EKG Flashcards
age heart disease lung disease surgery thyroidtoxicosis
can all atribute to
AFIB
3 types of medications used if patient is afib and HR over 100 to slow down HR as well as _____
AA B CC D
Anticoagulants (heparin, warfarin)
Amiodarone
Beta blocker (metopralol)
Calcium channel blocker (diltiazam)
Cardioversion
digoxin
Hypoxemia, acid-base imbalance, exacerbation of heart failure, ischemic heart disease, cardiomyopathy, hypokalemia, hypomagnesemia, valvular heart disease, genetic abnormalities, and QT prolongation are all possible causes of ______
Ventricular Tachycardia
a pacer spike without a corresponding p wave or QRS complex
failure to spike
when dealing with AFIB it is important to know if the condition is wht?
new or not
ECG where:
Rate: greater than 100 bpm
Rhythm: regular unless capture beats occur and momentarily interrupt
P-wave: none
PR interval: none
QRS: consistent in shape but appear wide and bizarre
Ventricular Tachycardia
4 interventions for idioventricular
CPR
anticipate TCP
atropine
treat cause
for decreased cardiac output, the first step would be to use ______
the second step would be to use ____
atropine IVP
external pacemaker
vagal stimuation
medication
are two main causes for
sinus block
ECG where:
Rate: >100
Rhythm: regular
P-wave: inverted
PR interval: if inverted p before QRS, <0.12
QRS: WNL (narrow)
junctional tachy
prolonged PR interval (>.20) but consistent is an indication of ____
first degree AV block
ECG where:
Rate: 20-40
Rhythm: regular
P-wave: absent
PR absent
QRS:greater than 0.12
idioventricular
digoxin toxicity
MI
age
ischemia
are all common causes of
junctional
every small box is ____ of a second on a ECG
.04 seconds
ECG where:
Rate: regular
Rhythm: regular W/pause
P-wave: normal
PR interval: WNL
QRS: WNL
not consistent R-R does not march out
sinus arrest
3 interventions for vfib
code blue
cpr
defib
the mode for a pace maker is either _____ or _____
demand – only when needed
fixed- asynchronous
(most patients on demand)
ECG where:
Rate: 40-60
Rhythm: regular
P-wave: inverted
PR interval: if inverted p before QRS, <0.12
QRS: WNL (narrow)
junctional
ECG where:
Rate: 60-100 beats/minute
Rhythm:Regular
P-wave:Upright, rounded, smooth,1 for each QRS complex, all look similar in size and shape
PR interval: 0.12-0.20 seconds
QRS:0.04-0.12 seconds
All QRS complexes look similar in size and shape
Normal Sinus Rhythm
ANTI: arrhythmics,biotics, depressants,emetics,psychotics,heroin
HYPO: kalemia,calcemia,magnesemia
massive blood transfusion
MI
are possible causes of _____
QT segment
stress, CAD,CHF,COPD, myocarditis, rheumatic heart disease, hypokalemia, hypomagnesemia, acid-base imbalances, and increased catecholamine levels can cause ______
PVCs.
interventions for sinus tachy
treat the cause
3 things before Cardioversion
Obtain consent
Give sedation
Anticoagulants
AMI
progression from VT
electrocution
blow to chest
could alll cause
v fib
intervntions for - 3rd Degree Block – Lethal rhythm
call RRT/code blue
atropine
TCP
for first degree AV block what inerventniosn should you do
notify MD
treat cause
late, wide ectopic beat that arises in the ventricles
occurs later than next expected complex
ventricular escape beats
ECG where:
Rate: 60-100
Rhythm: regular
P-wave: inverted
PR interval: if inverted p before QRS, <0.12
QRS: WNL (narrow)
accelerated junctional
MI
age
ischemia
are 3 main causes for
sinus arest
ECG where:
Rate: greater than 100
Rhythm: irregular
P-wave: indeterminate
PR interval: indeterminate
QRS: generally narrow and normal unless underlying disease present (within normal range)
uncontrolled AFIB
for treatment of V tach with a pulse
first you would give ____________
if that doesnt work, next you would do _________
amiodarone IVP
lidocane IVP
cardioversion
ECG where:
Rate: absent.
Rhythm: absent.
P-wave: absent
PR interval: absent
QRS: absent.
Asystole
you would treat accelerated junctional by
treat symptoms
PAC can be a precursor of what 4 things
AFIB
AFLUTTER
ATRIAL TACH
SVT
a finding that only occurs in thythms originating above the ventricles
bundle branch block
representing ventricular depolarization which comes before ventricular contraction
QRS interval
normal PR interval
.12 - .20 seconds
3-5 little boxes in length
______ does not prolong QT segment
digoxin
what 3 should you do with an elevated ST segment?
