ADVANCED – DYSRHYTHMIAS EXAM FULLY SOLVED #10
Excitability - correct answer the ability of non-pacemaker heart cells to respond to an
electrical impulse that begins in pacemaker cells.
Depolarization - correct answer occurs when the normally negatively charged cells
within the heart muscle develop a positive charge.
Conductivity - correct answer the ability to send an electrical stimulus from cell
membrane to cell membrane. As a result, excitable cells depolarize in rapid succession
from cell to cell until all cells have depolarized. Ex: the wave of depolarization causes
the deflections in the ECG waveforms that are recognized as the P wave and QRS
complex.
Contractility - correct answer the ability of atrial and ventricular muscle cells to shorten
their fiber length in response to electrical stimulation, causing sufficient pressure to push
blood forward through the heart. In other words, this is the mechanical activity of the
heart.
AV Node - correct answer where impulses slow down or are delayed before proceeding
to the ventricles. This delay is reflected in the PR segment on the ECG. This slow
conduction provides a short delay, allowing the atria to contract and the ventricles to fill.
SA Node - correct answer the heart's primary pacemaker. It can spontaneously and
rhythmically generate electrical impulses at a rate of 60-100 beats per min and therefore
has the greatest degree of automaticity.
Purkinje Cells - correct answer composed of the bundle of HIS, bundle branches, and
these fibers. Responsible for the rapid conduction of electrical impulses throughout the
ventricles, leading to ventricular depolarization and the subsequent ventricular muscle
contraction.
Semi-Reclined - correct answer While obtaining a 12-lead ECG, remind the patient be
as as still as possible in a ________________________ position, breathing normally.
Clea, Dry, Moist - correct answer For continous ECG monitoring, be sure to
__________________ skin and clip hairs/shave. Ensure that the electrode placement is
_____________ and the gel on each electrode is ______________ and fresh.
P Wave - correct answer a deflection on an ECG representing atrial depolarization.
When the electrical impulse is consistently generated form the SA node, this wave has
a consistent shape in a given lead. If an impulse is then generated from a different
(ectopic) focus, such as atrial tissue, the shape of this wave changes in the lead,
indicating that an ectopic focus has fired.
, PR Segment - correct answer the isoelectric line from the end of the P wave to the
beginning of the QRS complex, when the electrical impulse is traveling through the AV
node, where it is delayed.
PR Interval - correct answer measured form the beginning of the P wave to the end of
the PR segment. Represents the time required for atrial depolarization, the impulse
delay in the AV node, and the travel time to the Purkinje files. Normally measures from
0.12-0.20 seconds (five small blocks).
QRS Complex - correct answer represents ventricular depolarization on ECG lead.
ST Segment - correct answer an isoelectric line and represents early ventricular
repolarization. Changes may be a result of myocardial injury, ischemia, infarction,
conduction abnormalities or medications.
T wave - correct answer ventricular repolarization, usually positive, rounded, and slightly
asymmetric. May change as a result of myocardial ischemia, potassium/calcium
imbalances, medications, or ANS effects.
U wave - correct answer if this is present, it follows the T wave a may result from slow
depolarization of ventricular Purkinje fibers. An abnormal U wave may suggest an
electrolyte abnormality (Hypokalemia).
QT Interval - correct answer represent the total time required for ventricular
depolarization and depolarization. Measured from the beginning of the Q wave to the
end of the T wave. Varies with the patient's age and gender and changes with the heart
rate, lengthening with slower heart rates and shortening with faster rates.
Artifact - correct answer an interference seen on the monitor or rhythm strip, which may
look like a wandering or fuzzy baseline. It can be caused by patient movements, loose
or defective electrodes, improper grounding, or faulty ECG equipment such as broken
worse or cables. Some can mimic lethal dysrhythmias such as ventricular tachycardia or
ventricular fibrillation. ASSESS PATIENT TO DIFFERENTIATE ARTIFACT FROM
ACTUAL LETHAL RHYTHMS. DO NOT RELY ONLY ON THE ECG MONITOR.
Normal Sinus Rhythm - correct answer the rhythm originating from the SA node that
meets these ECG criteria:
-Rate: 60-100bpm
-Rhythm: atrial and ventricular rhythms regular
-P waves: present, consistent configuration, one P wave before each QRS complex
-PR Interval: 0.12-0.20 seconds and constant
-QRS Duration: 0.04-0.10 second and constant
60-100, normal, one, 0.12-0.20, .04-.10 - correct answer Normal Sinus Rhythm is the
rhythm originating from the SA node that meets these ECG criteria:
Rate: _______________ bpm
Excitability - correct answer the ability of non-pacemaker heart cells to respond to an
electrical impulse that begins in pacemaker cells.
