Telemetry (EXAM 1) 31 Questions with Verified Answers,100% CORRECT

Telemetry (EXAM 1) 31 Questions with Verified Answers What do the SA & AV nodes contract? - CORRECT ANSWER SA--AV=atrial contraction AV--bundle of HIS--purkinje fibers=ventricular contraction Normal intervals - CORRECT ANSWER *memorize these* PR: .12-.2 QRS: .04-.12 QT: .34-.43 BPM when different nodes are in control - CORRECT ANSWER SA: 60-100 AV: 40-60 HIS-Purkinje: 20-40 How many seconds are the squares worth on ECG paper? - CORRECT ANSWER small square: .04 large square: .20 5 large squares: 1.0 1 strip: 6.0 Questions to ask when reading ECG - CORRECT ANSWER 1. is there a P for every QRS? 2. does it walk out? 3. what are the intervals? 4. what is the rate/rhythm? How do you treat dysrhythmias? - CORRECT ANSWER based upon symptoms no symptoms=no treatment Sinus Bradycardia - CORRECT ANSWER 60bpm -walks out -SA node in control -causes: hypoxia, hypothermia, sleep, athletes, meds -symptoms: syncope, chest pain, hypotension, SOB, diaphoresis -treatment: atropine, underlying cause Sinus Tachycardia - CORRECT ANSWER 100bpm -walks out -SA node in control -causes: fever, anemia, hypotension, pulmonary embolism, MI -symptoms: dizzy, syncope, SOB, diaphoresis, anxiety, palps -treatment: underlying cause, vagal maneuvers, meds Atrial fibrillation (AFIB) - CORRECT ANSWER -no identifiable P wave -AV node in control -does not walk out -causes: cardiomyopathy, pericarditis, HTN, CAD, cardiac surgery -symptoms: palps, fatigue, SOB, dizziness, chest pain -treatment: meds, cardioversion (eval for clots 1st), anticoagulants Atrial flutter - CORRECT ANSWER -Sawtooth pattern -AV node in control -one random cell firing -does not walk out -causes: acute MI, chest surgery, mitral valve disease, digoxin toxicity -symptoms: palps, SOB, dizziness, chest pain/discomfort -treatment: meds, cardioversion, anticoagulants Supraventricular tachycardia (SVT) - CORRECT ANSWER -AV node in control -one cell firing rapidly -QRS can be narrow or wide -can look similar to sinus tach -causes: infection/fever, hypovolemia, hypoxia, ischemia, drug toxicity -symptoms: dizziness, syncope, SOB, diaphoresis, palps -treatment: adenosine, underlying cause Junctional rhythm - CORRECT ANSWER -AV node in control (40-60bpm) -inverted/no P wave -walks out -causes: MI, HF, meds -treatment: underlying cause, atropine, external pacemaker -symptoms: dizziness, syncope, SOB, diaphoresis, anxiety Accelerated junctional - CORRECT ANSWER -AV node in control -no P wave -faster than 60bpm -walks out treatment: underlying cause, external pacemaker Causes of heart blocks - CORRECT ANSWER angina, acute MI, meds Second degree type 1 heart block - CORRECT ANSWER PR interval gets longer & longer until a QRS gets dropped "Longer, longer, longer, drop, then you have a Wenckebach" First degree heart block - CORRECT ANSWER -PR interval greater than .20 -QRS & QT are normal -rate is slow or normal -usually no symptoms Second degree type 2 heart block - CORRECT ANSWER -PR is prolonged but remains the same until QRS is dropped -"same, same, drop" Third degree heart block - CORRECT ANSWER -medical emergency -P & QRS have no correlation -walks out 20-30bpm -only fix is pacemaker -"if P's & Q's don't agree, then you have a third degree" Bundle branch block - CORRECT ANSWER -delayed conduction in ventricle (rather than atria) -wider QRS Premature atrial contraction (PAC) - CORRECT ANSWER -SA fired prematurely -looks like early beat -often called normal sinus w/ PAC -caffeine can be stimulant -flutter in chest Premature ventricular contraction (PVC) - CORRECT ANSWER -looks like random QRS without P -unifocal or multifocal -electrolyte imbalance & caffeine can be stimulant Bigeminy - CORRECT ANSWER a pattern of PVC's occurring every second beat Trigeminy - CORRECT ANSWER a pattern of PVC's occurring every third beat What does an atrial pacemaker do? - CORRECT ANSWER -works as the SA node -looks like a spike before a P wave What does a ventricular pacemaker do? - CORRECT ANSWER -works as the AV node -looks like a line before QRS -P wave can be present What does an antrioventricular pacemaker do? - CORRECT ANSWER -works as the SA & AV nodes -looks like a line before both P and QRS Ventricular tachycardia (V-tach) - CORRECT ANSWER -SA or AV not in control -1 ectopic cell firing in ventricle -looks like constant PVC's -3 or more PVC's -with pulse: amiodarone -without pulse: CPR, defibrillation, epi/vasopressin Ventricular fibrillation (V-fib) - CORRECT ANSWER -SA & AV not in control multiple ectopic cells firing in ventricle -coarse vs fine -CPR, defibrillation within 2-3mins, epi/vasopressin/amiodarone Torsades - CORRECT ANSWER -V-tach but with "twists" along baseline -can lead to V-fib -does not look uniform -must give Mg Asystole - CORRECT ANSWER -heart is doing nothing -CPR, epi Pulseless Electrical Activity (PEA) - CORRECT ANSWER -heart is not pumping -leftover electricity looks like a beat but there's not