Advanced Dysrhythmias Study
Material 2+Questions with Accurate
Solutions
ST Segment
an isoelectric line and represents early ventricular repolarization. Changes may be
a result of myocardial injury, ischemia, infarction, conduction abnormalities or
medications.
T wave
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
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
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
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
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
Normal Sinus Rhythm is the rhythm originating from the SA node that meets these
ECG criteria:
Rate: _______________ bpm
Rhythm: atrial and ventricular rhythms _________________.
P waves: present, consistent configuration, ___________ P-wave before each QRS
complex.
PR Interval: ______________ second and constant.
QRS Interval: ____________ second and constant
, Sinus Arrhythmia
a variant of NSR. Results from changes in intrathoracic pressure during breathing. The
HR increases slightly during exhalation. This irregular rhythm is frequently observed
unhealthy adults. Has all of the characteristics of NSR except for its irregularity. The PP
and RR intervals vary with the difference between the short and longest interval
greater than 0.12 second. ***Occasionally may be due to non respiratory causes such
as digitalis or morphine (enhance vagal tone and cause decreased heart rate and
irregularity unrelated to the respiratory cycle).
Dysrhythmias
any disorder of the heartbeat. Could be a result of a disturbance in relationship between
electrical conductivity and the mechanical response of the myocardium, disturbance in
impulse formation, abnormal rate or ectopic focus, disturbance in impulse conduction,
delays and blocks, or the combination of several mechanisms.
Tachydysrhythmias
heart rates >100bpm, a major concern in the adult patient with coronary artery disease.
A serious issue as it shortens coronary perfusion time (the amt. of time available for
blood to flow through the coronary arteries to the myocardium), initially increase
cardiac output and BP (however ,a continued rise in HR decreases the ventricular filling
time because of a shortened diastole, decreasing the stroke volume. CO and BP will
begin to decrease), and an increase the work of the heart, increasing myocardial oxygen
demand. The patient may have: palpitations, chest discomfort (pressure/pain from
myocardial ischemia or infarction), restlessness and anxiety, pale, cool skin, syncope
("blackout") from hypotension.
-chest discomfort, pressure, or pain which may radiate to the jaw, the back ,or
the arm.
Material 2+Questions with Accurate
Solutions
ST Segment
an isoelectric line and represents early ventricular repolarization. Changes may be
a result of myocardial injury, ischemia, infarction, conduction abnormalities or
medications.
T wave
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
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
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
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
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
Normal Sinus Rhythm is the rhythm originating from the SA node that meets these
ECG criteria:
Rate: _______________ bpm
Rhythm: atrial and ventricular rhythms _________________.
P waves: present, consistent configuration, ___________ P-wave before each QRS
complex.
PR Interval: ______________ second and constant.
QRS Interval: ____________ second and constant
, Sinus Arrhythmia
a variant of NSR. Results from changes in intrathoracic pressure during breathing. The
HR increases slightly during exhalation. This irregular rhythm is frequently observed
unhealthy adults. Has all of the characteristics of NSR except for its irregularity. The PP
and RR intervals vary with the difference between the short and longest interval
greater than 0.12 second. ***Occasionally may be due to non respiratory causes such
as digitalis or morphine (enhance vagal tone and cause decreased heart rate and
irregularity unrelated to the respiratory cycle).
Dysrhythmias
any disorder of the heartbeat. Could be a result of a disturbance in relationship between
electrical conductivity and the mechanical response of the myocardium, disturbance in
impulse formation, abnormal rate or ectopic focus, disturbance in impulse conduction,
delays and blocks, or the combination of several mechanisms.
Tachydysrhythmias
heart rates >100bpm, a major concern in the adult patient with coronary artery disease.
A serious issue as it shortens coronary perfusion time (the amt. of time available for
blood to flow through the coronary arteries to the myocardium), initially increase
cardiac output and BP (however ,a continued rise in HR decreases the ventricular filling
time because of a shortened diastole, decreasing the stroke volume. CO and BP will
begin to decrease), and an increase the work of the heart, increasing myocardial oxygen
demand. The patient may have: palpitations, chest discomfort (pressure/pain from
myocardial ischemia or infarction), restlessness and anxiety, pale, cool skin, syncope
("blackout") from hypotension.
-chest discomfort, pressure, or pain which may radiate to the jaw, the back ,or
the arm.
