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MA 23 Qt 2 > Ekg Informations > Flashcards

Ekg Informations Flashcards

1
Q

Normal Sinus Rhythm (NSR)

A

Rhythm: Regular
Rate: 60-100 bpm
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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2
Q

Sinus Bradycardia

A

Rhythm: Regular
Rate: Less than 60 bpm
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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3
Q

Sinus Tachycardia

A

Rhythm: Regular
Rate: 100-150 bpm
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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4
Q

Sinus Dysrhythmia

A

Rhythm: Irregular
Rate: 60-100 bpm
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

Difference: like NSR but P-P and R-R intervals progressively wide, then narrow, following the pt.’s breathing pattern.

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5
Q

Sinus Arrest

A

Rhythm: Irregular
Rate: Depends on the amount of electrical activity occurring from the SA node
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

QRS do not fit equally

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6
Q

Sinus Exit Block

A

Rhythm: Irregular
Rate: Depends on the amount of electrical activity occurring from the SA node. If several impulses are blocked, the rate may be bradycardia.
P wave morphology: upright
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

QRS fit equally until next P wave

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7
Q

Premature Atrial Complexes (PAC)

A

Rhythm: Irregular
Rate: 60-100 bpm
P wave morphology: upright, with early complex, can be biphasic
PR interval: 0.12-0.20 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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8
Q

Wandering Atrial Pacemaker (WAP)

A

Rhythm: Irregular
Rate: 60-100 bpm
P wave morphology: Continuous changing (at least 3 different p waves)
PR interval: varies
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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9
Q

Multifocal Atrial Tachycardia

A

Rhythm: Irregular
Rate: 101-150 bpm
P wave morphology: varies, can be biphasic
PR interval: Varies due to the changing origin of the electrical activity
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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10
Q

Atrial Flutter

A

Rhythm: R-R Regular, occasionally irregular
Rate: 250-350 bpm
P wave morphology: sawtooth pattern, no P waves only F waves
PR interval: Unknown
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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11
Q

Atrial Fibrillation

A

Rhythm: Irregular
Rate: 375-700 bpm
P wave morphology: Unknown
PR interval: Unknown
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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12
Q

What is the rate of a Normal sinus rhythm?

A

60-100 bpm

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13
Q

Which sinus rhythm has a rate that is consistently less than 60 bpm?

A

Sinus bradycardia

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14
Q

Which question does not need to be answered when determining the QRS measurement?

A

Are all the QRS complexes of equal length

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15
Q

Which sinus rhythm has a rate of more than 100 bpm?

A

Sinus tachycardia

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16
Q

Which rhythm shows an irregularity during inspiration and expiration?

A

Sinus dysrhythmia

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17
Q

The normal PR interval is?

A

0.12-0.20 seconds

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18
Q

If a QRS complex measures 0.12 seconds or wider, it indicates?

A

delayed ventricular conduction

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19
Q

Which of the following is a common sign of low cardiac output?

A

Low blood pressure

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20
Q

Which of the following may be a cause of sinus exit block?

A

digitalis

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21
Q

Sinus tachycardia maybe a normal finding in a patient as a result of

A

Children

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22
Q

When sinus arrest continues for 6 seconds or more, it is considered

A

Medical emergency

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23
Q

The rhythm originating in the SA node that is considered normal is

A

Normal sinus rhythm

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24
Q

The rhythms originating in the SA node that results in the heart beating regularly, but slower or faster than normal are ____________ and _____________.

A

bradycardia and tachycardia

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25
Q

The rhythm originating in the SA node that is affected by vagal tone is

A

Sinus Dysrhythmia

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26
Q

What is the rate of wandering atrial pacemaker rhythm?

A

60-100 bpm

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27
Q

Which dysrhythmia is similar to wandering atrial pacemaker, except that the rate exceeds 100 bpm?

A

Multifocal Atrial Tachycardia

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28
Q

What is the major health risk for patients who have atrial fibrillation?

A

Thrombus formation

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29
Q

Which atrial dysrhythmia has capital F waves and a classic sawtooth or picket fence appearance?

