NCLEX ESSENTIALS MED SURG
Cardiovascular Disorders
Cardiac Dysrhythmias
Route Rate Rhythm
Rhythm P Wave PR QRS Rate Regularity Life Causes
Interval Threatenin
g
Normal Sinus Normal 0.12-0.20 <0.12 60-100 Regular No Normal Finding
Sinus Normal 0.12-0.20 <0.12 <60 Regular Dependant Sleep, inactivity,
Bradycardia on Cause athletic, vagal tone,
drugs, MI, K+,
respiratory arrest
Sinus Normal 0.12-0.20 <0.12 >100, Regular No Caffeine, exercise,
Tachycardia usually fever, anxiety, heart
100- failure, drugs, pain,
150 hypoxia,
hypotension,
volume depletion
Atrial Pause Looks like SR but drops a Normal Irregular Depends Elderly,
complex or slow on length digoxin
and toxicity, MI,
frequency rheumatic fever
Atrial Flutter Saw tooth None <0.12 Atrial Regular Dependant Valvular heart
rate 250- or on disease, MI, CHF,
400 Irregular ventricular pericarditis
rate
Atrial Wavy None <0.12 Atrial rate Irregular Dependant Heart disease,
Fibrillation unidentifia >400 on pulmonary disease,
ble ventricular emotional stress,
rate excessive alcohol or
caffeine
Junctional INVERTE <0.12 <0.12 40-60 Regular Dependant Electrical impulse
Rhythm D on not arriving from
before ventricular SA node, AV node
or after rate fires
QRS or at inherent rate
absent
,Accelerated INVERTE <0.12 <0.12 60-100 Regular Dependant Digoxin toxicity,
Junctional D on damage to AV node
Rhythm before or ventricular
after rate
QRS or
absent
Junctional INVERTE <0.12 <0.12 >100 Regular Dependant Same as SVT
Tachycardia D on
before ventricular
or after rate
QRS
or absent
Supraventricu Pointed or Immeasu <0.12 150-250 Regular Dependant Caffeine, CHF,
lar hidden in T rable on rate and fatigue, hypoxia,
, Tachycardia patient mitral valve disease,
ability altered pacemaker in
to heart
tolerate
Idioventricula None None >0.11 20-40 Regular Yes Digoxin
r Rhythm wide toxicity, acute
and MI
bizarr
e
Ventricular None None >0.11 150-250 Regular Yes, may MI, ischemia,
Tachycardia wid have digoxin toxicity,
e pulse hypoxia, acidosis,
and ↓K+, ↓BP
bizarre
Ventricular None None None None Irregular, Yes, no pulse Follow PVC, VT,
Fibrillation vary in size, most common cause
shape and of sudden death
height
Asystole Possible None None None No QRS Yes Follows VT/VFib,
acidosis, hypoxia,
↓K+, hypothermia,
drug overdose
1° AV Block Normal >0.20 <0.12 Varies Regular or Usually Not First sign of
irregular increasing AV block
2° AV Block Normal Varies: <0.12 Varies Regularly Usually Not Acute inferior MI,
Type I progress irregular: digoxin toxicity,
i vely QRS vagal stimulation,
prolonge dropped conduction system
d after disease
progressivel
y prolonged
PRI
2° AV Block Normal Consiste Norma Usuall Regular or Dependan BBB, anterior MI,
Type II nt l or y slow irregular; t on lesions of
normal wide occasionally overall conduction system
or dropped ventricula
prolonge QRS r rate,
d may
progress
to 3° AV
Block
Cardiovascular Disorders
Cardiac Dysrhythmias
Route Rate Rhythm
Rhythm P Wave PR QRS Rate Regularity Life Causes
Interval Threatenin
g
Normal Sinus Normal 0.12-0.20 <0.12 60-100 Regular No Normal Finding
Sinus Normal 0.12-0.20 <0.12 <60 Regular Dependant Sleep, inactivity,
Bradycardia on Cause athletic, vagal tone,
drugs, MI, K+,
respiratory arrest
Sinus Normal 0.12-0.20 <0.12 >100, Regular No Caffeine, exercise,
Tachycardia usually fever, anxiety, heart
100- failure, drugs, pain,
150 hypoxia,
hypotension,
volume depletion
Atrial Pause Looks like SR but drops a Normal Irregular Depends Elderly,
complex or slow on length digoxin
and toxicity, MI,
frequency rheumatic fever
Atrial Flutter Saw tooth None <0.12 Atrial Regular Dependant Valvular heart
rate 250- or on disease, MI, CHF,
400 Irregular ventricular pericarditis
rate
Atrial Wavy None <0.12 Atrial rate Irregular Dependant Heart disease,
Fibrillation unidentifia >400 on pulmonary disease,
ble ventricular emotional stress,
rate excessive alcohol or
caffeine
Junctional INVERTE <0.12 <0.12 40-60 Regular Dependant Electrical impulse
Rhythm D on not arriving from
before ventricular SA node, AV node
or after rate fires
QRS or at inherent rate
absent
,Accelerated INVERTE <0.12 <0.12 60-100 Regular Dependant Digoxin toxicity,
Junctional D on damage to AV node
Rhythm before or ventricular
after rate
QRS or
absent
Junctional INVERTE <0.12 <0.12 >100 Regular Dependant Same as SVT
Tachycardia D on
before ventricular
or after rate
QRS
or absent
Supraventricu Pointed or Immeasu <0.12 150-250 Regular Dependant Caffeine, CHF,
lar hidden in T rable on rate and fatigue, hypoxia,
, Tachycardia patient mitral valve disease,
ability altered pacemaker in
to heart
tolerate
Idioventricula None None >0.11 20-40 Regular Yes Digoxin
r Rhythm wide toxicity, acute
and MI
bizarr
e
Ventricular None None >0.11 150-250 Regular Yes, may MI, ischemia,
Tachycardia wid have digoxin toxicity,
e pulse hypoxia, acidosis,
and ↓K+, ↓BP
bizarre
Ventricular None None None None Irregular, Yes, no pulse Follow PVC, VT,
Fibrillation vary in size, most common cause
shape and of sudden death
height
Asystole Possible None None None No QRS Yes Follows VT/VFib,
acidosis, hypoxia,
↓K+, hypothermia,
drug overdose
1° AV Block Normal >0.20 <0.12 Varies Regular or Usually Not First sign of
irregular increasing AV block
2° AV Block Normal Varies: <0.12 Varies Regularly Usually Not Acute inferior MI,
Type I progress irregular: digoxin toxicity,
i vely QRS vagal stimulation,
prolonge dropped conduction system
d after disease
progressivel
y prolonged
PRI
2° AV Block Normal Consiste Norma Usuall Regular or Dependan BBB, anterior MI,
Type II nt l or y slow irregular; t on lesions of
normal wide occasionally overall conduction system
or dropped ventricula
prolonge QRS r rate,
d may
progress
to 3° AV
Block
