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Telemetry: Mid-Term > Module 4 > Flashcards

Module 4 Flashcards

1
Q

What is “sinus rhythm”?

A

a rhythm the originates from the SA node

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2
Q

What is the usual rate of the sinus rhythm ?

A

60-100 BPM

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3
Q

What is the rhythm of sinus rhythm?

A

Regular

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4
Q

What does the P wave look like in a sinus rhythm?

A

Upright/postive in lead 2, and occurs before every QRS complex

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5
Q

What is the length of the PR interval?

A

0.12-0.20 Secs

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6
Q

What is the length of the QRS complex?

A

0.10 secs or less

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7
Q

What is a “Sinus arrhythmia”?

A

Is the lack of normal sinus rhythm

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8
Q

Where does the sinus arrhythmia originate from?

A

The SA node

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9
Q

How do you know your patient is in a sinus arrhythmia?

A

The heart rate increases as the patient breathes in, and decreases as the patient breaths out

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10
Q

Why does the rate change with breathing in a sinus arrhythmia?

A

Due to changes in intrathoracis pressure that occurs during the respiratory cycle

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11
Q

How does the rhythm look on the strip?

A

Irregular firing but the waveform looks normal

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12
Q

Is there any conduction problem with a sinus arrhythmia?

A

None present, and no potential problems

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13
Q

What causes sinus arrhythmia?

A

Can be due to heart disease but is not usually a pathological rhythm

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14
Q

Is there any changes to O2 supply and demand in this rhythm?

A

This problem does not pose a problem in regards to O2 supply and demand

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15
Q

What interventions can be done for a sinus arrhythmia?

A

Document the rhythm

but no interventions are needed unless the rate drops below 60 BPM

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16
Q

What is the rate of sinus arrhythmia?

A

60-100 BPM

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17
Q

What is the rhythm in sinus arrhythmia?

A

Irregular, HR changes with respiratory cycle

18
Q

What does the P wave look like in sinus arrhythmia?

A

Positive/Upright in lead 2, one P before each QRS complex

19
Q

What is the length of the PR interval?

A

0.12-0.20 secs

20
Q

What is the length of the QRS complex?

A

0.10 secs or less

21
Q

What is “sinus

bradycardia”?

A

Heart rate is regular but is less than 60 BPM

22
Q

Where does SB originate from?

A

From the SA node

23
Q

What type of rhythm is sinus

bradycardia?

A

Regular

24
Q

What type of conduction problems are present in a sinus

bradycardia?

A

SA node is firing at a rate less than 60 BPM

25
Q

What is the cause of a sinus

bradycardia?

A

Always assess the patient first!
Medications such as digoxin and beta-blockers can cause this
Issues with the SA node

26
Q

What are the implications for O2 supply and demand in a sinus
bradycardia?

A

Since there is a decrease in HR, there is a decrease in CO

Assess your patient for signs and symptoms of decreased cardiac output

27
Q

What are some interventions for sinus

bradycardia

A

Check your patient first
Atropine to help increase HR (parasympahooyltic)
Temporary transvenous pacemaker may be needed

28
Q

What is the rate of sinus bradycardia?

A

Less than 60 BPM

29
Q

What type of rhythm is sinus bradycardia?

A

Regular

30
Q

What does the P wave look like in sinus bradycardia?

A

Positive, upright in lead 2. right before a QRS complex

31
Q

How long is the PR interval in sinus bradycardia?

A

0.12-0.20 secs

32
Q

How long is the QRS complex in sinus bradycardia?

A

0.10 secs or less

33
Q

What does failure of an impulse from the SA node called?

A

Sinus arrest or sinus pause

34
Q

Where do you see this type of failure of the SA node?

A

A gap in between QRS complexes

35
Q

What does the gap look like in a sinus arrest?

A

The gap between the QRS complex is greater than 3 seconds

36
Q

What does the gap look like in a sinus pause?

A

The gap between QRS complex is less than 3 seconds

37
Q

Is there a conduction problem with a sinus pause/gap?

A

Yes, if the SA node does not fire

38
Q

What can cause a sinus gap or pause?

A

They are caused by depression of the SA node including

  • hypoxia
  • hypothermia
  • drug toxicity
  • vagal stimulation
  • electrolyte imbalance
  • infections such as myocarditis
  • ischemia to the conduction system itself
  • disease of the RCA (RCA supplies blood to the SA node)
39
Q

How does the sinus pause/arrest affect oxygen supply and demand?

A
  • If the rhythm is transient, the patient should be asymptomatic
  • With frequent pauses, it causes a lower HR and therefore lower CO, which can lead to a loss of atrial kick and preload is affected and leading to further decreased CO
40
Q

What are some interventions for sinus pause/arrest?

A
  • Based on patient assessment
  • Atropine/possible pacing
  • Know unit guidelines

Telemetry: Mid-Term (5 decks)

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