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Nursing Study > EKG: Interpretation Rhythms > Flashcards

EKG: Interpretation Rhythms Flashcards

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1
Q

Each small box is equal to _____ seconds and there are _____ small boxes in each large box which represents to 0.20 seconds.

A

0.04; 5

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2
Q

The horizontal axis of an EKG strip represents _____ whereas the vertical axis represents _____

A

time (each small box = 0.04s); amplitude (each small box = 1 mV)

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3
Q

How many large boxes are in a 1 sec strip?

A

5

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4
Q

What does the P wave represent? And what is normal duration?

A
  • Atrial depolarization
  • < 0.12 second (< 3 small boxes)
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5
Q

The QRS complex represents the depolarization of _____ and the normal duration is _____.

A

ventricles; <0.12 second (< 3 small boxes)

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6
Q

What does the T wave represents?

A

Ventricular repolarization

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7
Q

Although not formally recognized in EKG interpretation, where would the atrial repolarization be?

A

Somewhere in the QRS

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8
Q

The PR interval stretches from the end of the P wave to the beginning of the _____ complex. What is that is the normal duration?

A
  • QRS
  • 0.12 - 0.20 second (3-5 small boxes)
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9
Q

What does the PR interval represent?

A

The time it takes to fire from the SA node to the AV node (slight delay) to start signaling the ventricles contract.

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10
Q

The QT interval from the the beginning of the QRS complex to the end of the _____ wave.

A

T

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11
Q

What does the QT interval represents the depolarization and repolarization of the _____.

A

ventricles

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12
Q

The ST segment represents the end of _____ depolarization. If it is elevated > _____ mV (2 small vertical boxes), then it is a problem i.e. myocardial injury.

A

ventricular; 2

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13
Q

The 5-step EKG interpretation method consists of the following steps:
1.) Is it regular aka equal spacing between each _____ complex?
2.) Determine the _____
3.) P to QRS Ratio (_____ : 1)
4.) Look at the PR interval
5.) Look at the QRS complex

A
  • QRS
  • Heart rate (HR)
  • 1: 1
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14
Q

What are the 2 ways of determining whether there is equal spacing between each QRS complex? (To determine regularity of rhythm)

A
  1. “Marching” the spaces out w/ a piece of paper
  2. Count the # of small boxes in btwn
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15
Q

To determine the HR of an EKG strip, there are 2 ways.
1. 10-times Method: If you have a _____ second strip (30 big boxes), count the total # of QRS complexes and multiply by 10.
2. 1500 Method: (Only works for regular rhythm) Count the # of small boxes between two _____ complexes then divide by 1500.

A
  • 6
  • QRS
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16
Q

When doing Step 3 of the EKG interpretation method, you can are looking for one _____ wave for every QRS complex.

A

p

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17
Q

The PR interval should be _____ 0.12 - 0.20 sec (3-5 small boxes)

A

<

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18
Q

The QRS complex should NOT be wide and should only < 0.12 sec (3 small boxes). TRUE or FALSE.

A

TRUE

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19
Q

What is the only difference btwn normal sinus rhythm and bradycardia? V.s tachycardia?

A

Everything is the same except for the HR. Bradycardia is < 60 bpm and tachycardia is > 100 bpm.

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20
Q

The following are characteristics of normal sinus rhythm:
- Regular rhythm
- HR: _____
- 1 P wave for every QRS complex
- Normal PR intervals (<0.12-0.20 sec or 3-5 small boxes)
- All QRS complexes are narrow (<0.12 sec)

A
  • 60-100 bpm
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21
Q

The following are characteristics of sinus arrhythmia:
- _____ rhythm
- HR: 60 - 100 bpm; vary w/ respiration
- 1 P wave for every QRS complex
- Normal PR intervals (< 0.12-0.20 sec or 3-5 small boxes)
- All QRS complexes are narrow (<0.12 sec)

A

Irregular; corresponding to the respiratory cycle

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22
Q

Sinus arrhythmias coincides w/ the _____ cycle.

A

respiratory

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23
Q

The following are characteristics of sinus bradycardia:
- Regular rhythm
- HR: _____ 60 bpm
- 1 P wave for every QRS complex
- Normal PR intervals (<0.12-0.20 sec or 3-5 small boxes)
- All QRS complexes are narrow (<0.12 sec)

A

<

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24
Q

If the pt is experiencing bradycardia but is asymptomatic, how would you intervene?

A

If pt is asymptomatic and vital signs are stable, just continue to monitor the pt.

25
Q

What medications would you give to treat bradycardia while waiting for a pacemaker or if pacing is ineffective?

