SHARP EKG EXAMS SCRIPT QUESTIONS AND
ANSWERS SET A+
✔✔Romazicon (Fumazenil) - ✔✔1. Main Actions: Antagonist for suspected
benzodiazepine overdose 2. Standing Order: Unstable V tach, Respiratory Depression
3. Considerations: Cardiac arrhythmias and bradycardia are reported rarely. Dizziness,
increased sweating, headache, blurred vision, and injection site pain are the most
common adverse effects with FLUMAZENIL. Seizures may occur with FLUMAZENIL
use, especially in cases of cyclic antidepressant or other mixed drug overdose.
✔✔Ventolin (Albuterol) - ✔✔1. Main Actions: Albuterol is an effective bronchodilator for
the treatment of asthma and reversible bronchospasm. 2. Standing Order: Respiratory
Distress 3. Considerations: Contraindicated in patients taking MAO inhibitors or tricyclic
antidepressants. Peak bronchodilation occurs within 1 to 2 hours and continues for 3 to
4 hours after administration; 72% of an inhaled dose is absorbed. Adverse effects
include tachycardia, premature ventricular contractions, palpitations, tremors, agitation,
nervousness, headache, dizziness, insomnia, hyperglycemia, nausea, and vomiting.
✔✔Rate for Sinus Brady - ✔✔40-60
✔✔Sinus Tach Rate - ✔✔100-160
✔✔Rate for Sinus Arrhythmia - ✔✔Rate 60-100 or <60
✔✔Sinus Pause (Block or Arrest) - ✔✔Usually normal rhythm (if not just call a "pause").
Block resumes on an R, Arrest does not.
✔✔WAP - ✔✔distinguished by varying shapes of P wave.
✔✔PAC - ✔✔usually normal, but PAC is abnormal. P can be hidden in preceding T
wave and appear larger or nonexistent.
, ✔✔Non-conducted PAC - ✔✔Normal rhythm. Non-conducted PAC doesn't march and is
early. Then rest of rhythm marches out again. P wave by be enlarged or hidden in T.
✔✔SVT - ✔✔140-250. T and P wave are usually one. QRS <.10 (>.12 for VT)
✔✔Atria Flutter - ✔✔250-400 Atrial rate looks like sawtooth (can be one sawtooth per
QRS). Usually normal V rate and QRS<.10
✔✔A Fib - ✔✔waving deflections on entire baseline
✔✔PJC - ✔✔PRI+=<.10. P wave before/after/hidden in QRS & inverted at PJC.
Regular, but irregular at PJC.
✔✔Junctional Rhythm - ✔✔40-60. Same PJC except slower. PRI=<.10, and P wave is
before/after/hidden in QRS and my be inverted. Regular except at JR.
✔✔Accelerated Junctional Rhythm - ✔✔60-100. P wave may be inverted and
before/after/hidden in QRS. PRI=<.10
✔✔Junctional Tachycardia - ✔✔>100. P wave inverted. May be before/after/hidden in
QRS. PRI=<.10
✔✔2nd degree Type 2 - ✔✔Consistent P wave before QRS, but then random other P
waves that doesn't coordinate with anything.
✔✔3rd degree - ✔✔Atrial and Ventrical both
✔✔BBB - ✔✔normal with wide QRS
✔✔PVC - ✔✔Normal rhythm w/ early and wide QRS (no P/measurable PRI at PVC)
✔✔Idioventricular Rhythm - ✔✔Rate 30-40, no P, QRS>.12 (reminds me of a seat)
✔✔Accelerated IVR - ✔✔50-100. No P, QRS>.12. Looks like a chair.
✔✔Unifocal, bifocal, bigeminal, trigeminal, quadrigeminal - ✔✔for PVC's/ectopic
definitions.