call RRT
12 lead
MONA
no consistency in the PR inerval and more P waves than QRS is a good indication of
3rd degree block
av diassociation
how would you treat a bundle branch block
treat the cause
see an organized rhythm on the monitor that would normally have a pulse, but the patient is pulseless
no mechanica response
PEA
with symptomatic sinius block and arrestwhat 4 things should you do for interventions
RRT
atropine
TCP
hold offending meds
ECG where:
Rate: WNL
Rhythm: regular except finding
P-wave: absent
PR absent
QRS:greater than 0.12
PVC
ECG where:
Rate:Less than 60 beats/minute
Rhythm:Regular
P-wave:Upright, rounded, smooth,1 for each QRS, all look similar in size and shape
PR interval:0.12-0.20 seconds
QRS: 0.04-0.12 seconds
All QRS complexes look similar in size and shape
Sinus Bradycardia
for treatment of asystole what 2 things would you do
CPR
epinephrine
(dfib will not work)
ECG where:
Rate: WNL
Rhythm: regular except disruption
P-wave: differs from sinus P wave
PR interval: WNL
QRS: WNL
PAC
ECG where:
Rate: WNL
Rhythm: regular except irregularity portion
P-wave: absent
PR interval: absent
QRS: > or equal to 0.12 ( wider than normal)
PVC
for treatment of V tach with NO PULSE and V fib what 3 things would you do
CPR
crash cart/defibrilator
epinephrine
ECG where:
Rate: WNL
Rhythm: regular or irregular
P-wave: more P waves than QRS
PR progressive lengthining until 1 QRS falls off
QRS: WNL
2nd degree AV block type 1
4 interventions for 2nd degree AV block type 2
call RRT/COde blue
pacer pads
TCP
atropine WITH CAUTION
with supraventricular tachycardia, 3 interventions are __
bear down
adenosine (IVP fast/ 6mg) flush after
cardioversion
suppression/ failur of SA and AV nodes
SA & AV blocks
increased vagal tone
medications
are all possible causes of
ventricular escape beats
ECG where:
Rate: regular
Rhythm: regular W/pause
P-wave: normal
PR interval: WNL
QRS: WNL
consistent R-R (marches out)
sinus block
normal QRS complex duration
0.4 - 0.10 seconds
ECG where:
Rate: 40-60
Rhythm: regular
P-wave: more p waves than QRS
PR interval: varies
QRS: greater than 0.12 second
P& Q work seperatly
Third-Degree Block
4 interventions for 3rd degree AV block
call RRT/COde blue
pacer pads
TCP
atropine
ECG where:
Rate: not discernible.
Rhythm: not discernible.
P-wave: none
PR interval: none
QRS: none
Ventricular Fibrillation
impulse starts at SA node (atrial depolarization) which comes before atrial contraction
should be uniform, round smooth and upright.
p wave
myocardial irritability electrolyte imbalance hypoxia stimulants meds
can all be a cause of
PVC
ECG where:
Rate: WNL
Rhythm: irregular
P-wave: indeterminate
PR interval: indeterminate
QRS: generally narrow and normal unless underlying disease present (within normal range)
controlled AFIB
may be caused by:
sleeping
athletes
vagal stimulation
meds such as digoxin
sinus bradycardia
ECG where:
Rate: greater than 150
Rhythm: regular
P-wave: P waves and T waves are fused together
PR interval: indeterminate
QRS: narrow and normal
supraventricular tachycardia
how would you treat a PVC
treat the cause
ST elevation is a sign of
infarction
pericarditis
you would treat junctional tachy by what 3 things
vasovagal
adenosine
cardioversion
with a cardioversion, a stable shock is done if AFIB is less than ___ hours or after ____
48 hours
TEE
rhythm that elevated very high BPMs instantly
140-250
atrial tachy
every big box is ____ of a second on a ECG
0.20
digitalis toxicity, electrolyte imbalance, lung disease, ischemic heart disease, valvular abnormalities, can also occur in normal hearts may be possible causes of _____
Supraventricular Tachycardia
with ventricular escape beats, you would intervene by
treating underlyong thythm disturbance
tcp, atropine,etc
ECG where:
Rate: 60-100 (unless bradycardic)
Rhythm: regular
P-wave: upright, smooth, and round
PR interval: longer than normal (>0.20)
QRS:narrow and normal
First Degree Heart Block
ST depressed is a sign of
ischemia
NSTEMI
hypokalemia
digoxin effects
pain fever anxiety dehydration exercise shock caffeine hypoxia
can all lead to
sinus tachycardia.
in a bundle branch block the QRS is __
greater than or equal to 0.12
ECG where:
Rate: WNL
Rhythm: regular or irregular
P-wave: more P waves than QRS
PR interval:constant when conducted
QRS: WNL
2nd degree AV block type 2
you would treat junctional by what 2 things
atropine
TCP
peaked T waves is usually a sign of
hyperkalemia
torsade de pointes (polymorphic Vtach) is commonly caused by ______
and is often treated with ___ & ______
prolonged QTC
mag & potassium
no pacer spike when needed
failure to pace
4 indications for cardiac pacing
symptomatic dysthythmias
sick sinus syndrome
drug refractory arrhythmias
CABG/CV surgery
3 things to do for patient who is symptomatic bradycardia
call RRT
atropine
prep for transcutaneous pacing
ECG where:
Rate:100-150 beats/minute
Rhythm:Regular
P-wave:Upright, rounded, smooth, 1 for each QRS complex, all look similar in size and shape
PR interval: 0.12-0.20 seconds
QRS:0.04-0.12 seconds
All QRS complexes look similar in size and shape
Sinus Tachycardia
