Week 1 (Dysrhytmias & EKGs)

Question 1

Measurement of a small square on an EKG strip

KNOW THIS!!!

Answer 1

0.04 seconds

Question 2

Measurement of 5 small squares / 1 large box on EKG strip

KNOW THIS!!!

Answer 2

0.20 Seconds

Question 3

Measurement of 5 large squares on EKG Strip

KNOW THIS!!!

Answer 3

1 second

Question 4

Normal PR Interval Measurement

KNOW THIS!!!

Answer 4

0.12 - 0.20 seconds

• 3-5 small squares

Question 5

Normal QRS Measurement

KNOW THIS!!!

Answer 5

0.04 - 0.12 seconds

• 1.5 - 2.5 small squares

Question 6

What does the P wave represent?

KNOW THIS!!!

Answer 6

atrial depolarization

Question 7

What does the QRS Complex represent?

KNOW THIS!!!

Answer 7

ventricular depolarization

Question 8

What is the intrinsic rate of the purkinje fibers?

KNOW THIS!!!…EXAM QUESTION!!!!!!!

Answer 8

20 - 40 bpm

Question 9

What is the pathway of conduction through the heart?

KNOW THIS!!!

Answer 9

SA node
AV node
Bundle Branch
Purkinje Fibers

• Stab A Big Pickle

Question 10

Telemetry Lead Placements

KNOW THIS!!!

Answer 10

Right: Clouds (W) over Grass (G)

Left: Smoke (B) over Fire (R)

• White (W) on the right
• Clouds (W) over Grass (G)
• Smoke (Black) over Fire (R)
• I heart chocolate (brown over the heart)

Question 11

Where does most coronary artery filling occur?

KNOW THIS!!!…EXAM QUESTION!!!!!!!

Answer 11

Diastole

Question 12

What type of MI is associated with the right coronary artery?

KNOW THIS!!!

Answer 12

Inferior Wall MI

Question 13

What pain scale is used for ventilated or critically ill patients?

KNOW THIS!!!

Answer 13

FLACC Scale

• Face
• Legs
• Activity
• Cry
• Consolability

Question 14

A patient has just undergone an ECG, the nurse notes that the QRS complex is measured to be 0.09 seconds. What is the first action the nurse should take?

a.) The nurse should document this finding.
b.) Administer oxygen.
c.) Place the patient on a cardiac monitor to look for arrhythmias.
d.) Administer dopamine.
e.) Call the HCP.

Answer 14

a.) The nurse should document this finding

Normal QRS complex is 0.04 - 0.12 so 0.09 is normal

Question 15

You obtain an EKG and notice a tachycardic, irregularly irregular rhythm wihtout any distinction of P-waves. Which of the following is the most likely cardiac rhythm seen on the patient’s EKG?

a.) Atrial Fibrillation (A-Fib)
b.) Complete heart block
c.) Atrial Flutter (A-Flutter)
d.) 1st degree heart block
e.) Sick sinus syndrome

Answer 15

a.) Atrial Fibrillation (A-Fib)

IRREGULARLY IRREGULAR rhythm; absent P-Waves

Question 16

Your patient’s EKG shows peaked T-waves. This finding correlates with which electrolyte abnormality?

a.) Hypokalemia
b.) Hyponatremia
c.) Hypernatremia
d.) Hyperkalemia
e.) Hypercalcemia

Answer 16

Hyperkalemia (high potassium)

Hyperkalemia = PEAKED T-waves

Hypokalemia = FLAT T-waves

Question 17

What is an elevated ST segment indicative of?

KNOW THIS!!!

Answer 17

Acute Myocardial Infarction

STEMI (ST-Elevated Myocardial Infarction)

Question 18

What is a depressed ST segment indicative of?

KNOW THIS!!!

Answer 18

Prior MI

Question 19

What is a U wave indicative of on an EKG?

KNOW THIS!!!…EXAM QUESTION!!!!!!!

Answer 19

hypOkalemia

low potassium

Question 20

How to read an EKG

KNOW THIS!!!

Answer 20

1.) Determine the rate

2.) Determine the R-R interval regularity
* R-R = HR (regular or irregular)

3.) Calculate the Heart Rate (R-R)

4.) Measure the QRS Interval
* normal = 0.04 - 0.12 (1-3 small boxes)
* is the QRS complex wide, narrow, normal?

5.) Identify, examine, & search for P-waves
* equal in size?
* normal, absent, inverted?
* are there extra P-waves?

6.) Measure the PR Interval (beginning of P wave to beginning of QRS complex)
* normal = 0.12 - 0.20 seconds (3-5 boxes)
* is PR interval the same, fixed, or varying?
* does it lengthen with each interval?