EKGs Flashcards
Review the most important EKGs and medications.
Where is the P, QRS, and T wave?
Using the rhythm below, how would you calculate the heart rate?
Count the peaks (the R waves) and multiply times 10.
Example: 5 peaks X 10 = 50 beats per minute
What are the common signs and symptoms for most dysrhythmias?
- heart palpitations
- tachycardia
- short of breath
- anxiety
- dizziness
- decreased level of consciousness
Identify this rhythm:
normal sinus rhythm
70 beats per minute
Identify this rhythm:
sinus bradycardia
50 beats per minute
Identify this rhythm:
sinus tachycardia
130 beats per minute
Identify this rhythm:
(immediate complication)
asystole
Identify this rhythm:
(immediate complication)
ventricular fibrillation
Identify this rhythm:
(immediate complication)
ventricular tachycardia
Identify this rhythm:
(immediate complication)
myocardial infarction
Identify this rhythm:
atrial fibrillation
Identify this rhythm:
atrial flutter
Identify this rhythm:
1st degree AV block
PR interval is elongated.
Identify this rhythm:
2nd degree AV block Type 1 (Wenkebach/Mobitz I)
PR interval gets longer and longer and then it drops.
Identify this rhythm:
2nd degree AV block Type 2 (Mobitz II)
PR interval stays the same and then QRS is missing.
What is common about most heart blocks?
- typically less than 60 beats per minute
- have an elongated PR interval
- will receive atropine if showing symptoms
- if atropine doesn’t work, client will either get cardioversion or a pacemaker.
Identify this rhythm:
(Immediate complication)
3rd degree heart block (complete heart block)
Identify this rhythm:
(Immediate complication)
supraventricular tachycardia
Identify this rhythm:
(Immediate complication)
torsades de pointes
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Identify this rhythm:
normal sinus rhythm with pre-ventricular contractions (PVC’s)
Medications:
sinus tachycardia
Give meds to decrease the heart rate:
- Beta blockers
- Calcium channel blockers
- Digoxin
Interventions:
asystole
(Immediate complication)
- start CPR
- epinephrine
- NO defibrillation
Interventions:
ventricular fibrillation
(Immediate complication)
- “defib the V-fib”
- CPR
- epinephrine
- amiodarone (or lidocaine)
Interventions:
ventricular tachycardia
(Immediate complication)
-
Pulseless V-tach
- CPR
- defibrillate
- epinephrine
- amiodarone (or lidocaine)
- With a pulse: amiodarone (or lidocaine)
Medications:
atrial fibrillation and atrial flutter
-
high risk for blood clots
- antiplatelets
- anticoagulants
-
to decrease heart rate
- beta blockers
- calcium channel blockers
- digoxin
Interventions:
myocardial infarction
(Immediate complication)
- give “OANM”
- oxygen
- aspirin
- nitroglycerin
- morphine
- “clot busters” if caused by a clot: T-PA
- cardiac catheterization if caused by plaque
Interventions:
supraventricular tachycardia
- vagal maneuvers (carotid sinus massage, beardown/valsalva)
- cardiovert with adenosine
Interventions:
normal sinus rhythm with pre-ventricular contractions
If getting 6 PVCs in a row or more than 6 in a minute treat with:
- beta blockers
- amiodarone
- catheter ablation
What is a pacemaker?
Uses batteries to send electric signals to the heart to help it pump correctly.
The pacemaker is connected to the heart by one or more wires.
Teaching:
Pacemakers
- take pulse daily and report abnormalities
- avoid contact sports
- inform airport security about pacemaker (can set off security detector)
- most electrical devices are OK to use: move back 5 - 10 feet if experience unusual feelings
- use cell phone on opposite side of pacemaker site
What is defibrillation and cardioversion?
Giving the client a controlled electric shock in order to put the client back into a normal sinus rhythm.
What is the difference between defibrillation and cardioversion?
- Cardioversion is an administered shock synchronized with the QRS complex.
- Defibrillation is a randomly administered shock anytime during the cardiac cycle. It is always done in emergencies.
What is catheter ablation?
A procedure where a part of cardiac tissue is burned off to prevent dysrhythmias.
What are some common causes of dysrhythmias?
- electrolyte imbalances
- CAD/blocked arteries
- heart damage from an MI
- cardiomyopathy
- increased blood pressure
- hyperthyroidism
- smoking
- caffeine/alcohol
- meds/illegal drugs
- genetics
Signs and Symptoms:
Myocardial infarction
- chest pain
- left arm pain
- gastric reflux pain
- jaw pain
- nausea/vomiting
- upper back/shoulder pain
- shortness of breath
What is the lead placement for an ECG?
What is the order of electrical activity in the heart?
- SA node
- AV node
- bundle of HIS
- bundle branches (let and right)
- purkinje fibers
What is an implantable cardio defibrillator?
It sends a shock to reset the heart.
Shock may be felt by others, but is not harmful.
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