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Nursing 213 > EKG Rhythms > Flashcards

EKG Rhythms Flashcards

1
Q

Name this rhythm

A

NSR

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2
Q

Name this rhythm

A

Sinus tachy

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3
Q

Name this rhythm

A

Premature Atrial Contraction

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4
Q

Name this rhythm

A

A-fib

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5
Q

Name this rhythm

A

Atrial Fibrillation
or
A-fib
W/ RVR

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6
Q

What is this rhythm

A

Atrial flutter
or
A flutter

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7
Q

What is this rhythm

A

Super ventricular tachycardia
or
SVT

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8
Q
A

Junctional rhythm

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9
Q

What is this rhythm

A

Accelerated Juntional

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10
Q

What rhythm is this?

A

Junctional tachycardia

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11
Q

What rhythm is this

A

PVC

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12
Q

What rhythm is this

A

PVC

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13
Q

What rhythm is this

A

PVC Couplet

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14
Q

What rhythm is this

A

PVC triplet

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15
Q

What rhythm is this

A

PVC Bigeminy

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16
Q

What rhythm is this?

A

PVC Trigeminy

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17
Q

What rhythm is this

A

Ventricular tachycardia
or
V-tach

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18
Q

What rhythm is this

A

V-tach

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19
Q

What rhythm is this

A

Ventricular Fibrillation
or
V-fib

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20
Q

What rhythm is this?

A

Ventricular Fibrillation
or
V-fib

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21
Q

What rhythm is this?

A

Idioventricular Rhythm
or
IVR

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22
Q

What rhythm is this?

A

Accelerated IVR

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23
Q

What rhythm is this?

A

Agonal rhythm

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24
Q

What rhythm is this?

A

Asystole

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25
What type of heart block is this?
1st degree heart block | *If the R is far from P, then you have a 1st Degree*
26
What type of heart block is this?
2nd degree heart block - type II or Mobitz II | If some Ps don’t get through, Then you have a Mobitz II
27
What type of heart block is this?
2nd degree block - type 1 wenkeback or Mobitz I | Longer, longer, longer, BLOCK Then you have a WENKEBACH
28
What type of heart block is this?
3rd Degree block or Complete heart block | If Qs and Ps don’t agree, Then you have a 3rd Degree
29
Conditions that can cause Sinus tach
* Infection * Fever * Anemia * Hypovolemia * Hypotension * PE * MI * Stimulant drugs
30
How to treat sinus tach
* Treat the underlying cause * Oxygen * vagal maneuvers or carotid massage * Beta blockers
31
Non-cardiac causes of Sinus Brady
* Hyperkalemia * Increased ICP * Hypothyroidism * Hypothermia * Sleep/deep relaxation * Glaucoma * Valsalva's maneuver * Vomiting
32
Cardiac diseases that can cause sinus brady
* SA node disease * Cardiomyopathy * Myocarditis * Myocardial Ischemia * Immediately after an inferior wall MI
33
Drugs that can cause Sinus brady
* Beta blockers * Calcium channel blockers * Lithium * Antiarrythmics (Sotalol, Amiodarone, Propafenone, Quinidine)
34
How to treat sinus brady
* Atropine * Transcutaneous Pacing * Oxygen
35
S/S of sinus brady
* Hypotension * Dizziness * Lightheaded * Fainting * SHOB * Sweating * Anxiety
36
# What rhythm is this? a regular rhythm that has the same characteristics as an N S R except the HR is greater than 100 bpm.
Sinus tach
37
# What is this rhythm? non–life-threatening dysrhythmias that can be seen in N S R. In this dysrhythmia, a pacemaker cell close to the S A node fires earlier than expected. This is an irregular rhythm due to the early impulse or beat.
Premature atrial contractions or PAC's
38
Causes of PAC's
* Hypoxia * Ischemia * Electrolyte imbalance * Medication toxicities - Dig * excessive Stimulant ingestion * Infection * CAD
39
S/S of PAC's
* SHOB * Sweating * Anxiety * Palpitations
40
How to treat PAC's
Treat underlying cause
41
# What rhythm is this? has no P waves. It is best described as multiple pacemaker cells generating independent electrical impulses and causing chaos within the atria. It is characterized as irregularly irregular. The Q R S complexes are usually narrow with irregular R–R intervals.
Atrial fibrillation or A-FIB
42
Causes of AFIB
* Cardiomyopathy * Pericarditis * Hyperthyroidism * HTN * Valvular Dx * Obesity * DM * CKD * Cardiac procedures or surgery * CAD
43
Meds for Afib
* Calcium channel blockers * Beta-blockers * Cardioversion * Anticoags * Anti-anxiety meds
44
How is new onset A-fib treated initially?
Meds to control HR i.e. digoxin, beta-blockers, calcium channel blockers.
45
Once heart rate is managed for a patient with new onset A-fib, what is considered?
* Antiarrythmic medications * cardiac ablation * Cardioversion
46
The scarring/destroying the tissue in the heart responsible for the irregular rhythm
Cardiac ablation
47
Cardioversion is considered after what is attained and why?
adequate coagualtion d/t delivering the shock could dislodge a clot on the wall of the atria which can travel to the brain or lungs
48
How long after onset of a-fib should cardioverson be done?
within the first 48 hrs of onset
49
# What rhythm is this? a dysrhythmia produced by a pacemaker cell other than the S A node. Because the S A node is not the primary pacemaker in this rhythm, there are no P waves. Flutter waves (F waves), however, are present. F waves resemble a sawtooth pattern between narrow Q R S complexes.
Atrial Flutter or A flutter
50
What could cause Atrial flutter
* Acute MI * Mitral valve disease * Thyrotoxicosis * COPD * Chest surgery - Coronary artery bypass or pneumonectomy * Medication toxicities - dig
51
S/S of Atrial Flutter & Atrial fibrillation
* Palpitations * SHOB * Hypotension * Lightheaded * Fainting * Sweating * Anxiety
52
Treatment for Atrial flutter | 6
* Antiarrythmic * Anticoagulants * Beta-blocker * Ca++ channel blockers * Consider cardioversion * Oxygen
53
Complications of A-fib & A-flutter
* Loss of cardiac output * Blood clots
54