A

Atrial flutter

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30
Q

Which atrial dysrhythmia has lowercase f waves, chaotic atrial electrical activity, and irregular R-R intervals?

A

Atrial fibrillation

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31
Q

Wandering atrial pacemaker rhythm must have _______ or more differently shaped P waves.

A

3

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32
Q

When premature complexes occur in a rhythm, they interrupt the underlying rhythm, causing it to be ________ when analyzing it.

A

Irregular

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33
Q

Which of the following is a common sign of low cardiac output?

A

Low blood pressure

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34
Q

Multifocal atrial tachycardia may occasionally be confused with _______.

A

Wander Atrial Pacemaker

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35
Q

When analyzing atrial flutter, you note that there are four F waves for each QRS complex. You will represent this pattern in your interpretation as ___________.

A

4:1

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36
Q

The patient has coronary artery disease. How would you expect PACs to affect this patient?

A

More PACs are more likely to occur because of myocardial cells are damaged and may cause low cardiac output

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37
Q

What treatment is usually indicated for patients with atrial flutter?

A

Oxygen therapy

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38
Q

What is the best way to describe the rhythm pattern for atrial fibrillation?

A

Irregular, Chaotic

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39
Q

Which rhythm is considered more serious, MAT or WAP, and why?

A

MAT because, is usually triggered by an acute exacerbation of emphysema, congestive Heart failure (CHF), or acute mitral valve regurgitation

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40
Q

Premature Junctional complex (PJC)

A

Rhythm: Irregular
Rate: depends on the rhythm and number of PJCs present
P wave morphology: inverted
PR interval: Less than normal
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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41
Q

Junctional Escape Rhythm

A

Rhythm: Regular
Rate: 40- 60 bpm
P wave morphology: inverted
PR interval: less than 0.12 secs, constant
QRS Duration & morphology: narrow, 0.06-0.10 seconds

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42
Q

Accelerated Junctional Rhythm

A

Rhythm: Regular
Rate: 60-100 bpm
P wave morphology: inverted
PR interval: less than 0.12 secs, constant
QRS Duration & morphology: narrow, 0.06-0.10 seconds

43
Q

Junctional Tachycardia

A

Rhythm: Regular
Rate: 100-180 bpm
P wave morphology: inverted
PR interval: less than 0.12 seconds
QRS Duration & morphology: narrow, 0.06-0.10 seconds

44
Q

Supraventricular Tachycardia (SVT)

A

Rhythm: Regular
Rate: 150-250 bpm
P wave morphology: unknown
PR interval: unknown
QRS Duration & morphology: narrow, 0.12 or greater with a delta wave

45
Q

What is the normal, inherent rate for the AV junction?

A

40-60 bpm

46
Q

Which of the following dysrhythmias is not considered part of the supraventricular tachycardia classification?

A

Atrial Fibrillation

47
Q

What sign or symptom might a patient complain about when experiencing a supraventricular tachycardia in an unstable condition?

A

Sensation of a racing heart

48
Q

The criterion needed to classify a dysrhythmia as a supraventricular tachycardia is?

A

a heart rate between 150 and 350 bpm with narrow QRS complex

49
Q

What is the primary difficulty in determining a supraventricular rhythm?

A
50
Q

When is the identification of the specific dysrhythmia important in terms of treatment of the patient?

A
51
Q

What is the heart rate range for junctional escape rhythm?

A

40-60bpm

52
Q

What is the heart rate range for accelerated junctional rhythm?

A

60-100 bpm

53
Q

What is the heart rate range for junctional tachycardia?

A

100-150 bpm

54
Q

Describe why P waves are inverted or buried within the QRS complex with junctional dysrhythmias.

A
55
Q

What happens in the heart during a heart block dysrhythmia?

