Advanced Dysrhythmias Questions and answers

Advanced Dysrhythmias Questions and
answers.


P wave:zx




PR interval: zx




QRS complex: zx




(ST segment) zx




T wave:zx




QT interval: - (correct answer) - • P wave - atrial depolarization and contraction
zx zx zx zx zx zxzx zx zx zx zx zx zx zx




• PR interval - time of travel from the SA node to AV node (.12-.2)
zx zx zx zx zx zx zx zx zx zx zx zx zx zx




• QRS - ventricular depolarization and contraction (.08-.12)
zx zx zx zx zx zx zx




- Note: Atrial repolarization occurs during this time, but cannot be seen on EKG
zx zx zx zx zx zx zx zx zx zx zx zx zx




• T wave - ventricular repolarization
zx zx zx zx zx




• QT interval - start of ventricular contraction to end of relaxation
zx zx zx zx zx zx zx zx zx zx zx




Systematic Approach to analyzing EKG (7 steps) - (correct answer) -
zx zx zx zx zx zx zx zx zx zx




1. Determine atrial & ventricular rate and rhythm.
zxzx zx zx zx zx zx zx zx




2. Identify P waves and shape, and if there are P waves for every QRS.
zx zx zx zx zx zx zx zx zx zx zx zx zx zx




3. Determine PR interval (0.12-.2), and if consistent, irregular but with pattern to irregularity, or just irre
zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx




gular.

4. Determine QRS duration, consistency, and shape. (<0.12)
zx zx zx zx zx zx zx




5. Identify T wave and shape.
zx zx zx zx zx




6. Identify ST segment, and any elevation/depression.
zx zx zx zx zx zx




7. Identify any ectopic beats occurring outside underlying rhythm.
zx zx zx zx zx zx zx zx

, Determining HR from EKG strip - (correct answer) - zx zx zx zx zx zx zx zx




Typical heart rhythm strips will contain 6 seconds (30 big boxes)
zxzx zx zx zx zx zx zx zx zx zx zx




• Rates in a 6 second strip can be obtained by
zx zx zx zx zx zx zx zx zx zx




- Ventricular rate = QRS (QRS to QRS-the gaps) x 10
zx zx zx zx zx zx zx zx zx zx




- Atrial rate = P waves x 10
zx zx zx zx zx zx zx




OR Ventricular rate = 1500 / # of small boxes between 2 QRS; Atrial rate = 1500 /
zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx




# of small boxes between 2 P waves
zx zx zx zx zx zx zx zx




• 1 small box = .04sec, 5 boxes/large box = 0.2sec; 5 large boxes = 1 second, 15 large = 3sec
zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx




To improve lead conduction... (4) - (correct answer) - - Clean and dry skin with soap and water
zx zx zx zx zx zx zx zx zxzx zx zx zx zx zx zx zx zx




- Remove excess hair
zx zx zx




-
Gentle abrasion of skin with clean gauze to expose epidermis (dry gauze, not alcohol which acts as barri
zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx zx




er, skin is a natural conductor)
zx zx zx zx zx




- Have patient remain still and supine
zx zx zx zx zx zx




Normal Sinus Rhythm - (correct answer) - • Ventricular and atrial rate: 60 to 100 bpm
zx zx zx zx zx zx zxzx zx zx zx zx zx zx zx zx




• Ventricular and atrial rhythm: Regular
zx zx zx zx zx




• QRS shape and duration: Usually normal, but may be regularly abnormal
zx zx zx zx zx zx zx zx zx zx zx




• P wave: Normal and consistent shape; always in front of the QRS
zx zx zx zx zx zx zx zx zx zx zx zx




• PR interval: Consistent interval between 0.12 and 0.20 seconds
zx zx zx zx zx zx zx zx zx




• P:QRS ratio: 1:1
zx zx zx




Sinus Bradycardia - (correct answer) - • Atrial/ventricular rate and rhythm: < 60 and regular
zx zx zx zx zx zxzx zx zx zx zx zx zx zx zx




• P wave: Normal and consistent shape; always in front of QRS
zx zx zx zx zx zx zx zx zx zx zx




• PR interval: Consistently between 0.12 and 0.2 seconds
zx zx zx zx zx zx zx zx




• QRS shape and duration: Usually normal, but may be regularly abnormal
zx zx zx zx zx zx zx zx zx zx zx




• Concern - decreased cardiac output and tissue perfusion
zx zx zx zx zx zx zx zx




Etiology of Sinus Brady (causes) - (correct answer) - • Lower metabolic needs -
zx zx zx zx zx zx zx zx zxzx zx zx zx zx




Sleep, Athletes, Hypothyroidism
zx zx zx