Relias Assessments Assistance Material DYSRHYTHMIAS Exam
Question With Detailed Answers
Ventricular Tachycardia - ANSWERS-Ventricular tachycardia (VT) is three or more
consecutive PVCs. it is considered a medical emergency because cardiac output (CO)
cannot be maintained because of decreased diastolic filling (preload).
Rate is 100 to 250 beats per minute
P wave is blurred in the QRS complex but the QRS complex has no associate with P
wave.
PR Interval is not present
QRS complex is wide and bizarre; T wave is in the opposite direction
Rhythm is usually regular
May start and stop suddenly
Clinical manifestations of VT includes lightheadedness, weakness, dyspnea and
unconsciousness. Causes includes MI, aneurysm, CAD, rheumatic heart diseases,
mitral valve prolapse, hypokalemia, hyperkalemia, and pulmonary embolism. Anxiety
may also caused VT.
Pulseless Ventricular Tachycardia - ANSWERS-Management for Pulseless VT: Initiate
cardiopulmonary resuscitation; follow ACLS protocol for defibrillation, ET intubation and
administration of epinephrine or vasopressin.
Ventricular Tachycardia with Pulse - ANSWERS-Management with Pulse VT: If
hemodynamically stable, follow ACLS protocol for administration of amiodarone, if
ineffective, initiate synchronized cardioversion.
Ventricular Fibrillation - ANSWERS-Ventricular fibrillation is rapid, ineffective quivering
of ventricles that may be rapidly fatal.
Rate is rapid and uncoordinated, with ineffective contractions
Rhythm is chaotic
QRS complexes wide and irregular
P wave is not seen
PR interval is not seen
Causes of ventricular fibrillation is most commonly myocardia ischemia or infarction. It
ma result from untreated ventricular tachycardia, electrolyte imbalances, digoxin or
quinide toxicity, or hypothermia. Clinical manifestations may include loss of
consciousness, pulselessness, loss of blood pressure, cessation of respirations,
possible seizures and sudden death.
Start CPR is pulseless. Follow ACLS protocol for defibrillation, ET intubation and
administration of epinephrine or vasopressin.
, Torsade de Pointes - ANSWERS-is a variant of polymorphic ventricular tachycardia and
is often caused by a prolonged QT interval.
Supraventricular Tachycardia - ANSWERS-rate varies btwn 160-250 bpm, regular
rhythm, originates from a location above AV node, will start and stop w/o cause.
common causes: mitral valve prolapse, cor pulmonale, digitalis toxicity, and rheumatic
heart disease
ST Depression - ANSWERS-subendocardial ischemia (e.g., classical angina pectoris)
Junctional Rhythm - ANSWERS-the SA node is nonfunctional, P waves are absent, and
heart is paced by the AV node at 40-60 beats/min
EKG interpretation - ANSWERS-One of the most useful and commonly used diagnostic
tools is electrocardiography (EKG) which measures the heart's electrical activity as
waveforms. An EKG uses electrodes attached to the skin to detect electric current
moving through the heart. These signals are transmitted to produce a record of cardiac
activity. Arrhythmia or dysrhythmia are disturbances in the normal cardiac rhythm of the
heart which occurs as a result of alterations within the conduction of electrical impulses.
These impulses stimulate and coordinate atrial and ventricular myocardial contractions
that provide cardiac output.
Sinus Tachycardia - ANSWERS-Sinus tachycardia is a heart rate greater than 100
beats per minute that originated from the sinus node.
Rate: 100 to 180 beats per minute
P Waves precede each QRS complex
PR interval is normal
QRS complex is normal
Conduction is normal
Rhythm is regular
Causes of sinus tachycardia may include exercise, anxiety, fever, drugs, anemia, heart
failure, hypovolemia and shock. Sinus tachycardia is often asymptomatic. Management
however is directed at the treatment of the primary cause. Carotid sinus pressure
(carotid massage) or a beta blocker may be used to reduce heart rate.
Sinus Bradycardia - ANSWERS-Sinus bradycardia is a heart rate less than 60 beats per
minute and originates from the sinus node (as the term "sinus" refers to sinoatrial node).
