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DPT830 (Exam 2) > EKG #2 > Flashcards

EKG #2 Flashcards

1
Q

The P Wave is associated with the activation of what area of the heart?

A

Activation of the Atria

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2
Q

The QRS Complex is associated with the activation of what area of the heart?

A

Activation of the Ventricles?

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3
Q

The T Wave is associated with the activation of what wave of the heart beat?

A

The Recovery Wave

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4
Q

How much time is equivalent to one square on an ECG readout?

A

1 square = 0.04 sec (40 m/s)

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5
Q

What is a normal HR for an ECG analysis?

A

60-100 bpm.

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6
Q

What is a normal PR Interval for an ECG analysis?

A

0.12 - 0.20 sec (about small 3 boxes)

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7
Q

What is a normal QRS Interval for an ECG analysis?

A

< 0.12 sec

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8
Q

How do you calculate rate on an ECG?

A

Count the number of large boxes between consecutive R waves and divide 300 by this number.

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9
Q

The SA Node has 3 levels of backup. What are they?

A

Atrial Foci, Junctional Foci, Ventricular Foci

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10
Q

What is Atrial Foci’s inherent rate?

A

60-80 per min

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11
Q

What is Junctional Foci’s inherent rate?

A

40-60 per min

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12
Q

What is Ventricular Foci’s inherent rate?

A

20-40 per min

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13
Q

What are Ectopic Beats?

A

Small changes in an otherwise normal heartbeat. [extra or skipped beat(s)]

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14
Q

What are some potential causes of ectopic beats?

A

Caffeine, Alcohol, Medications/Drugs, Hypokalemia, Ischemia, Infarction, Cardiomyopathy & Increase in Catecholamines (e.g. Epinephrine).

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15
Q

What are 6 causes of Irregular Rhythms (Arrhythmias)

A

Premature beats, Atrial flutter, Atrial fibrillation, Other Atrial Tachycardias, Bradycardias, Ventricular Tachycardias.

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16
Q

PAC’s, PSVT, A-Flutter, A-Fib are examples of what kind of Arrhythmias?

A

Supraventricular Arrhythmias

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17
Q

When does Premature Atrial Contraction (PAC) occur?

A

When a focus in the atrium (not the SA node), generates an action potential (AP) before the next scheduled SA node action potential.

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18
Q

What are the 4 main characteristics of PAC’s?

A

Premature, Ectopic, Narrow Complex’s, Compensatory Pause.

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19
Q

What is Paroxysmal Supraventricular Tachycardias (PSVT)?

A

Sudden run of >3 premature beats (both sustained for up to hours or longer + brief & non-sustained: 3 beats up to 30 sec)

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20
Q

What are some characteristics of Atrial Flutter’s?

A

Atrial rate is constant, Ventricular rate depends on AV junction, Variable Rhythm (regular or irregular), and No Observable P Waves.

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21
Q

What are 6 cases where an A-Flutter can be observed?

A

Acute M.I., Hypertensive Heart Disease, Valvular Heart Disease, Post Cardiac Surgery, Lung Disease, Pulmonary Emboli

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22
Q

What are some medications used for treatment of A-Flutter?

A

Digitalis, B-Blockers, Ca2+ Channel Blockers, Quinidine or Procainamide

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23
Q

In Atrial Fibrillations Atrial Rates are _____ and Ventricular Rates are ______ ?

A

Atrial: Chaotic | Ventricular: Irregular

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24
Q

How would you describe the Rhythm of Atrial Fibrillation?

A

Irregular, with no specific pattern. No stable relationship between fibrillary atrial waves and the QRS complex’s.

