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Adult Health Test 1 > EKG > Flashcards

EKG Flashcards

1
Q

SA Node ↓—AV Node↓—Bundle of His ↓ —Purkinje Fibers

A

The Electrical Conduction System of the Heart

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2
Q

ability of pacemaker cells to spontaneously initiate an electrical impulse

A

Automaticity

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3
Q

ability of myocardial cells to respond to stimuli generated by pacemaker cells

A

Excitability

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4
Q

ability to transmit an impulse from cell to cell

A

Conductivity

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5
Q

inability of cardiac cells to respond to additional stimuli immediately following depolarization.- keeps you from going into Vfib

A

Refractory

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6
Q

ability of myocardial fibers to shorten in response to a stimulus

A

Contractility

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7
Q

Fastest rate of automaticity.
Primary pacemaker of the heart
Rate: 60 to 100 bmp

A

SA node

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8
Q

Has a delay which allows for atrial contraction and more filling of the ventricles
Rate: 40 to 60 bmp

A

AV node

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9
Q

Has the ability to self-initiate electrical activity

Rate: 40 to 60 bmp

A

Bundle of His

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10
Q

Network of fibers that carry electrical impulses directly to ventricular muscle cells
Rate: 20 to 40 bmp

A

Purkinje Fibers

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11
Q

Shows: Heart rate, rhythm/regularity, impulse conduction time intervals, abnormal conduction pathways

A

Information Obtainable From EKG Rhythm Strip Analysis

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12
Q

Does not show: pumping action, cardiac output, blood pressure, cardiac muscle hypertrophy

A

Information NOT Obtainable From EKG Rhythm Strip Analysis

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13
Q

Defines the graphic representation of the electrical activity of the heart

A

Electrocardiogram

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14
Q

SA node fires, sends the electrical impulse outward to stimulate both atria and manifests as a P-wave.
Approximately 0.10 seconds in length

A

P wave

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15
Q

Time which impulse travels from the SA node to the atria and downward to the ventricles

A

PR Interval (PRI)

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16
Q

Impulse from the Bundle of HIS throughout the ventricular muscles
Measures less than 0.12 seconds or less than 3 small squares on the EKG paper

A

QRS complex

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17
Q

Ventricular repolarization, meaning no associated activity of the ventricular muscle
Resting phase of the cardiac cycle

A

T wave

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18
Q

Ventricular repolarization

Preparing for the next heartbeat

A

ST segment

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19
Q 
Step 1:  Heart Rate
Step 2:  Regular/Irregular
Step 3:  P waves
Step 4:  PR interval
Step 5:  QRS complex
A

Interpretation of an EKG Strip

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20
Q

6-second method: have a six second strip, count the number of QRS complexes and multiply by 10

A

Heart Rate

21
Q

Heart rhythms are classified as regular or irregular
Determining the heart rhythm involves establishing a pattern of QRS complex occurrences.
Measure ventricular rhythm by measuring the interval between R-to-R waves and atrial rhythm by measuring the P-to-P waves.
Intervals > than 0.06 seconds, irregular

A

Heart Rhythm

22
Q 
Are P-waves present?
Are P-waves occurring regularly?
Is there a P-wave for each QRS complex?
Are the P-waves smooth, rounded, and upright in appearance, or are they inverted?
Do all P-waves look similar?
A

5 questions to ask about P waves

23
Q

Normal length of the PRI is 0.12 to 0.20 second (3-5 small squares)

Are PRI greater than 0.20 second?
Are PRI less than 0.12 second?
Are the PRI constant across the EKG strip?

A

PRI and 3 questions to ask

24
Q

Are QRS intervals greater than 0.12 second (wide)? If so, the complex may be ventricular in origin.
Are QRS intervals less than 0.12 second (narrow)? If so, the complex is most likely supraventricular in origin.
Are QRS complexes similar in appearance across the EKG strip?

A

3 questions to ask about QRS

25
Q

Patient movement
Loose or defective electrodes
Improper grounding
Faulty EKG apparatus

A

4 common causes of artifact

26
Q

rate of < 60 bmp

A

bradycardia

27
Q

rate of 60 to 100 bpm

A

normal rate

28
Q

rate of > 100 – 150 bpm

A

tachycardia

29
Q

SA node

A

sinus

30
Q

SA node fails, impulse comes from the atria (internodal or the AV node)

A

atrial

31
Q

SA node or AV junction fails; ventricles will shoulder responsibility of pacing the heart

A

ventricular

32
Q

Normal Sinus Rhythm (NSR)
Sinus Arrythmia- speeds up during inspiration- due to lungs expanding and pushing on heart- heart gets a little sensitive- this is normal
Sinus Bradycardia (SB)
Sinus Tachycardia (ST)

A

sinus rhythms

33
Q

SA node fails to generate an impulse, the atrial tissue or areas in the internodal pathways may initiate impulse.
These are called atrial dysrhythmias
Generally not considered life-threatening or lethal. Careful and deliberate patient assessment must be continuous.

