EKG rhythms review

Question 1

sinus pause

Answer 1

2 missed beats

Question 2

sinus arrest

Answer 2

3 or more missed beats

Question 3

wandering atrial pacemaker

Answer 3

p waves that change in appearance (3 or more)

Question 4

is wandering atrial pacemaker concerning?

Answer 4

not really

normal in children, older adults, and athletes

Question 5

PAC- premature atrial complex

Answer 5

normal QRS, just one is early because an ectopic beat originates outside of the SA node

the p-wave of the early beat will be diff from the rest of the p-waves

Question 6

PACs are followed by

Answer 6

non-compensatory pause

Question 7

in what situation are PACs concerning?

Answer 7

sometimes can preD pts w heart dz to more serious dysrhythmias:

atrial tachy
atrial flutter
a- fib

Question 8

what can PAC serve as an early indicator to?

Answer 8

electrolyte imbalance, CHF

Question 9

atrial tachycardia

Answer 9

atrial rate of 150-250

a bunch of p waves b/w each QRS

Question 10

why is atrial tachycardia dangerous?

Answer 10

increases oxygen requirements, can compromise CO in those w underlying heart dz

—-> lead to MI

Question 11

multifocal atrial tachycardia

Answer 11

same features as wandering atrial pacemaker, but this rate is faster

120-150

Question 12

what two atrial beats can be confused?

Answer 12

multifocal atrial tachycardia (120-150 bpm)

A-fib

Question 13

SVT

Answer 13

p waves cannot be seen

Question 14

atrial flutter

Answer 14

“saw-tooth” waves

“F waves”

Question 15

with atrial flutter, the atrial rate is 250-350, but what is the ventricular (QRS) rate?

Answer 15

can vary depending on # of impulses conducted thru AV node

slower rates <40 or faster rates >150 can seriously compromise CO

Question 16

A-fib

Answer 16

Atria >350 !!

Question 17

Why is A-fib dangerous?

Answer 17

Leads to loss of Atrial kick, decreasing CO by 25%

Intra-atrial emboli bc the blood is sitting there in the atria

Question 18

A-fib leads to increased risk of

Answer 18

STROKE

Question 19

what is absent with SVT?

Answer 19

p waves are absent

Question 20

3 types of JUNCTIONAL complexes

Answer 20

junctional escape

accelerated junctional

junctional tachycardia

Question 21

p waves of Junctional rhythms

Answer 21

inverted

Question 22

premature junctional complex- PJC

Answer 22

the random early wierd beat has a p wave that is inverted, QRS Is normal

Question 23

junctional escape rhythm

Answer 23

40-60 bpm

Question 24

accelerated junctional rhythm

Answer 24

60-100 bpm

Question 25

junctional tachycardia

Answer 25

100-180 bpm

Question 26

3 diff categories of rates for junctional rhythms

Answer 26

40-60 60-100 100-180

Question 27

Things to look for on EKG

Answer 27

Mean axis (lead 1 and avF) p waves for sinus rhythm, atrial enlargement (lead II and V1) BBB (lead I and V6) RVH or LVH (V5-V6)

Question 28

ventricular dysrhythmia key points

Answer 28

wide, bizarre QRS complexes T waves in opp direction no p-waves

Question 29

3 breakdown types of ventricular dysrhythm

Answer 29

idioventricular accelerated idioventricular ventricular tachycardia

Question 30

Premature Ventricular Complex

Answer 30

wierd beat out of nowhere wide, bizarre QRA

Question 31

idioventricular rhythm

Answer 31

20-40

Question 32

what beat is suuuuuuper slow? and wide QRS

Answer 32

idioventricular rhythm

Question 33

accelerated idioventricular rhythm

Answer 33

40-100 bpm

Question 34

ventricular tachycardia

Answer 34

100-250 bpm

Question 35

torsades de pointes is a type of

Answer 35

v-tachy, it's polymorphic

Question 36

v-fib

Answer 36

chaotic firing of many sites in ventricles heart muscle is quivering full cardiac arrest, unresponsive, pulseless

Question 37

v-fib rate

Answer 37

300-500 vent unsynchronized impulses per minute

Question 38

1st degree AV block

Answer 38

not a true block just a consistently prolonged PRI longer than 0.2 seconds

Question 39

which type of 2nd degree block is more dangerous?

Answer 39

type II bc this one more often progresses to 3rd deg complete heart block

Question 40

2nd degree type 2 block

Answer 40

considered "malignant" in emergency setting can --> decreased CO, signs of hypoperfusion can progress --> more severe block and Ventricular asystole

Question 41

3rd degree heart block

Answer 41

atria and ventricles are each doing their own thing atria- SA node 60-100 ventricles- AV jx or ventricles

Question 42

SA node

Answer 42

60-100 bpm

Question 43

AV node

Answer 43

40-60 bpm

Question 44

ventricules rate

Answer 44

20-40 very slow