Heart rhythms Flashcards
5 small boxes in a strip (to make medium box) equals how long
.2 sec
One small box in a strip equals how long?
.04 sec
5 medium boxes (25 small boxes) is how long?
1 second
How long is a normal PR interval?
.12-.2 seconds
how long is the QRS complex?
<.12 seconds
how long is the QT interval?
<.44 seconds
treatment for sinus tach if asymptomatic?
treatment for sinus Brady?
sinus tach: treat the cause
sinus Brady: atropine, transcutaneous pacing
When is atropine contraindicated for treatment of sinus bradycardia?
if the pt has suspected inferior wall MI
classification for sinus Brady? (Rate)
<60 bpm
classification for sinus tach (Rate)?
> 100 bpm
Sinus arrhythmia facts…
irregular rhythm
rate is normal
good PR and QRS
occurs with respiration changes
inc with inspiration
dec with expiration
common in young adults and children
no treatment necessary
PAC facts
premature p wave occurs, pause may occur after early beat
treatment for PAC
if infrequent, no treatment necessary
if frequent, find cause and treat
SVT is used often interchangeably with what phrase?
atrial tachycardia
rate for SVT
140-250
characteristics of SVT
rapid fast rhythm
PR interval abnormal, usually hidden in T wave
QRS normal
What is the treatment for SVT?
if stable: adenosine
if unstable: cardiovert
Afib characteristics
very irregular rhythm
QRS normal
PRI interval not able to be distinguished
treatment for A fib
if stable: meds: ca channel blockers, dig, beta blockers
if unstable: cardiovert
Atrial Flutter characteristics
can be regular or irregular rhythm
P waves are flutter waves (saw tooth patterns)
Treatment for Atrial Flutter
if stable: meds (ca channel blockers, dig, beta blockers
if unstable: cardiovert
(treatment just like A fib)
Where does junctional rhythm occur?
AV node; AV junction
Characteristics of junctional rhythm
-rate: 40-60
-P waves are inverted in lead 2
-may occur before, after and hidden in QRS complex
-PR interval is short (<10 seconds)
names and rates of junctional rhythms
junctional: 40-60
accelerated junctional: 60-100
junctional tachycardia:>100
1st degree heart block characteristics
prolonged PR interval at >.20 seconds
regular rhythm
p for every qrs
treatment for 1st degree heart block
treatment not needed, monitor
this dysrhythmia entails: progressive elongation of PR interval until there is a drop in QRS complex and a pause, then is happens again
2nd degree Type 1 (Wenckebach)
rate characteristic of 2nd degree type 1 heart block
regular atrial
irregular ventricular
treatment of Second degree type 1 (Wenckebach) heart block
if unstable: atropine
2nd degree type 2 heart block
2 or 3 P waves before most QRS complexes
PR interval may be normal or long, remains constant
treatment for 2nd degree type 2
TCP
third degree heart block characteristics
atria and ventricles are contracting irrespective of their relationship to each other;
no relationship between p and qrs waves
regular rhythm
-p waves can be seen before qrs, before t wave, (marching through each wave)
treatment for third degree heart block
TCP
what does PVC stand for?
premature ventricular contraction
characteristic of PVC
premature beat
wide bizarre qrs complex included (wide v shape)
can be univocal (same shape) or multifocal)
what are the 5 life threatening arrhythmia?
V tach, V fib, Torsades de Pointes, Asystole, Pulseless Electrical Activity
Rate of V tach
140-250
characteristics of V tach
no discernable P waves
Wide even QRS complexes
treatment for V tach
if no pulse, call a code
MSET (med sure emergency team)
CPR
Defib
Meds
if has pulse: antiarrythmic drug, possible cardioversion
what lethal arrhythmia is a type of v tach?
torsades de pointes
rate of torsades
> 250
Torsades de pointes characteristics
qrs changes from + to - polarity
what is usually the cause of torsades
electrolyte abnormality, prolonged QT interval;
treatment for torsades
If no pulse:
call code (mset)
CPR
Defib
Antiarrythmic drugs
If has pulse:
Magnesium 1-2 gram
possible cardioversion
wavy chaotic baseline compose of irregular waveforms that vary in amplitude and morphology
V fib
rate of V fib
0 (pulseless)
V fib treatment
Defib
any p waves of v fib
none
treatment of asystole
call code (meet)
cpr
epi
is systole shockable
NO
what is PEA
when electrical impulse shows on monitor but pt has no pulse
treatment of PEA
treat like asystole
this is when: the heart chamber has failed to respond to a pacing stimulus
failure to capture
how does failure to capture look like on a strip?
after a pacer spike, a contraction is not followed as should
failure to capture symptoms & treatment
sob, diaphoretic, bradycardic
treatment: prep for TCP
if vagal maneuver does not work for pt experiencing SVT, what do you do?
administer adenosine
treatment for symptomatic SVT
cardioversion
this heart rhythm characteristic: p waves are inverted in lead 2
junctional rhythm
best interventional treatment for V fib
Defibrillate
