EKG and Heart Rhythms

Question 1

angina is obstruction of what blood vessel and who is at risk of death

Answer 1

LAD
younger pts bc no collateral vessels

Question 2

P wave

Answer 2

depolarization of atria

Question 3

QRS

Answer 3

depolarization of AV node

Question 4

T wave

Answer 4

repolarization of ventricles

Question 5

BNP

Answer 5

heart failure

Question 6

troponin

Answer 6

muscle damage (MI)
series of 3 q8h

Question 7

point of maximal impulse

Answer 7

the apex
midclav, 5th intercostal space

Question 8

CTA

Answer 8

checks for hard calcium deposits, not soft

Question 9

Normal PR

Answer 9

3-5 small boxes

Question 10

Normal QRS

Answer 10

3 small boxes or less

Question 11

sinus tach

Answer 11

100-160

Question 12

SVT

Answer 12

160+
associated with overexertion, stress, deep inspiration, stimulants, disease, digitalis toxicity

Question 13

PAC

Answer 13

ectopic site in atrium
premature P and QRS followed by pause

Question 14

aflutter

Answer 14

saw tooth!
atrial 250-400
Typically associated with disease
Symptoms result from high ventricular rate and loss of atrial “kick” → decreased CO → risk of HF

Question 15

afib

Answer 15

atrial >400
paroxysmal or persistent
in older ppl
in pts with underlying heart disease or other disease states

Question 16

sinus brady mani

Answer 16

Hypotension
Pale, cool skin
Weakness
Angina
Dizziness or syncope
Confusion or disorientation
SOB
Can be normal during sleep

Question 17

sinus tach causes

Answer 17

vagal inhibition (valsalva maneuver or bearing down stimulates vagus nerve, fixes sinus tach) or sympathetic stimulation
stress
drugs like albuterol

Question 18

mani of sinus tach

Answer 18

dizziness
dyspnea
hypotension
angina

Question 19

PAC causes

Answer 19

Stress
Fatigue
Caffeine
Tobacco
Alcohol (depletes electrolytes)
Hypoxia
Electrolyte imbalance
Disease states

Question 20

mani of PAC

Answer 20

palpitations
heart “skips a beat”

Question 21

treatment of PAC

Answer 21

Monitor for more serious dysrhythmias
Withhold sources of stimulation
Β-adrenergic blockers

Question 22

aflutter treatment

Answer 22

Pharmacologic agent
Electrical cardioversion
Radiofrequency ablation

Question 23

afib treatment

Answer 23

Drugs to convert ventricular rate and/or convert to sinus rhythm (amiodarone and ibutilide most common)
Electrical cardioversion
Anticoagulation (work on platelet aggregation, careful with ppl with high or low platelets)
Radiofrequency ablation
Maze procedure (also done thru angiogram, different technique) with cryoablation

Question 24

mani of SVT

Answer 24

HR 150-220
180+ is decreased CO
hypotension
dyspnea
angina

Question 25

SVT treatment

Answer 25

Vagal stimulation
IV adenosine
IV β-adrenergic blockers
Calcium channel blockers
Amiodarone
DC cardioversion

Question 26

PVC treatment

Answer 26

correct cause
antidysrhythmics

Question 27

torsades

Answer 27

Associated with heart disease, electrolyte imbalances, drugs, CNS disorder (GBS, parkinsons, spinal cord injury)
Can be stable (pt has a pulse) or unstable (no pulse, treat with CPR and defib)
treat cause

Question 28

vfib

Answer 28

associated with MI, ischemia, diseases, procedures
no pulse or breathing
CPR and ACLS (defib, epi, vasopressin)

Question 29

PEA

Answer 29

Electrical activity can be observed on the ECG, but no mechanical activity of the ventricles is evident, and the patient has no pulse

Question 30

Hs of PEA

Answer 30

Hypovolemia
Hypoxia
Hydrogen ion (acidosis)
Hyper/hypokalemia
Hypoglycemia
Hypothermia

Question 31

Ts of PEA

Answer 31

toxins
tamponade
thrombosis
tension pneumo
trauma

Question 32

treatment of PEA

Answer 32

CPR, intubation, and epi
correct cause