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EKG Technician > Electrocardiogram Technician: Module 5 > Flashcards

Electrocardiogram Technician: Module 5 Flashcards

1
Q

What is an important tool used to diagnose and treat various cardiac and cardiac related complications?

A

ECG

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2
Q

Being able to evaluate ECG waveforms is an essential and important

A

skill for healthcare professionals

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3
Q

Process of ECG evaluation involves a systematic approach that

A

varies among individuals who are evaluating

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4
Q

To determine atrial rates

A

pick a point at the p wave for atrial depolarization

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5
Q

To determine ventricular rates

A

pick a spot on the QRS complex for ventricular depolarization

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6
Q

To get the heart rate, you would find the same spot on the next waveform or either atrial or ventricular and

A

count the number of small boxes and use the 1500 method to determine the rhythm

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7
Q

What should you do after counting for heart rate

A

determine if the p wave is the same configuration for all waveforms either upwards, inverted, peaked, or different for each one.

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8
Q

After determine p wave configuration for all waveforms

A

determine if the p wave intervals are normal 0.12 - 0.20 second and make sure they are consistent in length

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9
Q

What are the four types of sinus rhythms?

A

Normal Sinus Rhythm
Sinus Tachycardia
Sinus Bradycardia
Sinus Arrhythmia

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10
Q

What is normal sinus rhythm?

A

The desired rhythm intervals between two P and R waves that occur in a consistent patter

Rate for normal sinus rhythm is between 60-100 beats per minute.

P wave is upright and in uniform shape. One p wave before every QRS Complex

PR interval will be constant at 0.12 to 0.20

The QRS duration will be constant between 0.06 and 0.10

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11
Q

What is sinus tachycardia?

A

Cardiac rhythm where the heart is beating faster than normal

Heart beat is more than 100 beats per minute

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12
Q

What is sinus bradycardia?

A

Originates in the SA node and has a rate that is less than 60 beats per minute

The waveforms are the same criteria as normal sinus rhythm just more spaced out. Distance equals time.

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13
Q

What is sinus dysrhythmia?

A

It is an irregular rhythm and is caused by pressure on the heart from the respiratory cycle. The beat is 60 per minute but regularity will not be constant

It can change from tachycardia to bradycardia in seconds

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14
Q

What is sinus arrest?

A

when the SA node stops firing and creates a stop or pause in electrical activity of the heart. Pause for 3 seconds or more.

No contraction of either the atria or ventricles

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15
Q

For a sinus arrest, rhythm between the two p and r waves will be

A

irregular

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16
Q

For a sinus arrest, rate of atrial and ventricular depolarization will be

A

the same but will vary on the electrical activity produced by the SA node.

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17
Q

To determine frequency of pause for sinus arrest

A

measure the length of the pause by measuring the R-R interval around the pause and multiply the number of small boxes by 0.04.

Note the frequency of the pause

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18
Q

What are atrial dysrhythmias?

A

Irregular heart rates caused by ectopic beats in the left or right atriums

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19
Q

ectopic beats are electrical impulse that is being generated from an area that does not usually have

A

automaticity

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20
Q

What are the types of atrial dysthymias?

A

Premature atrial contractions (PAC)
Atrial Tachycardia
Atrial Flutter (Aflutter)
Atrial Fibrillation (Afib)

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21
Q

What is Premature atrial contractions (PAC)?

A

Extra heartbeats in the upper chambers of the heart

Rhythms are constant except for occasional early complex or complexes

Rate will be 60-100 beats per minute but can be faster depending on frequency

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22
Q

For premature atrial contractions (PAC), the p wave is usually

A

uniform in shape except for early beat. Early beat may be flattened, notched, or biphasic

PR interval will be between 0.12 to 0.20 seconds. Early beat has a different PR measure but within normal limits.

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23
Q

For premature atrial contractions (PAC), the QRS duration will be

A

normal at 0.6 to 0.10 seconds

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24
Q

Depending on severity of Pac, patient may experience symptoms such as

A

low cardiac output, if complications start to occur, please notify a clinician.

