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Assessment > EKG interpretations > Flashcards

EKG interpretations Flashcards

Test 1

1
Q

Where are the pacemaker cells located?

A

SA node
AV node
Bundle of His
Right and left bundle branches
Perkinje fibers

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2
Q

What are the two types of cardiac cells? Which is the bulk?

A

Pacemaker and contractile

Contractile cells make up 99% of myocardium

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3
Q

What is your SA node rate?

A

60 - 100

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4
Q

Which system has the biggest influence on your SA node?

A

PNS

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5
Q

What 2 medications can block the PNS response? what type of drugs are they? what do they do?

A

Atropine
glycopyrrolate

Anticholinergics

increase HR

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6
Q

How does electrical signal get from the SA node to the AV node? What are they called?

A

Internodal pathways:
Anterior/middle/posterior

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6
Q

How does electrical signal get from the right atria to the left atria

A

Bachmann’s bundle

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7
Q

What is the rate of the AV node and bundle of His?

A

40 - 60

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8
Q

The AV node has a conduction delay time of ______. Why?

A

0.1 seconds

To give time for the atria to contract before the ventricle contracts

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9
Q

What is the rate of the bundle branches and Purkinje fibers?

A

20 - 40

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10
Q

What rhythm has a rate less than 20? Where is this originating from?

A

Agonal

Purkinje fibers

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11
Q

How long is a whole ECG strip?

A

6 seconds

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12
Q

How much is a a small box on an EKG?

A

0.2 secs (x-axis)

0.5 mV (y-axis)

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13
Q

How long is your P wave? What leads is it upright in?

A

< 0.12 seconds

Positive in leads: I, II, aVF, V4-V6

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14
Q

What is the flat part in the PR represent on the EKG?

A

The delay in AV node conduction that allows the atria to contract

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15
Q

How long is your PR interval on the EKG?

A

0.10 - 0.20 secs

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16
Q

How long is QRS on EKG?

A

< 0.12 secs

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17
Q

What causes a long QRS?

A

Not following normal conduction pathway –> BBB

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18
Q

What does an elevated T wave represent?

A

Hyperkalemia

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19
Q

ST elevation/depression is greater than _______ mm than it is significant.

A

1 mm

20
Q

What leads are the T wave positive in?

A

I, II, V3-V6

21
Q

What is the HR for ST?

A

100 - 150

22
Q

Describe junctional rhythms

A

Inverted/flat/post QRS p wave
conduction not originating in the SA node

junctional: HR 40-60
junctional Brady: HR <40
Junctional tachy: HR >60

Regular R-R
P for every QRS

23
Q

If you have wide SVT its originating in the ________ and its narrow its originating in the ________

A

Ventricle

Atria

24
Q

Describe a PAC

A

results in a reduced amplitude of the QRS and a compensatory pause afterwards

25
Q

Which medications can help Tx A fib?

A

Amio
Digoxin
Cardizem
Metoprolol
Last 2 rate control only

26
Q

T/F: caffeine can cause A-flutter & can resolve on its own

A

T

27
Q

What does it mean/called when your PVCs look the same? When they look different?

A

Same: Unifocal
-originating from the same cells in the vent

Different: Multifocal
-originating from different cells in the vent

28
Q

Why should we use caution when treating PVC?

A

These PVCs could be the heart only ventricular perfusion. If you treat them and take that away, the HR could be profoundly reduced. This would profoundly reduce CO.

29
Q

Your PR interval is _______ in 2nd degree, type 2 HB

A

fixed

30
Q

T/F: You can Tx 2nd degree, type 2 and 3rd degree HB w/ atropine

A

F

Rhythm not due to vagal influence

31
Q

The QRS complexes in 3rd degree HB are ______.

A

Wide

32
Q

Halothane/enflurane cause _________. What does this do?

A

myocardium sensitivity

Causes dysthymias to be more pronounced

33
Q

Cocaine, Ketamine, & other NE reuptake inhibitors cause _________

A

tachycardia

34
Q

Sevoflurane causes ________ in infants

A

bradycardia

35
Q

Desflurane causes ________ during induction

A

prolong QT

36
Q

Zofran & droperidol causes __________

A

prolong QT interval

37
Q

Local anesthesia injection can cause ______ but large amounts, such as in spinals, can cause ________.

A

tachycardia

severe bradycardia

38
Q

What happens if you inject large amounts of local anesthesia IV?

A

Asystole

39
Q

Large amounts of blood transfusion does what to electrolytes?

A

Increases K+
Decreases Ca++

40
Q

Hypoventilation can cause ____kalemia.

A

Hyper

41
Q

Intubation can trigger their _____ nerve or cause _______ from pain.

A

Vagal

tachycardia

42
Q

What are ways that the vagal nerve is stimulated?

A

carotid
peritoneum
cervix

Think of Sx that manipulate these organs/areas

43
Q

Children have _____ vagal tone

A

high

44
Q

How does CVP cannulation affect the heart?

A

It causes ectopy

Which means you’re in the right place; pull back out a little.

45
Q

Sx manipulation of the heart can _________ CO

A

decrease

46
Q

How can we prevent the oculo-cardiac reflex in eye Sx?

A

Local block

47
Q

Ketamine _____ CO, HR, and contractility

A

Increases

48
Q

Whats the difference between agonal and idoventricular rhythms?

A

Agonal: HR <20 & irregular

Idiovent: HR 20-40 & regular

Assessment (7 decks)

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