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Adults 2 > EKG Practice > Flashcards

EKG Practice Flashcards

1
Q

NSR

A

P wave before every QRS complex
HR 60-100, regular rhythm
Normal P wave (upright in leads 1 and 2)
PR interval remains constant (0.12-0.2 seconds)

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2
Q

NSR Considerations

A

None

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3
Q

Sinus Tachy

A

P wave before every QRS complex
HR >100 bpm (100-180), regular rhythm
Normal P wave axis (upright in leads 1 and 2)
PR interval remains constant (0.12-0.2 seconds)

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4
Q

Sinus Tachy Considerations

A

May affect CO/preload
Check lab work (K+, Mg, Ca+)
May need rate control drug if tachy is frequent/uncontrolled

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5
Q

Sinus Brady

A

P wave before every QRS complex
HR >100 bpm (100-180), regular rhythm
Normal P wave axis (upright in leads 1 and 2)
PR interval remains constant (0.12-0.2 seconds)

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6
Q

Sinus Brady Considerations

A 
May affect cardiac perfusion 
Check lab work (K+, Mg, Ca+)
May need atropine (anti-cholinergic) if vagal stimulation
May be a heart block
May need pacemaker if severe/chronic
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7
Q

Premature atrial contractions

A

P wave before every QRS complex
Premature – occurs earlier than expected
P wave is ectopic; originates outside the SA node
Compensatory pause after PAC

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8
Q

PAC Considerations

A

Check lab work (K+, Mg, Ca+)

Usually no interventions needed

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9
Q

Supraventricular Tachy

A

P wave not observed
Dysrhythmia originates at or above AV node
Narrow QRS complex
HR >100, but many times 160+

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10
Q

Supraventricular Tachy Considerations

A 
Stable vs unstable 
Check labs (K+, Mg, Ca+), replete as needed
EKG
May need IV fluid resuscitation 
May need adenosine/cardioversion
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11
Q

A Fib

A

P wave not observed
Irregularly irregular rhythm, variable ventricular rate
Narrow QRS complex
Absence of isoelectric baseline

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12
Q

A Fib Considerations

A

Stable vs unstable
Acute vs chronic
Check labs, replete as needed
EKG, TEE (transesophageal ECG)
May need IV fluid resuscitation, anticoags
May need amiodarone or other antiarrhythmic

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13
Q

Atrial Flutter

A

P wave not observed, but saw-tooth flutter waves
Regular or irregular rhythm, variable ventricular rate
Normal, narrow QRS complex
Atrial rate 250-350

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14
Q

Atrial Flutter Considerations

A

Stable vs unstable
Check labs, replete as needed
EKG, TEE (transesophageal ECG)
May need IV fluid resuscitation, anticoags
May need amiodarone or other antiarrhythmic

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15
Q

Premature Ventricular Contractions

A

Ectopic ventricular cardiac focus
Premature and bizarrely shaped QRS
Unusually long
Usually not life threatening

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16
Q

PVC Bigeminy

A

PVC every other beat
Tx based on sx
Could cause heart enlargement or clots
Can feel like chest fluttering

17
Q

PVC Trigeminy

A

PVC every third beat
Tx based on sx
Could cause heart enlargement or clots
Could cause chest fluttering

18
Q

PVC Multifocal

A

PVC morphology looks different
Ectopic ventricle foci from different areas
Sometimes tx is needed

19
Q

PVC Considerations

A 
Stable vs unstable 
Check lab works, replete as needed 
Calcium channel blockers
May need amiodarone or other antiarrhythmic 
May need cardiac ablation
20
Q

1st Degree Heart Block

A

P wave slightly delayed without interruption (PR interval >20 s, 5 small squares)
Electrical signals are slowed, but pass successfully
Regular rhythm
Normal, narrow QRS complex
No sx

21
Q

2nd Degree Heart Block

Type 1 Wenckebach

A

AKA Mobitz-1
Progressive prolongation of the PR interval
Irregular rhythm, RR interval progressively shortens with each beat of the cycle
Normal, narrow QRS complex
Usually due to a reversible conduction block in the AV node

22
Q

Wenckebach Considerations

A

Stable vs unstable
Can be scheduled for EP ablation
Pacemaker if needed, symptomatic

23
Q

2nd Degree Heart Block

Type 2 Mobitz 2

A

Irregular rhythm, intermittently non-conducted P waves
Normal, narrow QRS complex
Disease of the distal conduction system (His-Purkinje system)

24
Q

Mobitz 2 Considerations

A

Stable vs unstable
Can be scheduled for EP ablation
Pacemaker if needed, symptomatic

25
Q

Junctional Rhythm

A

Electrical activation occurs near the AV node
Absent P wave
Normal, narrow QRS complex, regular rhythm
Can create bradycardia

26
Q

Junctional Rhythm Considerations

A

Stable vs unstable

Pacemaker if needed, symptomatic bradycardia

27
Q

V Tach

A

Very broad complexes
Absent P wave
Most common is monomorphic (one origin), but can be polymorphic
Can be stable or unstable (hypotension, chest pain, decreased LOC)

28
Q

V Tach Considerations

A

Stable vs unstable
Antiarrhythmic drugs (amiodarone)
Ventricular cardioversion

29
Q

V Fib

A

Chaotic irregular deflections of varying amplitudes
Absent P wave, QRS complex, and T wave
Rate is 150-500 bpm, no effective perfusion
Amplitude decreases with duration (coarse VF to fine VF)

30
Q

V Fib Considerations

A

Immediate intervention
Ventricular defibrillation
CPR
ACLS algorithm

31
Q

Asystole

A

Cardiac arrest rhythm; heart standstill
No electrical activity
P waves and QRS complex are absent
No pulse; asystole confirmed in 2 separate leads when pronouncing death

32
Q

Asystole Considerations

A

Immediate intervention
CPR
ACLS algorithm

33
Q

Pulseless Electrical Activity

A

Cardiac standstill
Presence of organized cardiac electrical activity
Any rhythm can be present on tele
No pulse

34
Q

A Paced

A

Electrical conduction of the atria

Presence of pacer spike prior to the P wave

35
Q

V Paced

A

Electrical conduction of the ventricles
Presence of pacer spike prior to the QRS wave
Creates wide QRS

36
Q

AV Paced

A

Electrical conduction of the atrium and the ventricles
Presence of 2 pacer spikes prior to the P and QRS wave
Creates wide QRS

Adults 2 (1 decks)

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