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25
How would you describe the P waves of Atrial Fibrillation?
No identifiable P waves, only fibrillary (f) waves, irregular movements of baseline.
26
Is the PR Interval measurable in Atrial Fibrillation?
Not measurable.
27
What triggers an Atrial Fibrillation?
Rapid electrical activity starting in the pulmonary vein and spreading to the atrium.
28
Can Atrial Fibrillations occur suddenly or chronically?
Paroxysmal (both)
29
Who are Atrial Fibrillations most common in?
Person's with organic heart disease.
30
What are some consequences of Atrial Fibrillation?
Decreased Q, Congestive Heart Failure, Hypotension, Myocardial Ischemia, Atrial Thrombi & Embolism.
31
What does the treatment of Atrial Fibrillations entail?
Digitalis, B-Blockers, Ca++ Channel Blockers, Electrical Cardioversion, RF Ablation Therapy
32
What is AV (Atrio-Ventricular) heart block?
Conduction disturbances, impaired transmission from atria to ventricles. (AV node dysfunction)
33
What is the primary measure of AV Heart Blocks?
PR Interval
34
What are the most common causes of AV Heart Blocks?
Most often caused by aging, swelling, or scarring of the heart.
35
How many types of AV Heart Block are there?
1st Degree, 2nd Degree (Type 1 & Type 2), and 3rd Degree
36
How would you describe 1st Degree AV Heart Block?
Mildest, more of a delay & not a block. Impulses moving through the AV node too slowly.
37
What is the PR Interval of 1st Degree AV Heart Block?
> 0.20 sec
38
What are some causes of 1st Degree AV Heart Block?
Medication-Induced, Myocardial Infarction, and Hyperkalemia.
39
How would you characterize 2nd Degree Heart Block Mobitz Type I?
Progressive lengthening of PR interval w/non-conducted P wave. (usually only 2-3 P waves occur before a QRS is dropped)
40
What are some causes of 2nd Degree Heart Block Type 1?
Medication-Induced, Ischemic Heart Disease, Acute Inferior Wall Infarction, and Enhanced Vagal tone (Athletes)
41
How would you describe the Rhythm of 2nd Degree Heart Block Type 2?
Irregular with "grouped" beats.
42
How would you describe the Rate of 2nd Degree Heart Block Type 2?
Atrial: Constant between 60-100 bpm. Ventricular: Varies due to non-conducted P wave.
43
How would you describe the P wave & PR Interval of 2nd Degree Heart Block Type 2?
P Wave: sudden appearance of a non-conducted P wave PR Interval: NO progressive lengthening.
44
What is 2nd Degree Heart Block Type 2 a general sign of & what is the treatment?
General sign of severe conduction system disease (AV node & below) Treatment: Pacemaker
45
How would you describe 3rd Degree Heart Block?
PR Interval is irregular & not related to the flow of electrical stimuli.
46
What are some causes of 3rd Degree Heart Block?
Most common is Coronary Ischemia. Acute MI, Inferior wall MI, Congenital, Lyme Disease.
47
How is the pacemaker rhythm recognized?
Easily recognized through pacemaker spikes (vertical signals that represent the electrical activity of the pacemaker)
48
What is the most common ventricular Arrhythmias?
Premature Ventricular Contractions (PVCs)
49
What causes Premature Ventricular Contractions?
Either: Ventricular focus that generates AP's at an accelerated rate. (or) Problem in the heart's electrical conduction system.
50
How do Premature Ventricular Contractions occur?
Randomly or may alternate with normal beats in a regular pattern.
51
How do Premature Ventricular Contractions interact with age?
Occur more frequently Common with any type of Heart Disease PVC's will increase with underlying heart disease.
52
What are some EKG rhythm properties associated with PVC's?
P Wave: not conducted PR Interval: not measurable QRS Complex: > 0.12 secs with abnormal form Rhythm: irregular Rate: variable
53
A Unifocal PVC is what shape?
Identical
54
A Bigeminy PVC is what shape?
Every Other
55
A Couplet PVC is what shape?
Paired
56
A Triplet PVC is what shape?
Non-Sustained VTach
57
A Multifocal PVC is what shape?
More than one shape
58
Treatment is required of PVCs if?
Is associated with an acute MI Occur as couplets, bigeminy, trigeminy, or multifocal Is frequent (>6/min)
59
What is Ventricular Tachycardia (V-Tach)?
Fast heart rhythm that originates in one of the ventricles.
60
A Ventricular Tachycardia has a run of ___ QRX complex's?
> 3 (single, non-sustained, or sustained for > 30 sec)
61
What are some EKG rhythm properties associated with V-TACH?
Rate: Ventricular rate is 150-200 bpm Rhythm: Regular or Slightly Irregular P Wave: Usually not distinguishable PR Interval: Not Measurable QRX Complex: Wide & Bizarre (>0.12 secs)
62
What is a Ventricular Fibrillation (V-Fib)?
Uncoordinated contraction of the ventricles resulting in a "quivering" rather than a normal contraction.
63
What are some EKG rhythm properties?
P Wave: Not Identifiable PR Interval: Not Measurable QRS Complex: Not Identifiable Rhythm: Chaotic, not identifiable Rate: cannot be determined
64
In V-TACH & V-FIB, if the ventricles are not contracting properly, what is the outcome?
Decrease in cardiac output.
65
V-TACH may lead to what?
V-FIB, Asystole, and Sudden Death
66
How is V-FIB identified?
Most commonly identified as arrhythmia in cardiac arrest patients.
67
In F-FIB, if there is no intervention what will happen?
Quickly degenerate to asystole.
68
What are Bundle Branch Blocks?
Delays in electrical signal conduction to the R & L ventricular tissue
69
How do you determine the presence of BBB?
Primarily examine QRS waves
70
How is a R Bundle Branch Block typically spotted? (characteristics)
"Bunny Rabbit Ears"
71
How is a L Bundle Branch Block typically identified?
Produced an R, R' in the left chest leads V5/V6 with accompanying broad R-wave and deep S and inverted T-Wave.
72
What are some clinical causes of RBBB's?
Right-Sided heart disease Myocardial Infarction
73
What are some clinical causes of LBBB's?
One indicator of heart disease Long-Standing HTN with LVH Valvular Lesions Cardiomyopathy

DPT830 (Exam 2) (8 decks)

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