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Health Assessment - Autumn > EKG Basics > Flashcards

EKG Basics Flashcards

1
Q

When __________ is high, cells may not be able to start depolarizing appropriately.

A

Potassium

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2
Q

__________ stabilizes hyperkalemia, and it works by ___________

A

Calcium

Stabilizing the cell membrane

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3
Q

What electrolyte imbalance leads to ectopy?

A

Hypomagnesemia

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4
Q

This electrical conductance issue causes SVT

A

aberrant pathway - pissed off atrial nodal cell

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5
Q

________ and ________ makes someone unstable with SVT.

A

Low BP and poor mentation

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6
Q

What is the normal junctional rhythm?

A

40-60bpm

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7
Q

The AV node slows conduction by _______ seconds.

What is the purpose of this?

A

0.1s, allows the atria to contract before the ventricles

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8
Q

What is the purkinje fibers autonomic rate?

A

20-40bpm

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9
Q

The P wave will be positive in what leads?

A

I, II, aVF,V4-V6

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10
Q

_______, ________, _________, _________, ___________, are all rhythms where you may not see a P wave.

A

Idioventricular, A-fib, SVT, V-tach, V-fib

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11
Q

What is the only thing present in primary cardiac standstill?

What does this represent?

Causes:

A

P waves

The atria are working, ventricle are not doing anything

Blockade preventing impulse to move to ventricles - infarct @ AV node

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12
Q

What does it mean if you have ST elevation in all leads?

A

Pericarditis

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13
Q

_______ can cause big peaked QRS complexes, and _______ can cause smaller QRS complexes.

A

Low body tissue amount

Obesity/high tissue amounts

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14
Q

In what leads will the T wave be positive?

A

I, II, V3-V6

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15
Q

What is the difference b/w ST elevation & peaked T waves?

A

With ST elevation - they never return to the isometric line

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16
Q

5 steps to rhythm interpretation

A
  1. Figure out the HR
  2. Look @ the P waves
  3. Is the PR interval fixed or long?
  4. Look @ the QRS
  5. Assess T wave morphology
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17
Q

Potential causes of PSVT:

A

Medications (we stressed the pt), an intervention (medication for the SVT), Aberrant pathway

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18
Q

At above _____ bpm, is when it is considered SVT.

A

150

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19
Q

______________ usually follows PACs, PVCs, and PJCs.

A

A compensatory pause

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20
Q

__________ & _________ can be causes of PACs.

A

Hypoxia, caffeine

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21
Q

What medications clue you into someone having A-fib?

A

Aspirin, Eliquis, Plavix

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22
Q

_______ and _______ can actually treat/convert A-fib acutely.

_______ is a long-term treatment for A-fib.

A

Cardioversion & Amiodarone

Digoxin

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23
Q

Rate control meds for A-fib

A

BB, CCB (cardizem), Esmolol

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24
Q

What are the 3 common causes of A-flutter?

