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PHTH 536 - Body Systems > EKG and Irregular Atrial Rhythms > Flashcards

EKG and Irregular Atrial Rhythms Flashcards

1
Q

What does the EKG measure?

A

The electrical activity of a heart beat
- each beat sends an electrical wave through the heart tissue

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2
Q

What does an EKG determine?

A

heart rate and rhythm
needs interpretation

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3
Q

Phase 0 of EKG

A

Depolarization and rapid entry of Na+

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4
Q

Phase 1 of electrophysiological principles

A

Early depolarization
K+ slowly enters

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5
Q

Phase 2 of electrophysiological principles

A

Plateu continues
slower entry of Ca++

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6
Q

Phase 3 of electrophysiological principles

A

K+ moves out of the cell

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7
Q

Phase 4 of electrophysiological principles

A

Resting phase

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8
Q

What ability is indicated with automaticity?

A

Pacemaker ability

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9
Q

What does rhythmicity indicate?

A

systematic pattern

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10
Q

What does conductivity indicate?

A

spreads impulses

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11
Q

What does contractility indicate?

A

the contraction ability

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12
Q

What are the 4 electrophysiological principles?

A

Automaticity
Rhythmicity
Conductivity
Contractility

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13
Q

What is activated with the SA node?

A

the atria

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14
Q

What is the intrinsic rate of the SA node?

A

60-100 bpm

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15
Q

What is activated with the AV node?

A

ventricles

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16
Q

What is the intrinsic rate of the AV node?

A

40-60 bpm

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17
Q

What is the intrinsic rate of the bundle of HIS and purkinje fibers?

A

30-40 bpm

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18
Q

What happens during the P wave?

A

atrial depolarization
- impulses spread to the left atrium via the bachmann bundle

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19
Q

What happens during the P-R interval?

A

depolarization reaches the AV node causing that slight delay

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20
Q

What happens during the QRS complex?

A

Ventricular depolarization
- the electric impulse reaches the purkinje fibers

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21
Q

How many seconds in an EKG strip?

A

6 second intervals

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22
Q

How many seconds are in a small square?

A

0.04 seconds

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23
Q

How many seconds in a large square?

A

0.20

24
Q

How many leads are there?

A

6

25
Q

Where is V1 and V2 placed?

A

Near the sternal border

26
Q

Where is V3 placed?

A

Midway between V2 and V4

27
Q

Where is V4 placed?

A

5th intercostal space @ L midclavicular line

28
Q

Where is V5 placed?

A

Left anterior axillary line at V4 level

29
Q

Where is V6 placed?

A

Left mid axillary line at V4/V5 level

30
Q

How do you count the HR on an EKG?

A

count the QRS in a 6-second intervals then x10 which gives the HR for 1 minute

31
Q

When does the PR interval start and end?

A

start of P wave to start of R wave

32
Q

What does the P-R interval measure?

A

the time beween the start of atrial depolarization and ventricular depolarization

33
Q

What is normal PR interval?

A

3-5 small squares
or
0.12-0.20 seconds

34
Q

When does the QRS start and end?

A

starts of Q wave to end of S wave

35
Q

Describe the QRS complex in an EKG strip

A

Q - first downward deflection
R - first upward deflection
S - second downward deflection

36
Q

The QRS complex measures what?

A

the depolarization of ventricles

37
Q

What is normal QRS complex interval?

A

0.06-0.10 seconds (1 1/2 - 3 small boxes)

38
Q

What is an abnormal QRS complex interval?

A

> 0.12 seconds

39
Q

What is the systematic approach of an EKG?

A
  1. P wave
  2. PR interval
  3. QRS complex
  4. QRS interval
  5. T wave
  6. Look at the R to R wave
  7. How is the HR
  8. Observe the pt and sx
40
Q

What are the causes for PAC?

A
  • when isolated = benign finding (non-lethal)
  • associated with underlying cardiac conditions (early sign of CVD)
  • HTN, caffeine
  • Pregnant
  • COPD, asthma
  • Metabolic - hyperthyroid disease
  • stress or extreme fatigue
  • medications for asthma or hayfever
41
Q

What are the symptoms of PAC?

A

Skipped beat
fatigue or SOB
Exercise intolerance
Chest pain (advanced PAC)

42
Q

How do you decrease PAC symptoms?

A

reduce intensity
monitor vitals
report to a team

43
Q

What is atrial tachycardia (supraventricular)?

A

Atrial depolarization is happening so fast
P wave isnt seen and hidden in the QRS/ventricular activity

44
Q

What are the causes of atrial tachycardia?

A
  • stretching of the atria via HTN and cardiomyopathy
  • MI hx
  • excessive alchohol or stimulants
  • irritable focus

Sometimes idiopathic

45
Q

What is irritable focus?

A

cell outside the sinus node starts generating an electical impulse automatically on their own

46
Q

What are the sx of atrial tachycardia?

A

palpitations
fainting
chest pain
SOB
fatigue
exercise intolerance

47
Q

How do you reduce atrial tachycardia?

A

Reduce intensity
monitor vitals
alert the team

48
Q

What is the characteristic of atrial fibrillation?

A

A very common arrhythmias

  • Has no waves before QRS and very irregular HR
  • jagged baseline
49
Q

What is the characteristics of atrial flutter?

A

“saw-tooth” appearance that represents multiple P waves for each QRS complex

50
Q

What causes a-fib and a-flutter?

A
  • interferance of electrical conductivity
  • age
  • heart diseases
  • alchohol
  • endocrine disorders
  • neurologic disorders
  • hemodynamic stress
  • sleep apnea
  • inflammation
51
Q

What are the sx of a-fib and flutter?

A
  • tachycardia
  • SOB
  • dizziness
  • syncope
  • fatigue
  • exercise intolerance
  • chest pain
  • anxiety
  • night sweats or waking up with palpitations
52
Q

How do you decrease sx of a-fib and flutter?

A
  • stopping activity then calling the team to monitor patient
  • Use RPE for beta blockers
  • Deep breathing to slow down HR
53
Q

What happens with the electrical impulses of atrial impulses?

A

The impulses don’t travel in a straight line
- move in a circle inside the atria = regular tachycardia

54
Q

How is the speed of an electrical signals in a-fib?

A

travel through the atria - fast and disorderly = heart quivers instead of squeezing strongly

= tachycardia in an irregular rhythm and reduced atrial kick

55
Q

Why is a-fib more dangerous?

A

Irregular atrial contractions in fib = increasing the risk of clot formation

higher risk of CVA

PHTH 536 - Body Systems (28 decks)

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