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ECG 7150/7220 > midterm updated > Flashcards

midterm updated Flashcards

1
Q

sinus arrhythmia:

conduction prob-

A

none present. no potential

originate at SA node, but firing is variable. Related to resp pattern. HR increases when PT breaths in (from changes in intrathoracic pressure)

rate is firing irreg but conduction of impulse is normal

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2
Q

sinus arrhythmia:

cause

A

not associated with being a problem. occasional type associated with heart disease

R-R interval irreg by resp pattern

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3
Q

sinus arrhythmia:

implication O2 sup and demand

A

not a problem

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4
Q

sinus arrhythmia:

interventions

A

document but no intervention required unless HR <60

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5
Q

sinus arrhythmia:
rate-
rhythm-
P-wave-

A

rate - reg

rhythm- irreg

P wave norm

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6
Q

Sinus Brady:

conduction prob

A

SA node normal path of conduction atria to vents

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7
Q

Sinus Brady:

cause

A

athlete, dig, BB

slower = increased vent filling time = better coronary perfusion time = decreased myocardial consumption

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8
Q

Sinus Brady:

implication O2 sup and demand

A

decreased HR = decreased CO. need to assess PT to see if signs

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9
Q

Sinus Brady:

Intervention

A

If signs of decreased CO then intervene

Atropine or temp pacemaker

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10
Q

Sinus Brady:

rate-
rhythm-
P wave-

A

rate < 60

rhythm - reg

P wave +

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11
Q

Sinus arrest/ Pause

conduction prob

A

when SA node fires NP. When it doesnt fire = problem

lacks a P-QRS-T

pause/arrest can cause rate to be too slow

If pause long. back up pacemaker in junction or vents take over.

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12
Q

Sinus arrest/ Pause

cause

A

depression from automaticity of SA node

hypoxia
hypothermia, 
drug toxicity, 
vagal stimulation, 
electrolyte imbalance, 
infection/myocarditis, 
ischemia to conduction system
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13
Q

Sinus arrest/ Pause

implication O2 sup and demand

A

If transient - NP. The backup pacemakers will kick in

If protective pacemaker doesnt take over then act quick

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14
Q

Sinus arrest/ Pause

intervention

A

Symptom support

Atropine

temp pacemaker

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15
Q

Sinus arrest/ Pause

rate
rhythm
P wave

A

rate norm

rhythm- irreg. underlying could be reg

P wave +

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16
Q

Sinoatrial Block

conduction prob

A

Primary SA node. Period of time when impulses are prevented from depolarizing atrial tissue and there is a block in conduction to atria and vents

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17
Q

Sinoatrial Block

cause

A

Ischemia

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18
Q

Sinoatrial Block

implication O2 sup and demand

A

If the block is a long enough period of time can cause signif impact on CO. HR would decrease if prolonged and decrease CO

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19
Q

Sinoatrial Block

intervention

A

assess CO impact

atropine

temp external pacemaker

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20
Q

Sinoatrial Block

rate
rhythm
P wave

A

rate normal

rhythm irreg but can be underlying reg

P wave +

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21
Q

Sinus Tacky

Conduction

A

SA node fast > 100

< 180

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22
Q

Sinus Tacky

cause

A 
exercise
exertion
stimulant
fever
anemia
hypovolemia
CHF
PE
myocardial
ischemia
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23
Q

Sinus Tacky

Implications O2 sup and dem

A

Healthy - NP

increased HR = increased myocardial consumption = further ischemia.

shortens diastolic filling time = decreased preload and SV = decreased CO

decreased coronary artery perfusion time = decreased O2 supply to heart muscle = decreased contractility = decreased CO

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24
Q

Sinus Tacky

interventions

A

determine impact. correct cause and deal with symptoms

BB

25
Q

Sinus Tacky

rate
rhythm
P wave

A

rate > 100 and < 180

rhythm- reg

P wave +

26
Q

Premature Atrial Contractions (PAC’s)

conduction

A

site of impulse is both SA node and atrial tissue

**premature impulses in atrial tissue not the SA node = ectopic P focus

when ectopic impulses fire faster than SA node

27
Q

Premature Atrial Contractions (PAC’s)

cause

A

alcohol
caffeine
tobacco
narcotics **

dig toxicity, hypoxia, electrolyte imbalance, heart disease (HF can cause atrial tissue to stretch = PAC

28
Q

Premature Atrial Contractions (PAC’s)

Implications O2 sup and dem

A

Heathy = NP

If heart disease then increased HR = increased demand

could convert to A.fib A.flutter

29
Q

Premature Atrial Contractions (PAC’s)

Intervention

A

treat the causes:

pain, hypovolemic, myocardial ischemia, CHF

document, notify MRP

30
Q

Premature Atrial Contractions (PAC’s)

rate
rhythm
P wave

A

rate normal

underlying regular

P wave +, but looks different bc it doesnt fire from SA node. They dont always look the same, vary depend on where they come from

QRS normal

31
Q

atrial tissue doesnt like to fire faster than?

But can fire at?

A

150-180

250-300

32
Q

which is related to resp pattern?

A

sinus arrhythmia

33
Q

which drugs slow HR?