A
  1. Drug/medication induced
  2. Caffeine
  3. Cocaine intoxication
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25
Why are we more concerned about PVCs over PACs?
PACs - lose 25% CO PVCs - lose 75% CO *can lead to V-tach
26
________, _______, ________, & ______ are common causes of PVCs
Hypoxia (most common) Electrolyte abnormalities Ischemia Electrical injuries
27
Unstable bradycardia treatment
Pacing
28
_______ is the 1st line medication for bradycardia. _______ is the 2nd line medication for bradycardia. What other meds can we give for bradycardia? (2)
Atropine Isoproterenol Epi & Dopamine @ alpha dosing
29
___________ has a PR interval that gets longer, longer, longer, then drops a QRS. ___________ has a fixed PR interval, with a dropped QRS.
2nd degree type 1 (Wenckebach) 2nd degree type 2
30
Hints for a 3rd degree block
1. Fixed P-P interval 2. Fixed R-R interval *they are not communicating w/ each other
31
Causes of 3rd degree heart block
1. Lenegre Disease (fibrotic degeneration of distal conduction) 2. Ischemia 3. Metabolic/electrolyte abnormalities 4. Infection near conduction system 5. Reperfusion injury 6. Stunned myocardium after cardiac surgery
32
How do you treat stable Vtach?
Cardioversion or amiodarone
33
How do you treat unstable V-tach?
Cardioversion (prob. Not synchronized) - harder for computer to sync
34
Benefit of synchronized cardioversion
Can use less energy, less chance of R on T & V-fib
35
Energy amount for defibrillation w/ V-fib
Max recommendation from manufacturers Monophasic: 360J Biphasic: 120-200J
36
What end-tidal CO2 is associated w/ ROSC? what does it indicate?
>10mmHg or 50% increase in continuous monitoring -perfusion happening & cellular byproduct being blown off
37
Amiodarone dosing
1st: 300mg 2nd: 150mg Supplied: 150mg/5mL
38
Lidocaine Dosing (anti-arrhythmic)
1-1.5mg/kg - max 3mg/kg
39
______ is the most common cause of cardiac arrest and _______ is the 2nd most common cause.
Hypoxia, Hypovolemia
40
This electrolyte abnormality is a common cause of V-fib/pulseless V-tach Who is it seen in?
Hyperkalemia Rhabdo, burns, crush injuries, renal failure
41
Hs:
Hypovolemia, hypoxia, hypothermia, hydrogen ion (acidosis), hypo/hyperkalemia Hypo/hyperglycemia
42
Ts
Tension pneumothorax, cardiac tamponade, toxins, thrombosis (PE, coronary)
43
REVERSAL AGENTS ________ for Diltiazem. ________ for BB ________ for Digoxin ________ for Opioids ________ for TCAs
Calcium Glucagon Digibind Narcan Na Bicarbonate
44
Differences w/ kids hearts compared to adults
1. Vagal influence stronger 2. Fixed ventricular volume - cannot alter their contractility -compensate by changing HR
45
Why is IV bupivacaine worse r/t arrhythmias?
More cardiac toxic & longer acting
46
_________ can cause hyperkalemia, and ________ can cause hypokalemia
Hypoventilation, Hyperventilation
47
What can we do to prevent bradycardia in abdominal surgeries?
Give something that blocks vagal stimuli -Atropine, Ephedrine, Anticholinergics (Glycopyrrolate)
48
_________, __________, & __________ are common causes of post-op dysrhythmias.
Hypoxemia Cardiac Ischemia Catecholamine Excess (cocaine, ketamine, stress, surgical stimulation, inadequate analgesia/anesthesia)
49
Lidocaine 2nd dose
0.5-0.75mg/kg
50
______ is the energy for the 1st defibrillation in pediatric cardiac arrest. ______ is the energy for the 2nd defibrillation in pediatric cardiac arrest. ______ is the energy for subsequent defibrillation in pediatric cardiac arrest. ______ is the max energy.
2J/kg 4J/kg > or equal to 4J/kg Max: 10J/kg or the adult dose
51
Pediatric Epi dose
0.01mg/kg - 0.1mL of the 0.1mg/mL concentration Max dose 1mg
52
Pediatric Atropine Dose
0.02mg/kg
53
Common causes of V-fib/V-tach in kids
Electrocution, drowning
54
Pediatric Amiodarone dose
5mg/kg bolus in cardiac arrest *can repeat up to 3x in refractory v-fib/v-tach
55
Pediatric lidocaine dose
1mg/kg loading dose
56
Adenosine doses
6mg, 12mg
57
Procainamide Doses IV (adult tachycardia)
20-50mg/min until arrhythmias suppressed or if there is hypotension, or if QRS duration > by 50% *max dose: 17mg/kg Maintenance infusion: 1-4mg/min
58
When do we avoid Procainamide?
Prolonged QT or CHF
59
Amiodarone dose for adult tachycardia
150mg over 10min - repeat if V-tach recurs Maintenance: 1mg/min for 1st 6hrs
60
Sotalol IV dose for adult tachycardia
100mg (1.5mg/kg) over 5min *avoid in prolonged QT
61
Synchronized Cardioversion energy
50J, 100J, 200J Depends on rhythm & device
62
Pediatric synchronized cardioversion energy
0.5 - 1J/kg Increase to 2J/kg
63
Pediatric Adenosine Dose
0.1m/kg max 6mg 0.2mg/kg max 12mg
64
Potential causes for maternal cardiac arrest
Anesthetic complications, bleeding, cardiovascular, drugs, embolic, fever, general non-OB causes (Hs & Ts), HTN

Health Assessment - Autumn (6 decks)

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