A

atrial rhythms

34
Q

o What is the rate: atrial 250-300 BPM ventricular- variable
o What is the rhythm: atrial regular, ventricular- regular or irregular
o Is there a p wave before each QRS? Are the P waves upright and uniform? Normal P waves are absent replaced by F waves- sawtooth
o What is the length of the PR interval? Not measurable
o Do all the QRS complexes look alike? Yes
o The length of the QRS complexes? Usually less than 0.12 se- 3 small squares

A

Atrial Flutter

35
Q

o What is the rate: atrial 350-400 BPM ventricular- variable
o What is the rhythm? Irregularly irregular
o Is there a P wave before each QRS? Are there P waves upright and uniform? Normal P waves are absent, replaced by f waves
o What is the length of the PR interval? Not discernable
o Do all the QRS complexes look alike? Yes
o The length of the QRS complexes is? Usually less than 0.12 sec

A

Atrial Fibrillation

36
Q

o What is the rate: atrial- 150-250 BPM Ventricular 150-250 BPM
o What is the rhythm: regular
o Is there a p wave before each QRS? Are the P waves upright and uniform? Usually not discernable especially at the high rate range
o What is the length of the PR interval? Usually not discernable
o Do all the QRS complexes look alike? Yes
o The length of the QRS complexes is? Usually less than 0.12 sec

A

Supraventricular tachycardia

37
Q

once given rapidly, then 20ml of NS, will see 6 sec of asystole – resets pacemaker of heart- if 6 mg doesn’t work go up to 12 mg- have everything ready first

A

adenosine

38
Q

most common, can be due to electrolyte issues, hypokalemia, nicotine, tea, coffee, anything that interferes with blood supply to the heart- less cardiac filling so less cardiac output- no P wave

A

Premature Ventricular Complexes

39
Q

100-250; no atrial rhythm, very regular rhythm , can still have a pulse; Amiodarone, antiarythmic- class 3, bolus then start a drip , there are pills after drip is weaned off- tx- medication, if unstable cardiovert with pulse, if pulseless- defibrillate

A

Ventricular Tachycardia

40
Q

French term that signifies the “twisting of the points.”
May wax and wane in amplitude and may “flip” or “twist” on its electrical axes.
Similar to ventricular tachycardia.
Caused by hypomagnesemia or by antiarrhythmic drugs.
common in Alcoholics – bc low mag, cocaine, certain meds that deplete mag

A

Torsades de Pointes

41
Q

The absence of a palpable pulse and myocardial muscle activity with the presence of an organized electrical activity (excluding VT and VF) on cardiac monitor.
It is not an actual rhythm. It represents a clinical condition wherein the patient is clinically dead, despite the fact that some type of organized rhythm appears on the monitor.

A

Pulseless Electrical Activity (PEA)

42
Q

hypovolemia, hypoxia, hydrogen ion, hyper/hypokalemia, hypothermia, hypoglycemia

A

6 Hs

43
Q

tamponade, tension pnuemophorax, thrombosis, trauma, toxins

A

5 Ts

44
Q

PR interval is greater that 0.20- everything is regular rhythm, rate etc just longer PR interval – caused by cardiac medications

A

First Degree AV Block

45
Q

– lengthening PR interval until QRS is dropped- then resets to short and then lengthens all over again- ventricular rhythm irregular –tolerated unless heart rate is really slow

A

Second Degree AV Block (Mobitz Type I) or Wenckebach

46
Q

intermittent failure of the AV node to conduct an impulse to the ventricles without delay-no QRS- a pt may get dizzy depending on how fast rate is – anterior wall MI, if symptomatic- will pace them- on or in them – poor prognosis if remain symptomatic

A

Second Degree AV Block (Mobitz Type II)

47
Q

atria and ventricles don’t associate- fire whenever, no correlation – totally variable- dig toxic can cause- if tolerated they are watched

A

Third Degree AV Block (Complete)

48
Q

sensing or pacing

A

artificial pacemaker

Adult Health Test 1 (2 decks)

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