Sinus & Atrial Dysrhythmias

Question 1

NSR Rate…

Answer 1

60-100

Question 2

NSR P waves…

Answer 2

normal (0.06-0.10s),

precede each QRS complex

Question 3

NSR QRS

Answer 3

WNL (0.06-0.12s)

Question 4

NSR PR Interval

Answer 4

WNL (0.12 - 0.20s)

Question 5

NSR rhythm

Answer 5

regular

Question 6

rhythm, P waves, QRS, PR intervals WNL

Rate < 60

What arrhythmia?

Answer 6

sinus bradycardia

Question 7

rhythm, P waves, QRS, PR intervals WNL

Rate between 100-160

What arrhythmia?

Answer 7

sinus tachycardia

Question 8

Rate, P waves, QRS, PR intervals WNL

Rhythm patterned irregular

What arrhythmia?

Answer 8

Sinus Arrhythmia

Question 9

With sinus arrhythmia, when does the rate increase?

Answer 9

with inspiration

Question 10

SA node transiently stops firing

1-2 beats dropped

Answer 10

sinus Pause

Question 11

SA node transiently stops firing

3 or more beats dropped

Answer 11

Sinus Arrest

Question 12

Complexes all WNL, but long period of absent complexes (1-4 beats long)

Answer 12

Sinus pause/arrest

Question 13

Shortened QT

P waves superimposed in QRS, increased amplitude but WNL

PR not identifiable

Rate 100-160
Regular rhythm

Answer 13

Sinus tachycardia

Question 14

Three mechanisms of atrial dysrhythmias

Answer 14

automaticity
triggered activity
reentry

Question 15

The below features generally signify…

differing P waves

abnormal, shortened, or prolonged PR intervals

narrow and normal looking QRS

Answer 15

atrial dysrhythmias

Question 16

What dysrhythmia?

Rate: WNL

Rhythm: slightly irregular

P waves: changing appearance (3 or more)

QRS: WNL

PR Interval: variable

Answer 16

wandering atrial pacemaker

Question 17

What dysrhythmia?

Rhythm: Irregular, premature beat

P Waves: abnormal before early beat

PR Interval: abnormal or normal

QT: May be shortened

Non-Compensatory pause after premature beat

Answer 17

PAC

Question 18

PACs can lead to (3)

Answer 18

atrial tachy
atrial flutter
atrial fib

Question 19

What can serve as an early indicator of an
electrolyte imbalance or congestive heart
failure in patients experiencing an acute
myocardial infarction

Answer 19

PACs

Question 20

Early beat + wide QRS complex without compensatory pause…

Answer 20

PACs with aberrant ventricular conduction

Question 21

PVCs are differentiated from PACs w. aberrant ventricular conduction how?

Answer 21

PVCs have compensatory pause

Question 22

Rate: 150-250

P wave: Abnormal, might be hidden in T wave

Short PR interval ( < 0.12s)

Answer 22

Atrial tachycardia/paroxysmal atrial tachycardia

Question 23

Rate: 120-150
Rhythm: Irregular

P waves: change from beat to beat

Appears as faster wandering atrial pacemaker

Answer 23

Multifocal Atrial Tachycardia

Question 24

Appears as atrial tachycardia, but P waves cannot be seen due to the high rate…

What rhythm?

Answer 24

supraventricular tachycardia

Question 25

Rate: 250-350 in the atria (p waves), Ventricular rate (QRS rate) normal

Rhythm: regular, or irregular

P waves: Absent, replaced by saw tooth flutter waves (F waves)

Answer 25

Atrial flutter

Question 26

atrial flutter is commonly associated with ____ block. You can tell by measuring the…

Answer 26

AV block

measure conduction ratio (F waves : QRS complexes)

Question 27

If you notice sinus tachycardia looking ECG strip with a rate of 150, you should re-evaluate for…

Answer 27

atrial flutter with 2:1 conduction ratio… P waves may be hidden in QRS complex

Question 28

If sinus tachy with rate of 150, what can you do to the rhythm strip to be able to identify whether it is actually flutter waves?

Answer 28

turn it upside down

Question 29

Rhythm: Irregularly irregular

Rate: 350 in atria

P waves: absent, chaotic looking. replaced by f waves

Answer 29

a fib

Question 30

if a fib with ventricular rate > 100… what is it called? what can occur?

Answer 30

uncontrolled a fib

HF, angina, syncope