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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
Q

Why are we more concerned about PVCs over PACs?

A

PACs - lose 25% CO

PVCs - lose 75% CO
*can lead to V-tach

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26
Q

________, _______, ________, & ______ are common causes of PVCs

A

Hypoxia (most common)
Electrolyte abnormalities
Ischemia
Electrical injuries

27
Q

Unstable bradycardia treatment

A

Pacing

28
Q

_______ is the 1st line medication for bradycardia.

_______ is the 2nd line medication for bradycardia.
What other meds can we give for bradycardia? (2)

A

Atropine

Isoproterenol

Epi & Dopamine @ alpha dosing

29
Q

___________ has a PR interval that gets longer, longer, longer, then drops a QRS.

___________ has a fixed PR interval, with a dropped QRS.

A

2nd degree type 1 (Wenckebach)

2nd degree type 2

30
Q

Hints for a 3rd degree block

A
  1. Fixed P-P interval
  2. Fixed R-R interval

*they are not communicating w/ each other

31
Q

Causes of 3rd degree heart block

A
  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
Q

How do you treat stable Vtach?

A

Cardioversion or amiodarone

33
Q

How do you treat unstable V-tach?

A

Cardioversion (prob. Not synchronized) - harder for computer to sync

34
Q

Benefit of synchronized cardioversion

A

Can use less energy, less chance of R on T & V-fib

35
Q

Energy amount for defibrillation w/ V-fib

A

Max recommendation from manufacturers

Monophasic: 360J
Biphasic: 120-200J

36
Q

What end-tidal CO2 is associated w/ ROSC?

what does it indicate?

A

> 10mmHg or 50% increase in continuous monitoring
-perfusion happening & cellular byproduct being blown off

37
Q

Amiodarone dosing

A

1st: 300mg
2nd: 150mg

Supplied: 150mg/5mL

38
Q

Lidocaine Dosing (anti-arrhythmic)

A

1-1.5mg/kg - max 3mg/kg

39
Q

______ is the most common cause of cardiac arrest and _______ is the 2nd most common cause.

A

Hypoxia, Hypovolemia

40
Q

This electrolyte abnormality is a common cause of V-fib/pulseless V-tach

Who is it seen in?

A

Hyperkalemia

Rhabdo, burns, crush injuries, renal failure

41
Q

Hs:

A

Hypovolemia, hypoxia, hypothermia, hydrogen ion (acidosis), hypo/hyperkalemia

Hypo/hyperglycemia

42
Q

Ts

A

Tension pneumothorax, cardiac tamponade, toxins, thrombosis (PE, coronary)

43
Q

REVERSAL AGENTS

________ for Diltiazem.

________ for BB

________ for Digoxin

________ for Opioids

________ for TCAs

A

Calcium

Glucagon

Digibind

Narcan

Na Bicarbonate

44
Q

Differences w/ kids hearts compared to adults

A
  1. Vagal influence stronger
  2. Fixed ventricular volume - cannot alter their contractility
    -compensate by changing HR
45
Q

Why is IV bupivacaine worse r/t arrhythmias?

A

More cardiac toxic & longer acting

46
Q

_________ can cause hyperkalemia, and ________ can cause hypokalemia

A

Hypoventilation, Hyperventilation

47
Q

What can we do to prevent bradycardia in abdominal surgeries?

A

Give something that blocks vagal stimuli
-Atropine, Ephedrine, Anticholinergics (Glycopyrrolate)

48
Q

_________, __________, & __________ are common causes of post-op dysrhythmias.

A

Hypoxemia
Cardiac Ischemia
Catecholamine Excess (cocaine, ketamine, stress, surgical stimulation, inadequate analgesia/anesthesia)

49
Q

Lidocaine 2nd dose

A

0.5-0.75mg/kg

50
Q

______ 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.

A

2J/kg

4J/kg

> or equal to 4J/kg

Max: 10J/kg or the adult dose

51
Q

Pediatric Epi dose

A

0.01mg/kg - 0.1mL of the 0.1mg/mL concentration

Max dose 1mg

52
Q

Pediatric Atropine Dose

A

0.02mg/kg

53
Q

Common causes of V-fib/V-tach in kids

A

Electrocution, drowning

54
Q

Pediatric Amiodarone dose

A

5mg/kg bolus in cardiac arrest
*can repeat up to 3x in refractory v-fib/v-tach

55
Q

Pediatric lidocaine dose

A

1mg/kg loading dose

56
Q

Adenosine doses

A

6mg, 12mg

57
Q

Procainamide Doses IV (adult tachycardia)

A

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
Q

When do we avoid Procainamide?

A

Prolonged QT or CHF

59
Q

Amiodarone dose for adult tachycardia

A

150mg over 10min - repeat if V-tach recurs

Maintenance: 1mg/min for 1st 6hrs

60
Q

Sotalol IV dose for adult tachycardia

A

100mg (1.5mg/kg) over 5min

*avoid in prolonged QT

61
Q

Synchronized Cardioversion energy

A

50J, 100J, 200J

Depends on rhythm & device

62
Q

Pediatric synchronized cardioversion energy

A

0.5 - 1J/kg
Increase to 2J/kg

63
Q

Pediatric Adenosine Dose

A

0.1m/kg max 6mg

0.2mg/kg max 12mg

64
Q

Potential causes for maternal cardiac arrest

A

Anesthetic complications, bleeding, cardiovascular, drugs, embolic, fever, general non-OB causes (Hs & Ts), HTN

Health Assessment - Autumn (6 decks)

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