A

amiodarone, digoxin, BB. adenosine,

vagal maneuver, electrical

34
Q

which drugs increase HR and conduction?

A

Atropine

pacemaker

35
Q

what is the difference between sinus arrest and sinus pause?

A

arrest gap between QRS = > 3 sec

pause gap between QRS = < 3 sec

36
Q

what is the difference between sinus pause/arrest and sinus block?

A

pause/arrest = SA node does not generate impulse. There is no P when starts back up. backup can take over or a P is terminated by normal sinus beat.

sinus block = SA node does generate an impulse but blocked from entering atria. multiple QRS missing

37
Q

Atrial tachy

conduction

A

Atrial tissue - irritable atrial ectopic focus robs SA node of its power

> 180 BMP (110-250)

38
Q

Atrial tachy

cause

A

heart disease: ischemic and valvular

tissue hypoxia
dig toxicity
cor pulmonale
resp failure d/t atrial distension

39
Q

Atrial tachy

Implication O2 sup and dem

A

increased HR = increased consumption = increased ischemia = tissue damage

short diastolic filling = decreased CO and decreased coronary perfusion = decreased O2 supply

increased demand

no P wave= no atrial kick = decreased preload, and CO
possible clot formation

40
Q

Atrial tachy

Intervention

A

assess PT. depend on degree of compromise

Decreased BP, chest pain, SOB, dizzy, palpatations

medication interventions: BB, CCB

electrical/cardioversion- to attempt to terminate cardiac dysrhythmia

41
Q

Atrial tachy

rate
rhythm
P waves

A

rate > 180 (150-250)

rhythm reg

P waves - might not be able to see them. BC they travel diff pathway than those coming from SA node. BC atrial and vent depolarization fast, P wave blurred in QRS or T wave.

normal QRS (vent tachy is very wide QRS)

42
Q

Paroysmal atrial tachy

A

sudden onset and abrupt cessation (short lived)

43
Q

Atrial Flutter

conduction

A

irritable ectopic atrial focus. 250-350 BPM

rapid reg rate of atrial depolarization. The AV junction protects (blocks) the vents from rapid rate of fire (<150/min) d/t long refractory period (rest) that prevents conduction of all impulses from atria. Less QRS complexes

Called physiologic AV block

can be: atria 240 BPM, vents 78 BPM

Atrial flutter 3:1 block

44
Q

Atrial Flutter

cause

A

heart disease ischemic or valvular, hypoxia

dig tox
cor pulmonale
resp failure

45
Q

Atrial Flutter

implication O2 sup and dem

A

depends on PT and how long they can tolerate

No P wave = Loss atrial kick = loss 20-30 % CO
= decreased preload and decreased CO
possible clot formation

46
Q

Atrial Flutter

Intervention

A

assess PT. depend on degree of compromise

Decreased BP, chest pain, SOB, dizzy, palpatations

medication interventions: BB, CCB, amiodarone*

electrical/cardioversion- to attempt to terminate cardiac dysrhythmia (if dramatic)

47
Q

Atrial Flutter

rate

rhythm

P wave

A

rate 250-350 atrial, vent variable give reange**

rhythm- atrial reg, vent mostly reg

P wave - flutter (saw tooth)

PR/T/QT - NA

48
Q

Amiodarone

A

A,fib/A.flutter

49
Q

Atropine

A

bradycardia/ sinoatrial block

50
Q

what is SVT?

A

supraventricular tachycardia – Or Atrial tachy

51
Q

how do you know if it’s controlled or uncontrolled A.Flutter? or A. fib

A

controlled = HR vent response <100 BPM

uncontrolled = HR vent response > 100 BPM

52
Q

Atrial Fibrillation

conduction

A

site of impulse formation is the atrial tissue

wavy baseline is from multiple ectopic pacemaker sites generating impulses at a very fast and irregular rate> 350 BPM

Atrial kick lost

Ventricles are irreg but AV junction cause AV block to protect against v. rapid vent rate in A.fib

53
Q

Atrial Fibrillation

cause

A

heart disease ischemic or valvular, hypoxia

dig tox
cor pulmonale
resp failure

54
Q

Atrial Fibrillation

Implications O2 sup and demand

A

loss atrial kick and rapid vent response can seriously impact preload.

potential clot formation in atria

55
Q

Atrial Fibrillation

intervention

A

assess PT. depend on degree of compromise

Decreased BP, chest pain, SOB, dizzy, palpitations

medication interventions: BB, CCB, amiodarone*

electrical/cardioversion- to attempt to terminate cardiac dysrhythmia (if dramatic)

56
Q

Atrial Fibrillation

rate

rhythm

P wave

QRS

A

rate 300-500, vent variable

rhythm- vent usually irreg

P wave - fibrillary waves , cant ID P waves

QRS - usually normal appearance

57
Q

what are the two characteristics of A.Fib?

A
  • the baseline is wavy and chaotic looking

- the ventricular response is always grossly irregular

58
Q

what does it mean for CO to have an uncontrolled vent rate in A.fib/flutter

A

higher rate allows for less time for vents to fill = decreased preload and CO

ECG 7150/7220 (6 decks)

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