# What rhythm is this? a rapid heart rhythm that originates above the ventricles. It most commonly appears as a regular, narrow Q R S complex tachycardia. Heart rates greater than 100 bpm, can be as fast as 150 – 250 bpm.
Supraventricular tachycardia or SVT
55
SVT is an umbrella term for what narrow complex tachycardias?
* Sinus tach * A-fib w/ RVR * A-Flutter w/ RVR * Junctional tach
56
S/S of SVT
* Hypotension * Dizziness * Lightheaded * Fainting * SHOB * Sweating * Anxiety * Palpitations
57
Treatment for SVT | And other rhythms that fall under it ## Footnote 6 - AABCCO
* Adenosine * Amniodarone * Beta blockers * Calcium Channel blockers * Cardioversion (Possibly) * Oxygen
58
Causes of SVT
* Infection * Fever * Hypovolemia * Hypoxia * Ischemia * Electrolyte imbalance * Stimulants * MI * Med toxicities
59
*Before* treating SVT what needs to be done?
The underlying rhythm needs to be identified
60
# What rhythm is this? * Originates in AV Node * Causes the impulse to split and travel backwards up to the Atria, causing an inverted or absent P-wave * Rates can vary
Junctional rhythms
61
What are the types of junctional rhythms?
* Junctional tachycardia * Accelerated junctional rhythm
62
If a junctional rhythm has a rate from 61-100 BPM how is it identified?
Accelerated junctional rhythm
63
If a junctional rhythm has a HR greater than 100 BPM how is it identified?
Junctional tachycardia
64
Treatment for junctional rhythms | 4 - ADOT
* Atropine * Depends on symptoms and cause * Oxygen * Transcutaneous Pacing
65
# What rhythm is this? rhythms that originate somewhere within the ventricles. When an impulse starts in the ventricle, there is no P wave, and the Q R S is usually wide
Premature Ventricular Contractions or PVC's
66
Causes of PVC's
* Hypoxia * MI * Cardiomyopathy * Electrolyte imbalance * Stimulants * HTN * Recreational drug use * Medication toxicities
67
Treatment of PVC's
Treatment of PVCs is based on the patient’s symptoms. If the patient is symptomatic, treatment includes correcting the cause and, rarely, antiarrhythmic therapy.
68
# What rhythm is this? * Three or more PVCs in a row. * Can be a life-threatening dysrhythmia as a result of the significant reduction in cardiac output that can occur.
Ventricular Tachycardia or V-tach
69
Causes of V-tach
* Hypoxia * MI * Cardiomyopathy * Electrolyte imbalance * Stimulants * HTN * Recreational drug use * Medication toxicities
70
If you have a patient in V-Tach what do you need to do FIRST?
Assess for a pulse
71
How to treat V-Tach with a pulse?
* Antiarrythmic - amniodarone * Electrolyte r/p - K & Mg * Cardioversion
72
During cardioversion, when is the shock delivered?
at the time of ventricular depolarization
73
How to treat pulseless V-Tach?
* CPR * Defibrillation
74
* A lethal dysrhythmia requiring immediate treatment. * It is the most frequently seen rhythm in cardiac arrests occurring outside of the hospital. * Occurs when the ventricle has multiple chaotic impulses rapidly firing. * This chaotic firing prevents the ventricles from pushing blood out of the heart, stopping cardiac output, and causing death.
Ventricular fibrillation or V-FIB
75
Causes of V-fib
* Hypoxia * Hypovolemia * MI * PE * Acidosis * Electrolyte imbalance * Hypoglycemia * Cardiac tamponade * Toxins
76
Meds used in treatment for pt in V-fib
* Antiarrythmics * Epinephrine
77
Nursing interventions for V-fib
* Call a Code * Start and maintain CPR * Defibrillate per ACLS guidelines * Ensure IV access * Free-flowing NS fluid bolus * Administer meds
78
Nursing interventions for V-fib with a pulse
* Stay with client * Call Rapid Response * Frequent assessment for symptoms * Obtain ECG * Ensure IV access * Administer meds as ordered * Prepare for cardioversion
79
Meds used to treat V-Tach
* Antiarrythmics * Electrolyte r/p
80
Nursing Interventions for PVC's
Assess client frequently: * LOC * Palpable pulses * BP and HR * Symptoms
81
Meds used to treat Junctional rhythms
* Atropine * Anti-anxiety meds
82
Nursing interventions for junctional rhythms
* Get help and stay with client * Assess client frequently (q5min): LOC, palpable pulses, BP, and HR * Obtain ECG * Ensure IV access * Administer meds as ordered * Prepare for Transcutaneous pacing *
83
Meds used to treat SVT | And all the other rhythms under it's 'umbrella'
* Adenosine * Calcium channel blockers * Beta-blockers * Amnioderone
84
Nursing interventions for A-flutter & A-fib
