturbances

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11
Q

a 6 second strip of an EKG is how many large boxes?

A

30

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12
Q

1 small square on an EKG is

A

0.04seconds

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13
Q

how do you do a 6 second count?

A

multiple the # QRS complexes found over 6sec by 10 to get HR/minute

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14
Q

if ST segment goes below baseline, this means _______ is happening

A

ischemia

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15
Q

if ST segment is way up above baseline there is a

A

potential blockage (MI)

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16
Q

if no P wave, there is a(n) _______ problem

A

atrial

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17
Q

if no QRS complex, there is a(n) ________ problem

A

ventricular

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18
Q

what is the treatment for symptomatic sinus bradycardia?

A

vagal stimulation, supplemental O2/IV fluids, atropine, pacing

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19
Q

atropine dosing

A

if pt <90kg give 0.5mg, if >90kg give 1mg for a total of up to 3mg

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20
Q

treatment of symptomatic sinus tachycardia

A

digoxin, beta-blockers, diuretics (treat the cause)

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21
Q

HR elevated (150-250)

A

supraventricular tachycardia

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22
Q

treatment of SVT includes

A

vagal stimulation, adenosine, cardioversion

23
Q

long-term risk of untreated afib

A

stroke

24
Q

blood does what in atrial fibrillation?

A

pools –> coagultes

25
Q

what medications treat afib?

A

anticoagulants & antidysrhythmics

26
Q

what do P waves look like in atrial flutter?

A

saw tooth

27
Q
  • lack of communication between top to bottom of heart –> electrical impulse completely blocked b/t atria and ventricles
  • HR typically between 20-40
  • P to P regular, R to R regular, just not matching up
A

3rd degree heart block

28
Q

3rd degree heart block can progress to

A

asystole

29
Q

treatment of 3rd degree heart block involves:

A

medications (atropine/epi), temporary pacing wires, permanent pacemaker

30
Q

if a patient with 3rd degree heart block goes unconscious, what action must be taken?

A

initiate CPR

31
Q

3 beats of this turns into Vtach

A

PVC (premature ventricular contraction)

32
Q
  • P wave absent
  • widened QRS
  • can look completely normal except that one or 2 beats –> ventricle contracts out of turn
A

premature ventricular contraction (PVC)

33
Q

T/F: in a. beat of PVC, perfusion is occurring

A

F

34
Q
  • many PVCs together
  • may be intermittent or sustained
  • may or may not have pulse
A

ventricular tachycardia

35
Q
  • type of vtach
  • wont have pulse most time
A

torsades

36
Q

what medication can you give thats unique to torsades?

A

magnesium sulfate

37
Q
  • no intervals, never a pulse
  • ventricles quivering
  • looks irregular
A

ventricular fibrillation

38
Q

this rhythm can turn into vfib

A

SVT

39
Q

T/F: if you’re coded, you will get intubated

A

T

40
Q
  • final attempts to make an electrical impulse
  • rate 20-30, few beats here and there
A

agonal

41
Q

flatline

A

asystole

42
Q

causes asystole

A

hypovolemia, hypoxia, acidosis, hypothermia, hypo/erkalemia, OD, trauma, thrombosis, tension pneumothorax, cardiac tamponade

43
Q

can you shock aystole

A

NO

44
Q

what medications are indicated for asystole?

A

epi, bicarb, dextrose, calcium –> no amioderone

45
Q
  • can look like a normal rhythm on monitor but pt will have no pulse
  • electrical activity still present
A

PEA (pulseless electrical activity)

46
Q

digoxin is used to treat

A

SVT, sinus tachycardia

47
Q

indications for pacemaker placement:

A

3rd degree heart block, symptomatic bradycardia, asystole

48
Q

used to maintain HR in emergency situations or until permanent pacemaker can be implanted

A

temporary pacemakers (transvenous & transcutaneous)

49
Q

this pacemaking marker is before the P wave

A

atrial paced

50
Q

pacing spike will be before inverted QRS

A

ventricular paced

51
Q

most common permanent pacemaker, “dual chambered”; before every P wave & QRS complex

A

sequential paced

52
Q

T/F: failure to capture will look like pacing markers with nothing after them

A

T

53
Q

used for history of lethal dysrhythmias; programmed to deliver electrical impulses when it senses the HR becoming rapid, may increase voltage & shock again if first shock doesn’t convert rhythm

A

implantable cardioverter defibrillator (ICD)

54
Q

pacemaker/ICD teachings/considerations

A
  • don’t shower 24h following procedure
  • no baths x2wks
  • wear affected arm in sling
  • dont raise arm above site x2wks
  • no lifting >10lbs x2wks
  • no MRI ever
  • no contact sports ever
  • always carry medical alert card

critical care (3 decks)

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