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
Junctional Rhythm
Electrical activation occurs near the AV node Absent P wave Normal, narrow QRS complex, regular rhythm Can create bradycardia
26
Junctional Rhythm Considerations
Stable vs unstable | Pacemaker if needed, symptomatic bradycardia
27
V Tach
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
V Tach Considerations
Stable vs unstable Antiarrhythmic drugs (amiodarone) Ventricular cardioversion
29
V Fib
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
V Fib Considerations
Immediate intervention Ventricular defibrillation CPR ACLS algorithm
31
Asystole
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
Asystole Considerations
Immediate intervention CPR ACLS algorithm
33
Pulseless Electrical Activity
Cardiac standstill Presence of organized cardiac electrical activity Any rhythm can be present on tele No pulse
34
A Paced
Electrical conduction of the atria | Presence of pacer spike prior to the P wave
35
V Paced
Electrical conduction of the ventricles Presence of pacer spike prior to the QRS wave Creates wide QRS
36
AV Paced
Electrical conduction of the atrium and the ventricles Presence of 2 pacer spikes prior to the P and QRS wave Creates wide QRS