* Stay with client * Assess client frequently (Q5 min): LOC, palpable pulses, BP and HR * ECG * Ensure IV Access * Administer meds as ordered * Prepare for cardioversion
85
Meds used to treat A-fib
* Calcium channel blockers * Beta-blockers * Anticoags
86
Nursing interventions for PAC's
Assess client frequently (q 5 min) * LOC * Palpable pulses * BP and HR * Symptoms
87
Nursing interventions for Sinus tach
* Oxygen as ordered * Assess client frequently (q 5 min): LOC, palpable pulses, BP, and HR * Contact provider * Call Rapid Response * EKG * Ensure IV access * Administer meds as ordered * Anticipate antianxiety drugs * DO NOT LEAVE CLIENT
88
Meds given to treat Sinus tach
* Beta-blockers * Anti-anxiety meds
89
Nursing Interventions for Sinus brady
* Oxygen as ordered * Assess client frequently (q 5 min): LOC, palpable pulses, BP, and HR * Contact provider * Call Rapid Response * EKG * Ensure IV access * Administer meds as ordered * Prepare for transcutaneous pacing * Place defib/pacing pads on client * Anticipate sedation, if BP stable * DO NOT LEAVE CLIENT
90
Meds used to treat Sinus brady
Atropine
91
S/S of a Idioventricular rhythm
* Dizziness * Lightheaded * Fainting * SHOB * Sweating * Anxiety * Palpitations * Hypotension * Decreased LOC
92
Causes of Idioventricular Rhythm
* Hypoxia * Hypovolemia * Ischemia * Electrolyte imbalance * Stimulants * Toxins (cocaine, dig, anesthetics)
93
Heart conditions that can cause an IVR
* MI * Post cardiac arrest * myocarditis * CM * Congenital heart disease
94
# What is this rhythm? occurs when the S A and A V nodes fail to function and the rhythm is generated from the ventricle. The rate is usually less than 40 bpm.
Idioventricular rhythm or IVR
95
Nursing interventions for an IVR
* Call Rapid Response * Stay with client * Frequent assessment of symptoms: LOC, BP, and HR * Palpable pulses * Obtain ECG * Ensure IV access * Administer meds as ordered * Prepare for transcutaneous pacing
96
Treatment for IVR
based on the patient’s symptoms. If the patient is symptomatic, the treatment includes correcting the cause, pacing, and atropine.
97
How to treat Asystole
* Check for pulse * CPR * Epi
98
Nursing Interventions for IVR
* Call a Code * Start CPR * Ensure IV access * Free-flowing NS IV fluids * Administer emergency meds
99
Is asystole a shockable rhythm?
NO
100
Causes of Asystole
* Hypoxia * Hypovolemia * Acidosis * Cardiac tamponade * MI * PE * Electrolyte imbalance * Hypoglycemia * Toxins
101
Causes of heart blocks
* Acute Coronary Syndrome (ACS) * Unstable angina * NSTEMI * MISTEMI * Electrolyte imbalances * Medication toxicities
102
Treatment for 1st degree heart block
No specific tmnt, treat underlying cause
103
Nursing interventions for 1st degree heart block
* Obtain VS * Assess client for symptoms * Obtain ECG * Assess for causes
104
When the R is far from the P you have a...
1st degree
105
Tmnt for symptomatic 2nd degree type II heart block
temporary pacing
106
A second degree heart block type II is considered
Life threatening
107
2nd degree heart block type II can quickly progress to what>
Third degree heart block
108
Tmnt of symptomatic 3rd degree heart block
* Initially based on treating the patient’s symptoms, such as hypotension or SOB. * Attempts are made to reverse the cause(s) if possible. * Transcutaneous pacing is indicated in symptomatic CHB. * Long-term treatment is typically the insertion of a permanent pacemaker.
109
Effects of dysrhythmias on cardiac output
* Dysrhythmias cause changes in normal HR/rhythm which causes decrease in cardiac output. * Some dysrhythmias are lethal and can cause complete loss of cardiac output which results in cardiopulmonary arrest
110
Nursing Interventions for a suspected Dysrhythmia
* Perform ECG & Identify rhythm * Determine if symptomatic or asymptomatic * If Symptomatic assess: VS, LOC, Diaphoresis, Chest Pain, Poor peripheral circulation, n|v * Evaluate electrolytes and cardiac enzymes
111
Nursing actions when treating a dysrhythmia
* Administer anti arrhythmic therapy as ordered * Preform ECG/maintain cont ECG monitoring as ordered * Be prepared to administer advanced cardiac life support * Document occurrence of dysrhythmias * Teach patient to Immediately report chest pain/discomfort * Teach patient to recognize signs of complications

Nursing 213 (29 decks)

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