A

Causes a delay or absence of ventricular depolarization

56
Q

First Degree AV Block

A

Rhythm: Regular,
Rate: 60-100 bpm
P wave morphology: upright
PR Interval: greater than 0.12 (longer)
QRS duration and morphology: 0.06- 0.10 seconds

consistently long PR interval

57
Q

Second Degree AV Block, Type l ( Mobitz l or Wenckebach)

A

Rhythm: P-P Regular, R-R irregular due to the blocked impulse (s)
Rate: Atrial 60-100 bpm, Ventricular slower than atrial rate
P wave morphology: upright (*longer longer longer drop, you have a wenckebach)
PR Interval: progressively greater than 0.12 (longer)
QRS duration and morphology: 0.06- 0.10 seconds

58
Q

Second Degree AV Block, Type ll (Mobitz ll)

A

Rhythm: P-P regular, R-R may or may not be irregular due to pattern
Rate: Atrial 60-100 bpm, Ventricular slower than atrial, A and V rates are not the same
P wave morphology: upright
PR Interval: constant and remains constant even after QRS drop
QRS duration and morphology: 0.06- 0.10 seconds

59
Q

Third Degree AV Block (complete heart block)

A

Rhythm: P-P and R-R intervals regular but different
Rate: Atrial 60-100 bpm, ventricular slow between 20- 40 or 40- 60 bpm
P wave morphology: upright but maybe buried. Not every p wave will have a QRS following it
PR Interval: varies due to atrial and ventricular depolarizing at different rates
QRS duration and morphology: maybe either within normal limits or wide

60
Q

Which heart block rhythm has the distinguishing feature of a PR interval that measures greater than 0.20 second and measures the same duration each time?

A

First Degree Heart Block

61
Q

Which of the following heart block dysrhythmias is identified by a repetitious
Prolonging PR interval pattern after each blocked QRS complex?

A

Mobitz I or Wenchebach

62
Q

Which of the following heart block dysthythmias is identified by missing QRS complexes and a consistent PR interval measurement?

A

Mobitz II

63
Q

Which of the following heart block dysrhythmias is identified by regular P-P and R-R intervals that are firing at two distinctly different rates?

A

Third Degree Heart Block (complete)

64
Q

P-P intervals are _______ with all heart block dysrhythmias.

A

regular

65
Q

QRS complexes that measure 0.12 seconds or greater with a rate between 20 and 40 bpm indicate that the impulses causing ventricular depolarization are coming from that _____?

A

Purkinje fiber

66
Q

What is the typical heart rate range for first degree heart block?

A

60-100 bpm

67
Q

Frequent non-conducted QRS complexes are likely to cause signs of?

A

Low cardiac output

68
Q

Which heart block dysrhythmias has regular P-P and R-R intervals with both having the same rate?

A

First Degree Heart Block

69
Q

Which heart block dysrhythmia is known as the “classical” heart block?

A

Mobitz II

70
Q

Which of the heart block rhythm is the most serious?

A

Third Degree heart Block

71
Q

How can you tell the difference between a Mobitz I and a Mobitz II?

A

Mobitz I: PR longer longer longer-> QRS drops

Mobitz II: Constant PR -> some QRS drop

72
Q

What should you do if the patient has a third degree heart block?

A

pacemaker and call physician

73
Q

Why does it take longer than normal to depolarize the ventricles during a ventricular dysrhythmia?

A

Because current is not traveling down the normal ventricular conduction pathway to activate both the right and left ventricles simultaneously

74
Q

Agonal Rhythm

A

Rhythm: Irregular
Rate: A- Unknown V-less than 20 bpm
P wave morphology: unknown
PR Interval: Unknown
QRS duration and morphology: 0.12 or greater, wide and bizarre

75
Q

Idioventricular Rhythm

A

Rhythm: P-P unknown, R-R regular
Rate: A- unknown, V- 20-40 bpm
P wave morphology: unknown
PR Interval: unknown
QRS duration and morphology: 0.12 seconds or greater, wide and bizarre

76
Q

Accelerated Idioventricular Rhythm

A

Rhythm: P-P unknown, R-R regular
Rate: A- unknown, V- 40-100 bpm
P wave morphology: unknown
PR Interval: unknown
QRS duration and morphology: 0.12 seconds or greater, wide and bizarre

77
Q

Ventricular Tachycardia

A

Rhythm: P-P unknown, R-R regular
Rate: A- unknown, V- 100-200 bpm
P wave morphology: unknown
PR Interval: unknown
QRS duration and morphology: 0.12 seconds or greater, wide and bizarre w/ increase amplitude

78
Q

Another type of Ventricular Tachycardia is?

