EKG Rhythms Flashcards
what is the causes of normal sinus rythym
good functioning heart
good sv, CO, preload, after load and good perfusion
what is important to do for a pt who appears to be in sinus rhythm
make sure they are asymptomatic and that they are not in PEA (pulsless electrical activity) pt will not have a pulse and be unresponsive
*do not shock for PEA
what is it called if pt is in normal sinus rhythm but has an elongated PR interval (> 0.20)
AV block and if it is consistent then its called 1st degree heart block
*people can live with this rhythm
what are causes of 1st degree heart block
hx of infarct
BB, CCB, dig
myocarditis
age related heart changes
what is the treatment for 1st degree heart block
monitor pt, pt can live with this
*check cap refill, skin color, pulses to see if they occur with monitor
HR of less than 60 bpm
must have upright P wave
sinus bradycardia
what are the causes of sinus bradycardia
hypoglycemia hypothermia hypothyroidism hypovolemia toxic exposure meds infarctions *most healthy athletes
what are the different variations with sinus bradycardia
elevated T wave- caused by hypokalemia
ST depression- caused by injury or untreated hypovolemia
what would the treatment be for sinus bradycardia
treated only if the client is experiencing symptoms
IV atropine, fluid challenge, or pacemaker
if the pt who has sinus bradycardia perfusing
decreased perfusion
HR >100
sinus tachycardia
what are the causes of sinus tachycardia
initial hypovolemia HTN fever stress caffeine smoking hyperthyroidism excess alcohol cocaine abusers pain
what is the tx for sinus tachycardia
(tx the cause)
NS fluid challenge
maybe BB to slow heart rate
is the sinus tachycardia pt perfusing well
check pulses and color, if rate is consistent the perfusion will decrease
*due to loss of atrial kick and too fast to allow filling times
if the sinus tachycardia pt has an ST depression variation what should be done
fluid challenge, O2, call doc
umbrella term for unidentifiable rhythms
P waves often not identifiable
PR interval not measured
150-200bpm
supraventricular tachycardia (SVT)
what are S/S of SVT
chest pain, SOB, lightheadedness/dizziness, confused, syncope
what is the treatment for SVT
vagal maneuver slow heart rate with meds oxygen (if pt is stable) adenosine (chem cardioverter if stable) *if pt is UNSTABLE electrically cardiovert (synchronized)
does the pt who has SVT have perfusion
no because theres no atrial kick
atrium quivering, irregular, excess P waves but not true P waves
atrial fibrillation
what are S/S of A fib
dizzy/lightheadedness, syncope, confusion, fatigue, SOB, bird flopping feeling
what is the tx of A fib
if the HR is too fast slow it with meds
*make sure pt is on anticoags to reduce risk of clot formation
must get a TEE to r/o clots before cardioversion
the tx of choice is cardioversion
what are risks of A fib
develop clots in the heart
stroke
PE
low BP and decreased CO
sawtooth appearance
A flutter
what are S/S of A flutter
SOB, anxiety, weakness, angina, syncope
what is the treatment for A flutter
same as A fib- slow heart rate, anticoags, TEE before cardioversion
**can pace someone out of A fib- turn on pacemaker, dial up to what HR says, leave for a few sec, start turning down
greater than 100 bpm
P waves unidentifiable
QRS wide and bizarre shape
V tach
what are S/S of V tach
lightheadedness, dizzy, angina, syncope, SOB, absent or rapid pulse, LOC, hypotension
what is the tx for V tach
O2, lidocaine drip, and shock quickly (shock out of chaotic rhythm)
NO cardioversion
there is no perfusion
HR is undetermined, no PR interval, no P waves
v fib
*if v tach is untreated it goes to V fib
how do you treat V fib (worse than v tach)
CPR, Defib (NO cardioversion)
theres no perfusion
“flat line”
asystole
if you see asystole what should you do first
assess leads are on, assess pt, check pulse
how is systole treated
CPR- NO defib and theres not any perfusion