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25
What is a wandering atrial pacemaker?
when the electrical impulse for the atria is generated at different sites such as one impulse from SA node and the other from AV node.
26
wandering atrial pacemaker will have
an irregular rhythm a heart rate of 60-100 a constantly changing p wave
27
What is atrial flutter?
rapid impulse in atrial tissue that may lead to more serious health complications.
28
If atrial flutter is not treated within the atrial waveform
you may see flutter to flutter waves and will stay regular. R-R interval may be regular depending on the severity.
29
Atrial flutter waves resemble a
saw-tooth and are best seen using leads 2, 3, and F
30
For atrial flutter, the PR interval will be
unidentifiable and the QRS complex will be normal at 0.06 to 0.10 seconds.
31
When atrial flutter occurs, there will be a loss of
atrial kick or atrial output by 10% to 30% and patient will show signs of low cardiac output.
32
If you see low cardiac output, you must
notify clinician and treatment may include oxygen.
33
What is atrial fibrillation?
occurs when electrical impulses from areas of re-entry pathways or multiple ectopic foci (multiple areas of impulse)
34
With atrial fibrillation, depolarization happens
in small groups instead of the whole atrium causes chaotic wave with unidentifiable P-wave
35
With atrial fibrillation, the PR interval is
unidentifiable and atrial and ventricular rates will not match due to extra impulses in atrium.
36
With Atrial fibrillation, the atrial rate will be
about 375 to 700 beats per minute due to certain electrical currents going through the HIS bundle.
37
For atrial fibrillation, the ventricular rate will be
160 to 180 beats per minute due to multiple p waves
38
For atrial fibrillation, PR interval cannot be determined but the QRS complex
will remain normal at 0.06 to 0.10 seconds as with most dysrhythmias, patients will have low cardiac output
39
Atrial Fibrillation can be controlled with
medication
40
Because with atrial fibrillation less blood is moving from atrium to ventricles blood may
pool and clot in the atrium and lead to embolism. report changes or complications in vitals to licensed clinicans.
41
Cell in the AV Node have
automaticity and can function as a backup pacemaker
42
Normal rate for AV node to function is
40 - 60 beats per minute
43
What is Premature Junctional Complex (PJC)?
A premature junctional contraction (PJC) is an early, extra heartbeat. A PJC starts in the junction of the heart, also known as the atrioventricular (AV) junction.
44
What is Junctional Rhythm?
when heartbeat originates from AV node or his bundles Shows inverted P wave and produces retrograde depolarization. Report it to licensed clinician
45
What is supraventricular tachycardia (SVT)?
When your heart starts suddenly to beat faster than normal. Origin identification is difficult, either atrium or av node.
46
Premature Junctional Complex has a heart rhythm that is
irregular and the heart rate will depend on the rhythm P wave of early beat will be inverted indicating retrograde depolarization.
47
For Premature Junctional Complex, the PR interval may be
shorter than normal or completely absent. QRS duration will be 0.06 to 0.10 seconds.
48
Isolated Premature Junctional Complexes may cause no signs or symptoms
in healthy patients. Patients may experience low blood pressure and low cardiac output.
49
For Junctional Rhythm, PR and R-R intervals are
regular with possibility of difficulty determining PR interval due to beat originating at AV junction
50
Due to heartbeat being only 40-60 beats per minute from AV node this could lead to
hypotension (low blood pressure), confusion, and disorientation
51
The rhythm of Supraventricular Tachycardia is usually
regular if identifiable and P wave may be regular or inverted.
52
The ventricular rate of Supraventricular Tachycardia is
150 to 350 Atrial rate difficult to determine due to speed of SA or AV node Report rhythm to clinician.
53
What are heart blocks?
when electrical impulses are having difficulty travelling along the conduction pathway of the heart due to a block. This leads to ventricular depolarization delays or absence.
54
What are the three types of heart blocks?
First Degree Heart Block Second Degree Heart Block Third Degree Heart Block
55
What is First Degree AV Block?
Delay in electrical conduction around av node stopping travelling of electrical impulses to the ventricular conduction system.