A

1.) Atropine (0.5 mg rapid infusion and can be repeated every 3-5 minutes up to a max of 3 mg total)
2.) If atropine is ineffective, give epinephrine infusion at a rate of 2-10 mcg/min.
3.) If low BP also, administer dopamine infusion at 2-10 mg/kg/min

26
Q

The following are characteristics of sinus _____:
- Regular rhythm
- HR: > 100 bpm
- 1 P wave for every QRS complex
- Normal PR intervals (<0.12-0.20 sec or 3-5 small boxes)
- All QRS complexes are narrow (<0.12 sec)

A

tachycardia

27
Q

In SA block, the SA node discharges impulses at regular intervals but some of these are delayed on their way to the _____.

A

atria

28
Q

SA blocks are divided into three categories which are what?

A
  1. First-degree
  2. Second-degree (Type I and Type II)
  3. Third-degree
29
Q

In second-degree type I block, the rhythm is irregular and the P-P interval get progressively _____ until an entire cycle (PQRST complex) is dropped (conduction time btwn the sinus node and the surrounding atrial tissue becomes progressively longer).

A

shorter

30
Q

In second-degree type II block, the rhythm is _____ except for pauses (conduction time btwn the sinus node and atrial tissue is normal until an impulse is blocked, the duration of the pause is a multiple of the P-P interval), and an entire PQRST complex is missing .

A

regular

31
Q

In third-degree block, the rhythm is regular except for pauses, and entire PQRST complex is missing and the pause (can last indefinitely period) ends w/ a sinus beat. TRUE or FALSE.

A

TRUE

32
Q

The following are characteristics of _____ arrest:
- Rhythm: Regular, except for the missing PQRST complexes
- HR: 60-100 bpm
- P wave: Normal and constant when P wave is present; not measurable when P wave is absent
- QRS complex: Normal when present; absent during pause

A

sinus

33
Q

The following characteristics of _____ _____ contractions (PACs)
- Rhythm: Irregular as a result of PACs
- P wave: Premature w/ an abnormal configuration; may be buried in previous T wave
- PR intervals: Usually normal (<0.12-0.20 sec or 3-5 small boxes); may be slightly shortened or prolonged
- QRS complexes: Similar to underlying QRS complex when PAC is conducted; may not follow the premature P wave when a nonconducted PAC occurs

A

premature atrial

34
Q

The hallmark EKG characteristic of a PAC is a premature (early) P wave w/ an abnormal shape i.e. inside the preceding T wave. TRUE or FALSE.

A

TRUE

35
Q

PACs may occur in _____ (every other beat is a PAC), trigeminy (every 3rd beat is a PAC), or couplets (_____ PACs in a row)

A

bigeminy; 2

36
Q

The following are characteristics of atrial _____:
- Rhythm: Atrial– regular, irregular in MAT; ventricular– regular when the block is constant and irregular when it isn’t
- HR: Atrial – 3 or more successive ectopic atrial beats at a rate of 150-250 bpm
- P wave: A 1:1 ratio w/ QRS complex (unless a block is present); may not be discernible; may be hidden in previous ST segment or T wave; in MAT, at least 3 different P waves seen
- PR intervals: Sometimes not measurable; varies in MAT
- QRS complexes: Usually normal (< 0.12 sec)

A

tachycardia

37
Q

The following are characteristics of atrial flutter:
- Rhythm: Atrial– regular; ventricular– depends on the AV conduction pattern
- HR: Atrial– 250-350 bpm; ventricular < atrial
- P wave: Abnormal _____-toothed
- Normal PR intervals unmeasurable
- QRS complexes: Usually normal (< 0.12); may be widened if flutter waves are buried in complex

A

Saw

38
Q

Abnormal P waves that have a saw-toothed appearance is the hallmark characteristic of _____ _____.

A

atrial flutter

39
Q

The following are characteristics of _____ fibrillation
- Rhythm: Irregularly irregular
- HR: Atrial > 400 impulses/min, unable to measure; ventricular– varies from 100-150 bpm but can be ↓ or ↑
- P wave: Absent, replaced by fibrillatory waves
- PR intervals: Indiscernible

A

atrial

40
Q

“Quivering” waves instead of distinct P waves are a hallmark sign of atrial _____.

A

fibrillation

41
Q

The following are characteristics of wandering _____:
- Rhythm: Irregular
- HR: Usually normal or < 60 bpm
- P wave: Change in size and shape; first P wave inverted, second upright (at least 3 P waves of different size and shape)
- PR intervals: Variable; usually < 0.20 sec
- QRS complexes: Usually normal; < 0.12 sec

A

pacemaker

42
Q

The following are characteristics of premature _____ contraction (PJC):
- Rhythm: Irregular w/ PJC appearance
- HR: Varying w/ underlying rhythm
- P wave: Inverted; occurs before, during, or after QRS complex; may be absent
- PR intervals: < 0.12 sec or unmeasurable
- QRS complexes: Usually normal; < 0.12 sec