A

Torsades de Pointes

79
Q

Difference between traditional ventricular tachycardia and Torsades de pointes?

A

Traditional: Consistent morphology
Torsades de pointes: changing voltages and durations due to the depolarization impulses in ventricles (different directions)

80
Q

Ventricular Fibrillation

A

Rhythm: Both P-P and R-R=Unknown
Rate: Both A and V = Unknown
P wave morphology: unknown
PR Interval: unknown
QRS duration and morphology: Unknown

81
Q

apnea

A

The absence of breathing

82
Q

Asystole

aka Flatline

A

Rhythm: none
Rate: none
P wave morphology: none
PR Interval: none
QRS duration and morphology: none

83
Q

Which ventricular dysrhythmia has no P waves?

A

Idioventricular

84
Q

Which ventricular dysrhythmia has a heart rate between 40-100 bpm?

A

Accelerated Idioventricular

85
Q

Which ventricular dysrhythmia has a heart rate less than 20 bpm?

A

Agonal

86
Q

Which ventricular dysrhythmia has a heart rate between 20-40 bpm?

A

Idioventricular

87
Q

What is unique about ventricular dysrhythmias with regard to the P-P intervals?

A

There are no P waves, so the P-P interval cannot be measured.

88
Q

QRS complexes that measure 0.12 seconds or greater with a heart rate between 20 and 40 bpm indicate that the impulses causing ventricular depolarization are coming from the ______?

A

Purkinje Fibers

89
Q

Ventricular fibrillation is typically described as “_______”

A

chaotic

90
Q

Which of the following dysrhythmias is not considered to be a medical emergency?

A

Occasional PVCs

91
Q

What is the difference between idioventricular rhythm and accelerated idioventricular rhythm?

A

idioventricular-20-40 bpm
accelerated idio- 40-100 bpm

92
Q

How are agonal rhythm and asystole the same?

A

Less than 20 bpm
No consistent cardiac rhythm

93
Q

What is the difference between ventricular tachycardia and ventricular fibrillation?

A

Ventricular Tachycardia: can calculate rate with a pattern

Ventricular Fib: None

94
Q

Branch Bundle Blocks (BBB)

A

Rhythm: Regular and Irregular patterns are possible depends on SA and AV underlying rhythm
Rate: Depends on basic rhythm
P wave morphology: Depends on basic rhythm
PR Interval: 0.12- 0.20 seconds
QRS duration and morphology: 0.12 seconds or greater, Widening of QRS duration indicates presence of BBB

95
Q

LBBB (Left Bundle Branch Block)

A
96
Q

If majority of ventricular depolarization is positively deflected? LBBB or RBBB?

Also referred to as ?

A

RBBB (Right Bundle Branch Block)

Bunny ears

97
Q

If majority of ventricular depolarization is negative deflected? LBBB or RBBB?

Characteristic?

A

LBBB (Left Bundle Branch Block)

QS complex is deep wave with no preceding R wave.

98
Q

You observe a wide QRS complex while continuously monitoring a patient in lead II. Which lead placement is referenced to evaluate the location of blockage in the bundle branch system?

A

Lead V1

99
Q

The labeling of the EKG rhythm strip for documentation of the bundle branch block should include what other information besides the bundle branch designation?

A
100
Q

Why do the QRS complexes in bundle branch block have a longer than normal duration of more than 0.12 seconds?

A

The electric current is delayed between the SA and AV node

101
Q

Which of the following rhythms cannot be an underlying rhythm in patients with bundle branch block?

-Accelerated junctional rhythm
-Atrial flutter
-Sinus bradycardia
-ventricular tachycardia

A

ventricular tachycardia

102
Q

Fill in the blank

The view referred to when differentiating left from right BBB is _________.

A

V1

103
Q

Fill in the blank

The QRS complex is __________ for a BBB.

A

0.12 seconds or longer
or deeper

MA 23 Qt 2 (9 decks)

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