Rhythms

Question 0

Sinus bradycardia rhythm

Answer 0

Heart rate= less than 60 BPM 
Rhythm= regular 
P wave= upright and uniform 
PR interval= .12-.20 sec
QRS complexes= less than .12 sec

Question 1

Normal sinus rhythms present

Answer 1

Rate= 60-100 BPM
Rhythm= regular
P wave= present and upright 
PR Interval= .16 sec
QRS complex= .06 sec

Question 2

Sinus tachycardia rhythm

Answer 2

Heart rate= 100-160 BPM 
Rhythm= regular 
P waves= upright and uniform
PR interval= .12-.20 sec 
QRS= less than .12 sec

Question 3

Sinus dysrhythmia

Answer 3

Heart rate= 60-100
Rhythm= IRREGULAR (r-r more than .08 sec)
P waves= upright and uniform 
PR interval= .12-.20 
QRS= less than .12 sec

Question 4

Sinus arrest rhythm

Answer 4

Heart rate= variable, depending on arrest
Rhythm= IRREGULAR when arrest is present
P wave= present if QRS is present
PR interval= .12-.20
QRS= less than .12

Question 5

Wandering atrial pacemaker

Answer 5

Heart rate= usually 60-100
Rhythm= may be slightly irregular
P waves= change in shape, size, and location
PR interval= variable, depending on site shifts
QRS= usually less than .12

Question 6

Multifocal atrial tachycardia

Answer 6

Heart rate= more than 100
Rhythm= irregular
P wave= present but shape is variable 
PRI= variable
QRS= less than .12

Question 7

Premature atrial complexes PAC

Answer 7

Heart rate= usually 60-100
Rhythm= usually normal except for PAC site
P wave= differs in shape, size, and location
PRI= variable
QRS= usually less than .12
Also usually a pause after PAC

Question 8

Atrial flutter

Answer 8

Heart rate= atrial 250-300 ventricular varies
Rhythm= regular atria ventricular varies
P wave= absent, replaced by F waves, sawtooth
PRI= not measurable
QRS= usually less than .12 sec

Question 9

Atrial fibrillation

Answer 9

Heart rate= atrial 350-400 ventricular variable
Rhythm= irregularly irregular 
P waves= absent! replaced by F waves 
PRI= not discernible
QRS= usually less than .10 sec

Question 10

Supraventricular tachycardia

Answer 10

Heart rate= 150-250
Rhythm= regular 
P waves= usually not noticeable 
PRI= usually not discernible 
QRS= usually less than .10 sec

Question 11

Premature Junctional complexes

Answer 11

Heart rate= rate of rhythm+ PJCs 
Rhythm= usually regular except PJCs 
P waves= inverted or absent 
PRI= usually less than .12 if there is a P wave
QRS= less than .12 sec

Question 12

Junctional escape rhythm

Answer 12

Heart rate=usually 40-60 
Rhythm= usually regular 
P wave= inverted or absent 
PRI= usually less than .12 unless no P wave 
QRS= less than .12

Question 13

Accelerated Junctional rhythm

Answer 13

Heart rate= 60-100
Rhythm= regular
P wave= inverted or absent
PRI= usually less than .12 unless no P wave 
QRS= less than .12 sec

Question 14

Junctional tachycardia rhythm

Answer 14

Heart rate= 100-180 
Rhythm= regular
P wave= if visible inverted 
PRI= usually less than .12 unless no P wave
QRS= less than .12 sec

Question 15

Premature ventricular complexes

Answer 15

Heart rate= depends on rate of rhythm and PJC
Rhythm= occasionally irregular
P wave= no P waves associated with PVC
P waves will be present of underlying rhythm
PRI= not present on PVCs
QRS= wide usually greater than .12 sec

Question 16

Idioventricular rhythm

Answer 16

Heart rate= 20-40 or less
Rhythm= atrial not distinguishable ventricular usually regular
P waves= none present 
PRI= none 
QRS= bizarre, greater than .12 sec

Question 17

Accelerated idioventricular rhythm

Answer 17

Heart rate= 40-100
Rhythm= regular 
P wave= absent
PRI= absent
QRS= greater than .12 sec

Question 18

Ventricular tachycardia

Answer 18

Heart rate= 100-250 
Rhythm= atrial not distinguishable ventricular usually regular
P wave= may be present or absent
PRI= none
QRS= yes bizarre greater than .12 sec

Question 19

Torsades De Pointes

Answer 19

Heart rate=100-250?
Rhythm= irregular
P wave= absent 
PRI= absent
QRS= greater than .12 sec and appears to "twist" at the baseline
QRS show variations in width and shape

Question 20

Ventricular fibrillation

Answer 20

Heart rate= cannot be discerned 
Rhythm= rapid, unorganized, not distinguishable 
P wave= none
PRI= none present
QRS= none present

Question 21

Ventricular asystole

Answer 21

Heart rate= absent 
Rhythm= absent, not distinguishable 
P wave= none 
PRI= none 
QRS= none present

Question 22

First degree heart block

Answer 22

Heart rate= based on underlying rate 
Rhythm= usually regular 
P wave= upright and uniform 
PRI= greater than .20 sec 
QRS= less than .12 sec

Question 23

Second degree block, Mobitz type 1

Answer 23

Heart= atrial normal, ventricular slower than atrial
Rhythm= atrial regular, ventricular irregular
P wave= normal and upright
PRI= progressively prolongs until no QRS
QRS= less than .12 sec some are missing

Question 24

Second degree block, Mobitz type 2

Answer 24

Heart= atrial regular, ventricular may be Brady
Rhythm= atrial regular, ventricular irregular
P wave= yes, some not followed by QRS
PRI= constant for conducted beats
QRS= some absent, less than or greater than .12 sec

Question 25

Third degree (complete) heart block

Answer 25

Rate= atrial 60-100 ventricular based on escape of pacemaker
Rhythm= regular
P waves= yes but no relation to QRS
PRI= totally variable! no pattern 
QRS= yes, based on site of pacemaker

Question 26

Artificial pacemaker rhythm

Answer 26

Heart rate= varies according to pacemaker
Rhythm= regular if pacing is fixed
P wave= may be present or absent
PRI= variable
QRS= usually bizarre with presence of spikes, greater than .12 sec