56
The rhythm of first degree block between PR and RR intervals are
constant with a heart rate of 60 - 100 beats per minute P wave will occur before all QRS complex due to block
57
For first degree blocs the PR interval will be
greater than 0.20 seconds, but the QRS complex will stay 0.06 to 10 seconds as regular.
58
Patients with first degree heart block will have
normal cardiac output during AV block and the rhythm should be monitored in case of severity to get to another type of heart beat.
59
What is second degree AV block (Mobitz I or Wenckebach)?
When some electrical impulse is blocked or not conducted at AV region. AV Node will conduct electrical impulse to ventricles till it fails and resets the repeated pattern.
60
For second degree AV block (Mobitz I or Wenckebach), the ventricular rhythm will be
irregular PR interval will be regular except for where the pause occurs. PR interval will be irregular due to block. P wave configuration will be normal and PR interval increasingly gets longer till cycle restarts. QRS duration will be normal.
61
For second degree AV block (Mobitz I or Wenckebach), the atrial rate
stay within normal limits but ventricular rates will be slower than atrial rates.
62
During second degree AV block (Mobitz I or Wenckebach), a patient may not
experience low cardiac output but the heart rate decreases to 40 beats or less. This condition is temporary but needs to be treated immediately and notify clinician.
63
What is second degree AV block (Mobitz II)?
This is the classical heart block where the av node selects which electrical impulses to block causing no discovered pattern or reason for dropping of the QRS complex. an unexpected nonconducted atrial impulse, without prior measurable lengthening of the conduction time. This type of heart block progresses frequently to third degree heart block.
64
For second degree AV block (Mobitz II) the PR interval
stays regular, while the RR interval is irregular.
65
For second degree AV block (Mobitz II) the atrial rate
remains in normal limits but ventricular rate will be slower due to block P wave configuration is normal and upright. ORS complex will be normal and always observed.
66
What is third degree heart block?
It is the complete heart block and all electrical impulses are blocked from getting to ventricles. There will be no synchronicity between atrial and ventricular depolarization rhythm.
67
For third degree AV block the PR and RR interval
will be regular but different from each other. SA node will produce 60 - 100 bpm but ventricles will fire separately at 20 - 40 bpm
68
For third degree AV block the P wave configuration will
be normal but at times buried into the QRS complex due to block number of p waves will out number the QRS complex because atrial depolarization happens faster than ventricular depolarization.
69
For third degree AV block the PR interval will
vary but the QRS complex duration will remain constant and be with normal limits or be wider depending on location of block.
70
Patients of a third degree block will show signs of
low cardiac output and may be unconscious. If patient is unconscious follow your facility's policy on CPR. Initiate code blue and may require temporary pacemaker.
71
What are branch bundle block?
when one or both of the ventricular pathways (left and right bundle branches) have been damaged. Longer contraction time will be reflected on the QRS Complex
72
What is a right sided bundle branch block?
when the electricity on right side of heart has stopped somewhere around the HIS bundle. Due to block, electrical impulse must travel to left ventricle first then to right ventricle.
73
What is a left sided bundle branch block?
when the electricity on left side of heart has stopped somewhere after the HIS bundle. Due to this electrical activity will travel to right side and then move to left.
74
For branch blocks, the p wave configuration and deflection
will depend on the basic rhythm. The PR interval will be normal 0.12 to 0.20 seconds and QRS duration will be 0.12 seconds or greater. This extended time helps electrical impulse get to the ventricles
75
Patients with Branch Blocks will exhibit
effects of underlying rhythm and widening of QRS complex must be reported. If patient goes unconscious follow your facility's policy for code blue.

EKG Technician (8 decks)

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