Relias Dysrhythmia Basic Test Answers Solution guide 2023

1. Normal sinus rhythm 2. Sinus Bradycar- dia 3. Sinus Tachycar- dia 4. Premature Atrial Contraction Regular Rate: 60-100 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: 0.12 sec Regular Rate: 60 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: 0.12 sec Regular Rate: 100-150 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: 0.12 sec IRREGULAR Rate: depends on underlying rhythm P wave: Present or hidden in T wave PR Interval: 0.12-0.20 sec QRS: 0.12 sec 5. Atrial Fibrillation IRREGULAR Atrial rate: UNMEASURABLE Ventricular rate: variable P wave: unable to see PR Interval: N/A QRS: 0.12 sec 6. A fib RVR IRREGULAR Ventricular rate: 100-175 P wave: unable to see PR Interval: N/A QRS 0.12 sec 7. Atrial Flutter Usually REGULAR can be irregular Atrial rate: 250-350 Ventricular rate: variable BUT atrial rate P Wave: Flutter PR Interval: N/A QRS: 0.12 sec 8. Supraventricular Tachycardia 9. Junctional Rhythm Regular Rate: 150-350 P wave: Hidden in QRS or T wave PR: unable to determine QRS: 0.12 sec Regular Rate: 40-60 P Wave: ABSENT or INVERTED PR Interval: None or 0.12 QRS: 0.12 sec 10. Accelerated Junctional Rhythm 11. Junctional Tachy- cardia 12. Premature Ven- tricular Contrac- tion 13. Ventricular Tachycardia 14. Ventricular Fibril- lation Regular Rate: 60-100 P Wave: NONE or INVERTED PR Interval: None or 0.12 QRS: 0.12 sec Regular Rate: 100 P Wave: NONE or INVERTED PR Interval: None or 0.12 QRS: 0.12 sec IRREGULAR Rate: refer to underlying rhythm P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE , 0.12 sec Regular Rate: 100 P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE, 0.12 sec Chaotic Coarse: big waves Fine: small waves Rate: unmeasurable P Wave: NONE PR Interval: N/A QRS: N/A 15. Idioventricular Regular Rate: 20-50 P wave: NONE PR Interval: N/A QRS: WIDE, 0.12 sec 16. Accelerated Idoventricular Rhythm 17. 1st Degree AV Block 18. 2nd Degree AV Block Type I Mob- itz, Wenckebach Regular Rate: 50-100 P wave: NONE PR Interval: N/A QRS: WIDE, 0.12 sec Regular Rate: 60-100 P Wave: Present, upright PR interval: 0.20 sec CONSISTENTLY LONG QRS: 0.12 sec Husband stays late till 9 consistently IRREGULAR Rate: 60-100 P wave: Present, upright PR Interval: Progressively longer until drop (PR interval longer and longer until drop) QRS: 0.12 sec Husband stays late till 9, then 11, then 1, then doesn't come home at all 19. 2nd Degree AV Block Type II Irregular or regular Rate: 60 P wave: Present, upright PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop QRS: 0.12 sec Husband stays late till 9 consistently, then wife goes out and doesn't come home 20. 3rd Degree AV Block Atrials and ventricles don't communicate Rate: regular atrial P wave: Present, upright No relationship between P waves and QRS PR Interval: VARIABLE QRS: variable P-P ad R-R consistent but NO correlation Husband and wife live separate lives and don't communi- cate 21. SA Node 1st 60-100 22. AV Node 2nd 40-60 23. Bundle of His 3rd 40-45 24. Right and Left 4th Bundle Branches 40-45 25. Purkinje Fibers 5th 20-50 26. 1 Small Box 0.04 sec 27. 1 Big Box 0.20 sec 28. Junctional Rhythms SA Node DID NOT FIRE AV Node fired NO P WAVE bc SA node didn't fire Narrow QRS 29. P Wave Amplitude 0.5-2.5 mm Will be shorter than T wave Shows firing of SA node 30. QRS 0.06-0.10 sec SHOULD BE 0.12 sec Wide QRS: delay in ventricular contraction, delay of con- duction through bundle branches or purkinje fibers BUNDLE BRANCH BLOCK or BLOCK IN PURKINJE FIBERS (idioventricular) 31. Calculate Regu- lar Rate 1500/ # boxes R-R 32. Calculate Irregu- lar Rate # of Rs in 6 sec strip X 10 33. Unifocal PVCs Only 1 shape PVC 34. Bigeminy PVC occurs every OTHER beat 35. Trigeminy PVC occurs every THIRD beat 36. Couplet 2 PVCs together 37. Triplet 3 PVCs together 38. Multifocal Multiple shapes 39. Monomorphic V Tach Same Shapes V Tach 40. Polymorphic V Tach Different Shapes V tach 41. Coarse V Fib Chopy but not as high as polymorphic V tach 42. Fine V Fib Fine and fibrillatory 43. Idioventricular Rhythms Only purkinje fibers firing WIDE QRS always 44. Atrially Paced Spike comes before P 45. Ventricularly Paced Spike comes before QRS and QRS will be wide 46. AV Paced Spike before P and before QR 47. Failure to Cap- ture Spikes with no QRS 48. Failure to Sense Spikes happen regardless of QRS on their own 49. How to determine the rhythm Regular or irregular? Rate? P before every QRS? QRS for every P? QRS wide or narrow? 50. QT Interval 0.34-0.43 51. P Wave 0.06-0.12 sec 52. PR Interval 0.12-0.20 sec 53. SA Node Firing *Fires normally @ 60-100* Rhythms -SR 60-100 -SB 60 -ST 100-150 -SVT . AV Node Firing, *Fires normally @ 40-60* SA Node Failed -Junctional rhythm 40-60 Rhythms -Accelerated junctional rhythm 60-100 -Junctional tachycardia . Only Purkinje *Fires normally @ 20-50* Fibers Firing -Idioventricular 20-50 Rhythms (Every- -Accelerated idioventricular 50-100 thing else has failed)