It has the following characteristics
Rate is less than 60 beats per minute
P Waves precede each QRS complex
PR interval is normal
QRS complex is normal
Conduction is normal
Rhythm is regular
Question With Detailed Answers
Ventricular Tachycardia - ANSWERS-Ventricular tachycardia (VT) is three or more
consecutive PVCs. it is considered a medical emergency because cardiac output (CO)
cannot be maintained because of decreased diastolic filling (preload).
Rate is 100 to 250 beats per minute
P wave is blurred in the QRS complex but the QRS complex has no associate with P
wave.
PR Interval is not present
QRS complex is wide and bizarre; T wave is in the opposite direction
Rhythm is usually regular
May start and stop suddenly
Clinical manifestations of VT includes lightheadedness, weakness, dyspnea and
unconsciousness. Causes includes MI, aneurysm, CAD, rheumatic heart diseases,
mitral valve prolapse, hypokalemia, hyperkalemia, and pulmonary embolism. Anxiety
may also caused VT.
Pulseless Ventricular Tachycardia - ANSWERS-Management for Pulseless VT: Initiate
cardiopulmonary resuscitation; follow ACLS protocol for defibrillation, ET intubation and
administration of epinephrine or vasopressin.
Ventricular Tachycardia with Pulse - ANSWERS-Management with Pulse VT: If
hemodynamically stable, follow ACLS protocol for administration of amiodarone, if
ineffective, initiate synchronized cardioversion.
Ventricular Fibrillation - ANSWERS-Ventricular fibrillation is rapid, ineffective quivering
of ventricles that may be rapidly fatal.
Rate is rapid and uncoordinated, with ineffective contractions
Rhythm is chaotic
QRS complexes wide and irregular
P wave is not seen
PR interval is not seen
Causes of ventricular fibrillation is most commonly myocardia ischemia or infarction. It
ma result from untreated ventricular tachycardia, electrolyte imbalances, digoxin or
quinide toxicity, or hypothermia. Clinical manifestations may include loss of
consciousness, pulselessness, loss of blood pressure, cessation of respirations,
possible seizures and sudden death.
Start CPR is pulseless. Follow ACLS protocol for defibrillation, ET intubation and
administration of epinephrine or vasopressin.
, Torsade de Pointes - ANSWERS-is a variant of polymorphic ventricular tachycardia and
is often caused by a prolonged QT interval.
Supraventricular Tachycardia - ANSWERS-rate varies btwn 160-250 bpm, regular
rhythm, originates from a location above AV node, will start and stop w/o cause.
common causes: mitral valve prolapse, cor pulmonale, digitalis toxicity, and rheumatic
heart disease
ST Depression - ANSWERS-subendocardial ischemia (e.g., classical angina pectoris)
Junctional Rhythm - ANSWERS-the SA node is nonfunctional, P waves are absent, and
heart is paced by the AV node at 40-60 beats/min
EKG interpretation - ANSWERS-One of the most useful and commonly used diagnostic
tools is electrocardiography (EKG) which measures the heart's electrical activity as
waveforms. An EKG uses electrodes attached to the skin to detect electric current
moving through the heart. These signals are transmitted to produce a record of cardiac
activity. Arrhythmia or dysrhythmia are disturbances in the normal cardiac rhythm of the
heart which occurs as a result of alterations within the conduction of electrical impulses.
These impulses stimulate and coordinate atrial and ventricular myocardial contractions
that provide cardiac output.
Sinus Tachycardia - ANSWERS-Sinus tachycardia is a heart rate greater than 100
beats per minute that originated from the sinus node.
Rate: 100 to 180 beats per minute
P Waves precede each QRS complex
PR interval is normal
QRS complex is normal
Conduction is normal
Rhythm is regular
Causes of sinus tachycardia may include exercise, anxiety, fever, drugs, anemia, heart
failure, hypovolemia and shock. Sinus tachycardia is often asymptomatic. Management
however is directed at the treatment of the primary cause. Carotid sinus pressure
(carotid massage) or a beta blocker may be used to reduce heart rate.
Sinus Bradycardia - ANSWERS-Sinus bradycardia is a heart rate less than 60 beats per
minute and originates from the sinus node (as the term "sinus" refers to sinoatrial node).
It has the following characteristics
Rate is less than 60 beats per minute
P Waves precede each QRS complex
PR interval is normal
QRS complex is normal
Conduction is normal
Rhythm is regular
