Introduction to Dysrhythmias (Exam 2) Flashcards
What drives the mechanical pumping of the heart?
The electrical conduction
What initiates electrical conduction in the heart
The SA node
Where is the SA node located and what is it’s intrinsic rate?
SA node is located in the right atrium and has a rate of 60-100 beats per min
After the SA nodes fires what happens next?
The atria contracts and the impulses travels to the AV node
What causes the ventricles to contract?
The nerve impulse traveling through the AV to the bundle of his / purjinke fibers
Dysrhythmias are defined as
Abnormal cardiac rhythms
Electrocardiogram Monitoring is
Graphic tracing of electrical impulses produced by the heart
The wave forms of EKG represent
activity of charged ions across membranes of myocardial cells
Normal Electrical Pattern of the Heart
P wave (atrial contraction) (depolarization)
PR interval (impulse through AV node)
QRS complex (ventricular contraction) (depolarization)
ST segment
T wave (ventricular relaxation) (Repolarization)
What is the RR interval?
The tip of one R to the tip of the other R
What is the normal PR interval?
0.12 - 0.20
If PR interval is not within normal range it suggest
That is a problem between atria and ventricle
What is the normal QRS interval?
<0.12
Isoelectric line
Can be indicative of ST elevated MI
ST segment should = isoelectric line
ST segment is elevated above isoelectric line and troponin is elevated =
STEMI
ST is not elevated above isoelectric line and troponin is elevated =
NSTEMI
Each little box on EKG =
0.04 seconds
Each large box on EKG =
.20 seconds
Rhythm Strips are always
6 seconds (3 second interval between the two bars)
Telemetry
Continuous monitoring only unidimensional view
Telemetry Lead Placement
Snow on the grass
smoke over fire
and chocolate next to my heart
WHITE IS RIGHT
What is the most come telemetry lead?
Lead 2
Typical Telemetry Patient
Lead 1 = Reading right shoulder to left shoulder
Lead 2 = Reading right shoulder to left grown
Lead 3 = Left shoulder to left grown
Telemetry monitoring
Continuous observation of HR and rhythm at a distant site
Sophisticated alarm system alerts dysrhythmias detected
12 Lead EKG
Snapshot in time routine or STAT multidimensional view
Can be done to diagnose
Contiguous Leads
means that two leads are next to each other anatomically
Patient with ST elevation in two contiguous leads
Indicates patient is having or has had a STEMI
What is artifact?
Irregularly electrical conduction but is not the patient
Could be muscle tremor or loose electrodes or battery running low
