EKG

Question 1

Artifact

Answer 1

Interference
Appears wavy, bumpy, or tremulous
Patient: Seizure, chills, anxiety
Equipment: Dry/corroded electrode, mobility, short circuit of leads, defective leads

Question 2

Sinus Bradycardia

Answer 2

Heart rate < 60 bpm

Can still treat patient as long as patient can increase HR with activity

Question 3

Sinus Tachycardia

Answer 3

Heart rate > 100 bpm
If unable to increase stroke volume, may not be able to exercise because can’t maintain cardiac output  need to monitor HR and BP

Question 4

Atrial Fibrilation

Answer 4

Quivering or twitching of atrial muscle
Absent P waves
Irregular rate
Controlled with HR < 115 bpm
if rate controlled, exercise can be performed.  If rapid rate (>120 @ rest), then likely will have poor cardiac output and unable to maintain during exercise.  Therefore, would recommend waiting until have better rate control.  In all cases, monitor symptoms, HR, BP when with patient.

Question 5

Atrial Flutter

Answer 5

P waves in sawtooth pattern
Atrial rate 250-350
Usually regular unless AV block present
Treat: if rate controlled, yes. If rapid rate (>120 @ rest), then likely will have poor cardiac output and unable to maintain during exercise. Therefore, would recommend waiting until have better rate control. In all cases, monitor symptoms, HR, BP when with patient.

Question 6

Premature Ventricular Contraction (PVC)

Answer 6

Irregular rhythm
P wave present with normal QRS, not with PVCs
Prolonged QRS complex as impulse originates below Bundle of His
Stop treating if PVC is new; otherwise, exercise is okay as long as CO is maintained

Question 7

Trigeminy

Answer 7

PVC occurs every third beat

Treat: if new rhythm would discuss with MD. If known rhythm and monitor hemodynamic response, OK to treat them.

Question 8

Bigeminy

Answer 8

PVC occurs every other beat
Normal QRS on other beats
Treat: if new rhythm would discuss with MD. If known rhythm and monitor hemodynamic response, OK to treat them.

Question 9

Couplet

Answer 9

2 PVCs in a row

Treat: if new rhythm would discuss with MD. If known rhythm and monitor hemodynamic response, OK to treat them.

Question 10

Triplet

Answer 10

3 PVCs in a row

Treat: if new rhythm would discuss with MD. If known rhythm and monitor hemodynamic response, OK to treat them.

Question 11

Ventricular Tachycardia

Answer 11

> /= 4 PVCs in a row
Absent, unrelated or buried P wave
Widened QRS complex
Usually irregular
Rate: 120-250 beats per minute
Shockable rhythm if patient has lost consciousness and AED available
Patient is medically unstable and needs immediate medical attention
Treat: no, won’t be able to sustain activity and increased risk of sudden death due to myocardial irritation

Question 12

Ventricular Fibrilation

Answer 12

Erratic quivering of ventricular muscle
Chaotic electrical activity
Shockable rhythm if AED is available
Treat: no, won’t be able to sustain activity and increased risk of sudden death due to myocardial irritation
This patient is medically unstable and needs immediate medical attention. If you are the person to discover this, get assistance from MD.

Question 13

Asystole

Answer 13

No electrical activity
Check another lead to ensure asystole
Call for help and initiate CPR