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Telemetry: Mid-Term > Module 3 > Flashcards

Module 3 Flashcards

1
Q

How do you calculate the atrial rhythm?

A

Place the ruler on the P-wave and count three over

-This rule only works if the P-waves are regular and present

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2
Q

How do you count the ventricular rhythm?

A

Place the ruler on the R-R complex and count three over

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3
Q

What is the PR interval?

A

The P-R interval represents the amount of time it takes for the electrical impulse to leave the SA node, depolarize the atria, and pass through the AV junction.

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4
Q

What is the normal range of the PR interval?

A

0.12-0.20 seconds

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5
Q

If the heart rate is faster, the PR is?

A

Shorter

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6
Q

If the heart rate is slower, the PR is?

A

Longer

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7
Q

What does the QRS represent?

A

Ventricular depolarization
-If the wave of electrical activity proceeds in a normal, orderly fashion from the junction, through the remainder of the conduction system and over the right and left ventricles, then we will see a normal QRS complex.

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8
Q

What is the normal QRS complex?

A

0.10 sec

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9
Q

What does the ST segment represent?

A

It represents the time during which the ventricles have completely depolarized and repolarization begins

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10
Q

What does ST depression indicate?

A

Myocardial ischemia

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11
Q

What does ST elevation reflect?

A

Myocardial injury

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12
Q

When is ST depression or elevation considered significant?

A

When it is greater than 1mm difference

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13
Q

What does the T wave represent?

A

Ventricular repolarization; the period of time it takes both the right and left ventricles to recover

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14
Q

If there is no clear ST segment, where does the T wave begin?

A

At the end of the QRS complex

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15
Q

What does the QT interval represent?

A

represents total ventricular activity, that is, ventricular depolarization to ventricular repolarization

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16
Q

What is associated with lengthening of the QT interval?

A

Life-threatening arrhythmia

17
Q

What is a normal QT?

A

It is based on the heart rate

18
Q

What implications on cardiac output do you consider when you are looking at a rhythm strip?

A
  • Is the ventricular rate too slow?
  • Is the ventricular rate too fast?
  • Is there a P wave?
  • Are there any ST changes?
19
Q

What impact does CO have on a slow rate?

A

Potential for decrease CO due to the slow ventricular rate

20
Q

Rate to fast? (Effect on CO)

A
  • leads to decrease in ventricular filling time
  • decrease in coronary artery perfusion
  • increase in myocardial oxygen demand
  • all of the above lead to a decrease in CO
21
Q

No P wave?

A

Potential loss of artial kick and therefore a decrease in preload, and therefore a decrease in CO

22
Q

ST changes?

A

Poteitnal for ischemia/injury to the myocardium and therefore potential for decrease in contractility, leading to a decrease in CO

23
Q

What are so inteventions for a rate that is to slow?

A

-Speed up the heart rate, using drugs or a pacemaker

24
Q

Rate too fast?

A

intervention will be to slow the rate down, using drugs or electrical conversion (cardioversion/defibrillation)

25
Q

No P wave?

A

Potential intervention will be to chemically or electrically convert the rhythm

26
Q

ST changes?

A

Intervention will be to prevent ischemia and injury to the myocardium

27
Q

What are the 13 steps to analysis a rhythm?

A

STEP 1: determine the atrial and ventricular rates
STEP 2: assess the rhythm; is it regular or irregular
STEP 3: identify and examine the P waves
STEP 4: examine and measure the P-R interval
STEP 5: identify, examine and measure the QRS complex
STEP 6: locate and examine the ST segment
STEP 7: locate and examine the T wave
STEP 8: locate and measure the QT interval
STEP 9: interpret the rhythm
STEP 10: state the conduction problem if one exists
STEP 11: describe the cause or possible cause of the rhythm
STEP 12: determine the implications for oxygen supply and demand, and clinical significance
STEP 13: decide on interventions

Telemetry: Mid-Term (5 decks)

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