Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

CPR 2 Exam 1 > Johnston ECG Rhythms and Disturbances > Flashcards

Johnston ECG Rhythms and Disturbances Flashcards

1
Q

What is a normal axis considered?

A
  • AVF positive and lead 1 positive
  • bottom right quadrant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Left axis?

A
  • Positive lead 1
  • Negative AVF
  • Top right quadrant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Right axis?

A
  • negaitve lead 1
  • positive AVF
  • bottom left quadrant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

rate rhythm axis

A
  • 100 bpm
  • Left axis
    • positive lead 1 negative AVF
  • sinus rhythm tachy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of arrhythmia?

A
  • Palpitations such as skipping, pounding, irregular
  • Lightheadedness
  • Syncope
  • Chest pain
  • Dyspnea
  • Sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Etiology for arrhythhmia?

A
  • Stress
  • Ischemia
  • Hypoxia
  • Metabolic acidosis
  • Infection
  • Inflammation
  • Cardiomyopathy
  • Electrolyte imbalance
  • Drugs
  • Htn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is sinus tachycardia?

A
  • physiologic/pathologic process
  • can be caused by emotion, anxiety, fear, drugs, hyperthyroidism, fever, pregnancy, anemia, CHF
  • Hypovolemia
  • Treat underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is this

A

normal sinus rhythm with physiologic sinus arrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is this and what is rate

A

all are sinus tachycardia

  • 138 bpm
  • 160 bpm
  • 140 bpm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is considered bradycardia?

A

<60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Where are you going to see sinus bradycardia?

A
  • Normal people
  • Healthy athlete
  • Physiologic component to sleep, fright, carotid sinus massage/hypersensitivity
  • Obstructive jaundice
  • Sliding hiatal hernia
  • Valsalva maneuver
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of drugs can cause bradycardia?

A

Beta blockers such as propanolol and metoprolol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Medical conditions/situations associated with bradycardia? (labs)

A
  • Acute inferior MI (increased vagal tone, N/V)
  • Ischemia
  • decreased pO2
  • Increased pCO2
  • Decrease PH
  • Increase BP
  • Sick Sinus Syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is this?

A

sinus bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat sinus bradycardia?

A
  • Depends on clinical setting and cause
    • it may not need to be treated
  • Depends on hemodynamics
  • Use Atropine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is automaticity?

A
  • Property of cardiac cell to depolarize spontaneously during phase 4 action potential leads to generation of an impulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the significance of premature atrial contractions?

A
  • can feel it or see it on ECG but it is of no hemodynamic significance
    • unless it turns into a lot of irregular beats or causes distress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When can you see a PAC?

A
  • Absence of significant heart disease
  • associated with stress alcohol tobacco coffee COPD and CAD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is this?

A

PAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is this?

A

non conductive PAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Different types of PAC

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment of PACs?

A
  • treat cause
  • Beta adrenergic antagonist
    • Metoprolol 25-50 mg BID-TID
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is paroxysmal atrial tachycardia?

A
  • Sudden heart rate greater than 100 BPM
  • look for irritable focus P wave
  • This one is about 150-200 bpm
24
Q
A

PAT with AV block

  • think digitalis excess or toxicity
  • ratio of 2:1 P:QRS
25
What is multifocal atrial tachycardia?
* 3 or more P waves * PR interval varies * Irregular ventricular rhythm * Atrial rate \>00 bmp * Associated with an underlying pulmonary disease
26
What is this?
MAT 3 or more different types of atrial contractions (look at P )
27
what is this?
* Multifocal Atrial Tachy * biphasic * decreased amplitude * inverted (#4)
28
How do you treat MAT?
* Ca channel blocker * Diltiazem * Verapamil * Mg SO4 * amiodarone * digitalis isn't helpful and DC cardioconversion isn't effective
29
What is A fib?
* Atrial quivering with a rate of 350-600 bpm * Undulating baselines, no discernible P waves * Irregular PR intervals * **Irregularly irregular**
30
what is this
* A fib * can't make out any P waves at the arrows, just see undulation of the baseline
31
what is seen?
a fib
32
What has a typical “saw tooth pattern”
* Atrial flutter: 250-350 bpm * Seen best on leads II, III, AVF, and V
33
What is paroxysmal junctional tachycardia?
* 150-250 bpm * P wave may be lost in QRS, inverted before or after each QRS * Comes from the junction UP to the atrium (that is why P wave is inverted)
34
what is happening?
P wave is buried in QRS or ST segment, it is a **paraxysmal junctional tachycardia** as it is irritable junctional focus paces rapid
35
what is this?
* QRS is narrow and rate is around 200 * Junctional tachycardia
36
What is this?
* Paroxysmal Supraventricular Tachycardia * includes PAT and PJT
37
What causes Premature Ventricular Contractions (PVC's)
* normal heart * CAD MI HF MI Hypoxia * Valvular heart disease * Congenital heart disease * Cardiomyopathy * Acid base imbalance * Hyperthyroid
38
ECG characteristics of PVC's?
* premature bizarre wide QRS * No preceding P wave, may produce a retrograde P wave in ST segment * ST-T wave moves opposite direction of QRS * Usually full compensatory pause
39
what is this
PVC
40
what is happening?
* multiple PVC's * QRS is elevated ST segment is down with a notch in it, possibly a P wave
41
what is this?
run of PVC's Run \>3 is considred Ventricular Tachycardia for at least 30 seconds or more
42
what is this?
* wide QRS * ST segments inverted * Multifocal premature ventricular contractions * hemodynamically unstable
43
What is ventricular premature contraction with R on T phenomenon?
* The beat is hitting during the ventricular repolarization * can lead to v tach or v fib * watch patient closely
44
What is an Accelerated idioventricular rhythm?
* Good sign of reperfusion, indicates that the thrombolytic agent is working * Do not treat just leave alone
45
How do you treat PVC's?
* If stable no treatments * If sx in setting of ACS use Metoprolol * If unstable Amiodarone, lidocaine, Procainamide
46
What is V tach?
* 3+ consecutive bizarre QRS complexes * Ventricular rate is 120-200 * Usually regular with a wide ARS * P wave is lost and if it is seen it has no relation to QRS * Lasts longer than 30 seconds
47
what is this?
* Paroxysmal Ventricular Tachycardia beating around 150-250 * Wide QRS * ST going opposite direction * Suddenly occurred
48
what is happening?
* Runs of V tach * first QRS is inverted ST elevated * 4 QRS elevations in a row * end of strip is more runs of v tach * Multifocal (from different sites, they don't all look alike)
49
what is happening?
from one foci, they all look alike V tach
50
what is this?
* Wide QRS 200+bpm * Premature Ventricular contraction but sustained so it is **Vtach**
51
What is Torsades de Pointes?
* Twisting of the points * QRS swings from positive to negative * May be inherited from Prolonged QT * Could be acquired by meds, electrolyte imbalances, alcohol
52
what is the diagnosis? what can happen later on?
This is Torsades de Pointes, this can lead to V tach
53
How do you treat torsades?
* MgSO4 * Overdrive pacing * Isoproternol * Get off what might have induced the arrhythmia
54
What is Ventricular fibrillation?
* Disorganized depolarization * Not an effective pump
55
what is this?
v fib
56
what is this?
vfib differentiate from artifact, if patient is stable and talking probably not v fib

CPR 2 Exam 1 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions