ACLS EKG Review Questions with graded A+ Answers

ACLS EKG Review Questions with graded A+ Answers Ventricular Tachycardia EKG Rhythm-Regular Rate- 180-190 QRS Duration - prolonged P Wave- not seen Ventricular Tachycardia Phys Abnormal tissues in ventricles generate a rapid and irregular heart rhythm. Poor cardiac output Shock rhythm if patient is unconscious and w/o pulse. Ventricular Fibrillation EKG Rhythm-Irregular Rate 300+, irregular QRS Duration - Not recognizable P wave- not seen. Ventricular Fibrillation Phys Disorganized signals in ventricles cause it to quiver instead of contract. Pt unconscious, blood unable to pump from brain. Immediate defibrillation needed. Condition can occur during or after MI Supraventricular Tachycardia EKG Rhythm- Regular Rate 140-220 bpm QRS Duration- usually normal P wave: often buried in preceding T wave P-R interval: depends on site of supra ventricular pacemaker Supraventricular Tachycardia Patho Impulses stimulating the heart are not being generated by the sinus node, but instead are coming from a collection of tissue around and involving the AV node. Atrial Fib EKG Rhythm- irregularly irregular Rate- usually 100-160 bpm but slower if on medication QRS Duration- usually normal P Wave- not distinguishable as the atria are firing off all over P-R interval, not measurable Atria fire electrical impulses in an irregular fashion causing irregular heart rhythm. A Fib Patho Many sites within atria generate own electrical impulses, leading to irregular conduction of impulses to the ventricles that generate the heartbeat. Irregular rhythm can be felt when palpating a pulse. It may cause no symptoms, but is often associated with palpations, fainting, chest pain, or CHF Atrial Flutter EKG Rhythm- Regular Rate, 110 bpm QRS- usually normal P-wave rate- 300 bpm PR interval not measurable Atrial flutter Patho Abnormal tissue generating the rapid heart rate is in the aorta, but AV node not involved. Order of Electrical Pathway SA Node AV Node His Purkinge System o His Bundle (the start of the system) o Right bundle branch o Left bundle branch o Purkinje fibers (the end of the system) EKG Squares 5 large blocks = 1 second Each large block = 0.2 seconds Small block = 0.04 seconds P wave Atrial depolarization Normal duration is 0.06-0.11 seconds (1.5 to 2.75 small boxes). The shape of a P-wave is usually smooth and rounded. PR interval AV conduction time From beginning of P to beginning of QRS 0.12 to 0.20 seconds (3 to 5 small boxes) in adults, longer in elderly people QRS Ventricular depolarization Normally this interval is 0.06 to 0.12 seconds (1.5 to 3 boxes). T wave Repolarization of ventricles