Depolarization - correct answer occurs when the normally negatively charged cells
within the heart muscle develop a positive charge.
Conductivity - correct answer the ability to send an electrical stimulus from cell
membrane to cell membrane. As a result, excitable cells depolarize in rapid succession
from cell to cell until all cells have depolarized. Ex: the wave of depolarization causes
the deflections in the ECG waveforms that are recognized as the P wave and QRS
complex.
Contractility - correct answer the ability of atrial and ventricular muscle cells to shorten
their fiber length in response to electrical stimulation, causing sufficient pressure to push
blood forward through the heart. In other words, this is the mechanical activity of the
heart.
AV Node - correct answer where impulses slow down or are delayed before proceeding
to the ventricles. This delay is reflected in the PR segment on the ECG. This slow
conduction provides a short delay, allowing the atria to contract and the ventricles to fill.
SA Node - correct answer the heart's primary pacemaker. It can spontaneously and
rhythmically generate electrical impulses at a rate of 60-100 beats per min and therefore
has the greatest degree of automaticity.
Purkinje Cells - correct answer composed of the bundle of HIS, bundle branches, and
these fibers. Responsible for the rapid conduction of electrical impulses throughout the
ventricles, leading to ventricular depolarization and the subsequent ventricular muscle
contraction.
Semi-Reclined - correct answer While obtaining a 12-lead ECG, remind the patient be
as as still as possible in a ________________________ position, breathing normally.
Clea, Dry, Moist - correct answer For continous ECG monitoring, be sure to
__________________ skin and clip hairs/shave. Ensure that the electrode placement is
_____________ and the gel on each electrode is ______________ and fresh.
P Wave - correct answer a deflection on an ECG representing atrial depolarization.
When the electrical impulse is consistently generated form the SA node, this wave has
a consistent shape in a given lead. If an impulse is then generated from a different
(ectopic) focus, such as atrial tissue, the shape of this wave changes in the lead,
indicating that an ectopic focus has fired.
, PR Segment - correct answer the isoelectric line from the end of the P wave to the
beginning of the QRS complex, when the electrical impulse is traveling through the AV
node, where it is delayed.
PR Interval - correct answer measured form the beginning of the P wave to the end of
the PR segment. Represents the time required for atrial depolarization, the impulse
delay in the AV node, and the travel time to the Purkinje files. Normally measures from
0.12-0.20 seconds (five small blocks).
QRS Complex - correct answer represents ventricular depolarization on ECG lead.
ST Segment - correct answer an isoelectric line and represents early ventricular
repolarization. Changes may be a result of myocardial injury, ischemia, infarction,
conduction abnormalities or medications.
T wave - correct answer ventricular repolarization, usually positive, rounded, and slightly
asymmetric. May change as a result of myocardial ischemia, potassium/calcium
imbalances, medications, or ANS effects.
U wave - correct answer if this is present, it follows the T wave a may result from slow
depolarization of ventricular Purkinje fibers. An abnormal U wave may suggest an
electrolyte abnormality (Hypokalemia).
QT Interval - correct answer represent the total time required for ventricular
depolarization and depolarization. Measured from the beginning of the Q wave to the
end of the T wave. Varies with the patient's age and gender and changes with the heart
rate, lengthening with slower heart rates and shortening with faster rates.
Artifact - correct answer an interference seen on the monitor or rhythm strip, which may
look like a wandering or fuzzy baseline. It can be caused by patient movements, loose
or defective electrodes, improper grounding, or faulty ECG equipment such as broken
worse or cables. Some can mimic lethal dysrhythmias such as ventricular tachycardia or
ventricular fibrillation. ASSESS PATIENT TO DIFFERENTIATE ARTIFACT FROM
ACTUAL LETHAL RHYTHMS. DO NOT RELY ONLY ON THE ECG MONITOR.
Normal Sinus Rhythm - correct answer the rhythm originating from the SA node that
meets these ECG criteria:
-Rate: 60-100bpm
-Rhythm: atrial and ventricular rhythms regular
-P waves: present, consistent configuration, one P wave before each QRS complex
-PR Interval: 0.12-0.20 seconds and constant
-QRS Duration: 0.04-0.10 second and constant
60-100, normal, one, 0.12-0.20, .04-.10 - correct answer Normal Sinus Rhythm is the
rhythm originating from the SA node that meets these ECG criteria:
Rate: _______________ bpm