✔✔What rhythms can you defib? - ✔✔Pulseless vtach and vfib
✔✔What can you pace? - ✔✔symptomatic brady
✔✔What rhythm can you cardiovert? - ✔✔Unstable vtach
ANSWERS SET A+
✔✔Romazicon (Fumazenil) - ✔✔1. Main Actions: Antagonist for suspected
benzodiazepine overdose 2. Standing Order: Unstable V tach, Respiratory Depression
3. Considerations: Cardiac arrhythmias and bradycardia are reported rarely. Dizziness,
increased sweating, headache, blurred vision, and injection site pain are the most
common adverse effects with FLUMAZENIL. Seizures may occur with FLUMAZENIL
use, especially in cases of cyclic antidepressant or other mixed drug overdose.
✔✔Ventolin (Albuterol) - ✔✔1. Main Actions: Albuterol is an effective bronchodilator for
the treatment of asthma and reversible bronchospasm. 2. Standing Order: Respiratory
Distress 3. Considerations: Contraindicated in patients taking MAO inhibitors or tricyclic
antidepressants. Peak bronchodilation occurs within 1 to 2 hours and continues for 3 to
4 hours after administration; 72% of an inhaled dose is absorbed. Adverse effects
include tachycardia, premature ventricular contractions, palpitations, tremors, agitation,
nervousness, headache, dizziness, insomnia, hyperglycemia, nausea, and vomiting.
✔✔Rate for Sinus Brady - ✔✔40-60
✔✔Sinus Tach Rate - ✔✔100-160
✔✔Rate for Sinus Arrhythmia - ✔✔Rate 60-100 or <60
✔✔Sinus Pause (Block or Arrest) - ✔✔Usually normal rhythm (if not just call a "pause").
Block resumes on an R, Arrest does not.
✔✔WAP - ✔✔distinguished by varying shapes of P wave.
✔✔PAC - ✔✔usually normal, but PAC is abnormal. P can be hidden in preceding T
wave and appear larger or nonexistent.
, ✔✔Non-conducted PAC - ✔✔Normal rhythm. Non-conducted PAC doesn't march and is
early. Then rest of rhythm marches out again. P wave by be enlarged or hidden in T.
✔✔SVT - ✔✔140-250. T and P wave are usually one. QRS <.10 (>.12 for VT)
✔✔Atria Flutter - ✔✔250-400 Atrial rate looks like sawtooth (can be one sawtooth per
QRS). Usually normal V rate and QRS<.10
✔✔A Fib - ✔✔waving deflections on entire baseline
✔✔PJC - ✔✔PRI+=<.10. P wave before/after/hidden in QRS & inverted at PJC.
Regular, but irregular at PJC.
✔✔Junctional Rhythm - ✔✔40-60. Same PJC except slower. PRI=<.10, and P wave is
before/after/hidden in QRS and my be inverted. Regular except at JR.
✔✔Accelerated Junctional Rhythm - ✔✔60-100. P wave may be inverted and
before/after/hidden in QRS. PRI=<.10
✔✔Junctional Tachycardia - ✔✔>100. P wave inverted. May be before/after/hidden in
QRS. PRI=<.10
✔✔2nd degree Type 2 - ✔✔Consistent P wave before QRS, but then random other P
waves that doesn't coordinate with anything.
✔✔3rd degree - ✔✔Atrial and Ventrical both
✔✔BBB - ✔✔normal with wide QRS
✔✔PVC - ✔✔Normal rhythm w/ early and wide QRS (no P/measurable PRI at PVC)
✔✔Idioventricular Rhythm - ✔✔Rate 30-40, no P, QRS>.12 (reminds me of a seat)
✔✔Accelerated IVR - ✔✔50-100. No P, QRS>.12. Looks like a chair.
✔✔Unifocal, bifocal, bigeminal, trigeminal, quadrigeminal - ✔✔for PVC's/ectopic
definitions.
✔✔What rhythms can you defib? - ✔✔Pulseless vtach and vfib
✔✔What can you pace? - ✔✔symptomatic brady
✔✔What rhythm can you cardiovert? - ✔✔Unstable vtach
