Quiz 1 EKG

Question 1

an irregularity/disturbance of the normal electrical activity of the heart

Answer 1

dysrhythmia

Question 2

how do you know the seriousness of dysrhythmias

Answer 2

depends on seriousness of condition

Question 3

how many sec is one small sq of EKG paper

Answer 3

0.04 sec

Question 4

how many sec is a 5 x 5 sq

Answer 4

0.20 sec

Question 5

what is the saying for telemetry

Answer 5

white on right
clouds over grass
smoke over fire
Christmas tree on bottom

Question 6

describe the cardiac conduction

Answer 6

SA (initiates rate, 60 to 100)
AV (relays impulses to ventricles 40-60)
Bundles of His
Purkinje Fibers (ventricular myocardium)

Question 7

what is Dubin’s method

Answer 7

count large blocks between QRS complexes for rate

300, 150, 100, 75, 60, 50, 43, 38, 33, 30

Question 8

describe what happens with the P wave

Answer 8

depolarization of atria

depolarization of SA node is not seen, assume it occurred

Question 9

describe what happens during the QRS complex

Answer 9

depolarization of ventricles

duration= 3 small blocks (0.04-0.12 sec)

Question 10

describe what happens with the T wave

Answer 10

repolarization of ventricles

Question 11

describe what happens during the PR interval

Answer 11

beginning of P wave to beginning of QRS

duration = 3-5 small blocks (0.12 - 0.20 sec)

Question 12

normal sinus rhythm rate, PR, and QRS

Answer 12

rate: 60-100 (75)
PR: upright (0.16)
QRS: (0.06)

Question 13

abnormal or ectopic focus that initiates beat

Answer 13

dysrhythmia

Question 14

what are the causes of dysrhythmias

Answer 14

• hypoxia
• ischemia
• medications (antiarrhythmias, bronchodilators, cardiac glycosides)
• electrolyte disturbances (K, Ca, Mg)
• stretch or hypertrophy
• sympathetic stimulation (stress, trauma, CHF , hyperthyroidism)

Question 15

normal K levels

Answer 15

3.5 to 5

Question 16

normal Ca levels

Answer 16

8.6 to 10.3 mg/dl

Question 17

normal Mg levels

Answer 17

1.5 to 2.5

Question 18

causes of sinus tachycardia

Answer 18

stress, exercise, fever, pain, meds, metabolic demands, hypovolemia

Question 19

treatment for sinus tachycardia

Answer 19

• treat underlying problem
• Beta Blockers (Metoprolol or Labetolol)
• Calcium Channel Blockers (Ditiazen or Cardizem)
• adenosine if rate continues to SVT (>200)

Question 20

causes of sinus bradycardia

Answer 20

HB, dig toxicity, MI, hyperkalemia

Question 21

treatment for sinus bradycardia

Answer 21

• Atropine (1 mg IVP)
• Pacemaker (MUST use if 2nd or 3rd degree heart block)
• *AVOID suctioning, gag reflex

Question 22

what are the causes of atrial tachycardia (SVT)

Answer 22

fever, stress, adrenergic meds, caffeine,m hypertrophy of atrium, asthma

Question 23

what does atrial tachycardia (SVT) eventually lead to

Answer 23

leads to increased workload, < coronary bloodflow and < CO

Question 24

what is the treatment for atrial tachycardia (SVT)

Answer 24

• Adenosine (Adenocard)
• Diltazem (Cardizem)
• Carotid massage
• Cardioversion

Question 25

what are the causes of Atrial Fib/Flutter

Answer 25

CHF, LV failure, injury to SA node, catecholamine

Question 26

describe flutter vs fib

Answer 26

flutter: more dangerous, < filling, < SV and < CO
Fib: more chronic

Question 27

treatment for Atrial Fib and Flutter

Answer 27

• Cardizem
• Digoxin
• Amiodarone
• Cardioversion
• Anticoagulants (esp A Fib)

Question 28

what are the causes of V-Tach and V Fib

Answer 28

myocardial irritability, MI, ischemia, plaque formation, toxic irritation from drugs, hypoxia, hypertrophy of ventricles

Question 29

what is the treatment of V Fib

Answer 29

Defibrillation

Question 30

treatment for V Tach

Answer 30

shock/cardioversion
epinephrine
vasopressin
amiodarone
lidocaine
Mg sulfate