A

junctional

43
Q

The following are characteristics of junctional _____ rhythm:
- Rhythm: Regular. If the escape rhythm is intermittent, it will begin after a pause in the underlying rhythm
- HR: 40-60 bpm
- P wave: Inverted in leads II, III, and aVF; can occur before, during, or after QRS complex
- PR intervals: < 0.12 sec if P wave comes before QRS complex
- QRS complexes: Normal; < 0.12 second

A

escape

44
Q

The following are characteristics of _____ junctional rhythm:
- Rhythm: Regular
- HR: 60-100 bpm
- P wave: Inverted in leads II, III, and aVF (if present); occurs before, during, or after QRS complex
- PR intervals: Measurable only w/ P wave that comes before QRS complex; < 0.12 sec
- QRS complexes: Usually normal; < 0.12 sec

A

accelerated

45
Q

The following are characteristics of junctional _____.
- Rhythm: Regular
- HR: 100 - 200 bpm
- P wave: Inverted in leads II, III, and aVF; location varies around QRS complex
- PR intervals: Shortened at < 0.12 sec or unmeasurable
- QRS complexes: Normal; < 0.12 sec

A

tachycardia

46
Q

Ventricular arrhythmias share the following 3 characteristics:
1. QRS complex: Wide, > 0.12 sec
2. T wave and QRS complex deflect in opposite directions
3. P wave is _____

A

absent

47
Q

The following are characteristics of premature _____ contraction:
- Rhythm: Irregular during PVC; underlying rhythm may be regular
- HR: Patterned after underlying rhythm
- P wave: Absent
- PR intervals: Unmeasurable
- QRS complexes: Wide >0.12 sec and bizarre

A

ventricular

48
Q

The following are characteristics of _____ rhythms:
- Rhythm: Atrial– undetermined; ventricular – usually regular
- HR: Atrial– unmeasurable; ventricular– 20-40 bpm
- P wave: Absent
- PR intervals: Unmeasurable
- QRS complexes: Wide >0.12 sec and bizarre

A

idioventricular

49
Q

The following are characteristics of _____ tachycardia:
- Rhythm: Atrial– can’t be determined; ventricular – regular or slightly irregular
- HR: Atrial– can’t be determined; ventricular–100-250 bpm
- P wave: Absent or hidden by QRS complex
- PR intervals: Unmeasurable
- QRS complexes: Wide >0.12 sec and bizarre

A

ventricular

50
Q

The following are characteristics Torsades de pointes:
- Rhythm: Ventricular– _____
- HR: 150-250 bpm
- P wave: Absent
- PR intervals: Unmeasurable
- QRS complexes: Wide, > 0.12 sec; rotates around the baseline; deflection downward and upward for several beats

A

irregular

51
Q

The following are characteristics of ventricular _____:
- Rhythm: Can’t be determined
- HR: Can’t be determined
- P wave: Can’t be determined
- PR intervals: Can’t be determined
- QRS complexes: Can’t be dtermined

A

fibrillation

52
Q

What cardiac rhythm is characterized by ventricular standstill and cardiac arrest aka a nearly flat line?

A

Asystole

53
Q

What cardiac rhythm is characterized by electrical activity that is present on EKG but heart muscle can’t contract?

A

Pulseless Electrical Activity

54
Q

AV blocks result from an interruption in impulse conduction between the _____ and _____.

A

atria; ventricles

55
Q

AV blocks typically have a usually normal atrial rate (60-100 bpm) w/ a _____ ventricular rate

A

slowed

56
Q

The following are characteristics of _____ AV block:
- Rhythm: Regular
- P wave: Normal (< 0.12 sec)
- PR intervals: Consistent for each beat; > 0.20 sec
- QRS complexes: Normal (< 0.12 sec); occasionally widened because of bundle branch block

A

first-degree

57
Q

The following are characteristics of _____ second-degree AV block also known as Mobitz type I block:
- Rhythm: Atrial– regular; ventricular– irregular
- HR: Atrial rates > ventricular rate
- P wave: Normal
- PR intervals: Gradually gets longer w/ each beat until P wave fails to conduct to the ventricles
- QRS complexes: Usually normal < 0.12 sec

A

Type 1

58
Q

The following are characteristics Type II _____ AV block also known as Mobitz II block:
- Rhythm: Atrial– regular; ventricular– irregular if block is intermittent, regular if block is constant (i.e. 2:1 or 3:1)
- PR intervals: Constant for all conducted beats, may be prolonged in some cases
- QRS complexes: Usually wide > 0.12 sec

A

second-degree

59
Q

The following are characteristics third-degree _____ block:
- Rhythm: Atrial– regular; ventricular– regular
- HR: Atrial rate > ventricular rate
- P wave: Normal (< 0.12 sec)
- PR intervals: Variations w/ no regularity; no relation btwn P waves and QRS complexes
- QRS complexes: Normal (junctional pacemaker) or wide and bizarre (ventricular pacemaker)

A

AV

Nursing Study (6 decks)

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