Dysrhythmia Qustions with Answers

Dysrhythmia Qustions with Answers . B. 6 second method - ANSWER-The number of QRS Complexes between 6 sec marks on the EKG paper is multiplied by 10. Used generally for estimating slow or irregular rhythms. 12 lead ECG - ANSWER-Limb leads: I, II, II, AVR, AVL, AVF Chest leads: V₁ , V₂ , V₃ , V₄ , V₅ , V₆ Abnormal P-R interval - ANSWER-delays in conduction. Abnormal QRS complex - ANSWER-anything greater than 0.11 s. abnormal T wave - ANSWER-moves opposite of the QRS complex hyperkalemia: peaked t waves hypokalemia: low T waves absolute refractory period - ANSWER-the cell will not respond to further stimulation within itself. the myocardial cells cannot contract and cannot conduct an electrical impulse. Accelerated Idioventricular Rhythm (AIVR) - ANSWER-three or more ventricular beats occur in a row at a rate of 41-100 bpm. they look like chairs accelerated junctional rhythm - ANSWER-61-100 bpm regular rhythm with no P ave Acetylcholine - ANSWER-NT parasympathetic stimulation active MI - ANSWER-looks like chair. acute coronary syndrome (ACS) - ANSWER-distinct conditions caused by a similar sequence of pathological events involving abruptly reduced coronary artery blood flow. Adensoine - ANSWER-drug that stops the heart for 1 second to restart the rhythm AFib patients are at risk for - ANSWER-atrial thrombus formation leading to stroke peripheral thromboembolism - give warfarin after 20 minutes of angina what happens? - ANSWER-the heart becomes irreversibly damaged and no electrical activity can flow through the heart. afterload - ANSWER-Pressure or resistance against which the ventricles must pump to eject blood - similar to PVR - fluid decreases afterload decreases agonal rhythm or a dying heart - ANSWER-ventricular rate less than 20 bpm. agonal rhythm or dying heart - ANSWER-ventricular rate less than 20 bpm anterior portion of the heart - ANSWER-right atrium, R. and L. ventricles. the R. ventricle lies directly behind the sternum Aortic heart sound - ANSWER-second intercostal space, right sternal border aortic valve - ANSWER-The semilunar valve separating the aorta from the left ventricle that prevents blood from flowing back into the left ventricle. apex - ANSWER-tip of left ventricle, above the diaphragm 5th intercostal space, MCL (point of maximal index) artifact - ANSWER-distortion of an ECG tracing by electrical activity that is noncardiac in origin. asystole - ANSWER-nonshockable. no rhythms or cardiac output. there at be super tiny atrial beat. atrial diastole - ANSWER-blood from superior vena cava and coronary sinus pour into r. atrium atrial fibrillation - ANSWER-most common dysrhythmia. abnormal automaticity in one or several rapid firing sites in the atria or reentry involving one or more circuits in the atria. atrial fibrillation - ANSWER-quivering P waves Atrial Fibrillation (A-Fib) - ANSWER-rhythm: ventricular rhythm usually irregularly irregular rate: atrial rate usually 300-600 bpm; ventricular rate variable P waves: no identifiable P waves, fibrillatory waves present; erratic, wavy baseline PR Interval: not measurable QRS duration: 0.11 seconds or less unless abnormally conducted atrial flutter - ANSWER-reentrant rhythm in which an irritable site within the atria fires rapidly Atrial Flutter - ANSWER-rhythm: atrial regular; ventricular regular or irregular depending on AV conduction blockade rate: atrial ranges from 240-300 bpm; ventricular rates varies and determined by AV blockade; the ventricular rate will not exceed 180 bpm as a result of the intrinsic conduction of AV junction P waves: no identifiable P waves; saw toothed “flutter” waves are present. PR Interval: not measurable QRS duration: 0.11 seconds or less but may be widened if flutter waves are buried in the QRS complex or if abnormally conducted Atrial Flutter - ANSWER-saw tooth pattern atrial kick - ANSWER-additional contribution of blood resulting from atrial contraction atrial tachycardia - ANSWER-3 or more PACs in a row. no P wave rate 101-250 (usually in 200s) Atrial Tachycardia - ANSWER-Rate: 150-250 beats per minute Regularity: regular P-waves: may be upright or inverted will appear different from underlying rhythm QRS-complex: Normal PR interval- may be normal, shortened, or prolonged atrial tachycardia, AVNRT, AVRT (WPW), PSVRT - ANSWER-no P waves HR in the 200s atrioventricular nodal reentrant tachycardia - ANSWER-2 pathways in the AV node that conduct impulses at different speeds and recover at different speeds rate: 200 and no P waves, no pRI atrioventricular node - ANSWER-a group of specialized cells that conduct an electrical impulse through the heart; located in the floor of the R. atrium immediately behind the tricuspid valve and near the coronary sinus opening Atrioventricular reentrant tachycardia - ANSWER-preexcitation: rhythm above the ventricles and transmits an impulse along a pathway outside the AV node and AV bundle. Automaticity - ANSWER-ability of cardiac pacemaker cells to create an electrical impulse without being stimulated from another source. AV Node - ANSWER-specialized conduction tissue that carries an electrical impulse from the atria to the ventricles baroreceptors - ANSWER-Located in carotid sinuses and aortic arch. detect changes in pressure by the stretching of the arteries. increased volume causes increased BP. stimulation can cause sympathetic or parasympathetic responses/ base (posterior) of the heart - ANSWER-left atrium, small part of R. atrium, proximal portion of SVC and IVC and pulmonary veins beta blockers - ANSWER-cause vasoconstriction and a decreased heart and try to improve contraction beta blockers do what to chronotropy - ANSWER-decrease the HR beta1 cells - ANSWER-on the heart and kidneys. increase HR and contractility beta2 cells - ANSWER-arterioles of the heart, lungs, and skeletal muscles that cause vasodilation. bicuspid (mitral) valve - ANSWER-between left atrium and left ventricle Blood flow of the heart - ANSWER-Right Coronary Artery, Left coronary artery, circumflex artery Blood flow through the heart - ANSWER-1-Superior & Inferior Vena Cava & Coronary sinus, 2-Rt Atrium, 3-Tricuspid Valve, 4- Rt Ventricle, 5-Pulmonary Valve, 6-Pulmonary Artery, 7- Lungs-pick up oxygen, 8-Pulmonary Veins, 9- Lt Atrium, 10- Mitral Valve (Bicuspid), 11-Lt Ventricle, 12- Aortic Valve, 13-Aorta, 14- Body blood pressure - ANSWER-force exerted by the circulating blood volume on the walls of the arteries bottom (inferior) surface of the heart - ANSWER-left ventricle, small portion of right ventricle and atrium. lies the diaphragmatic surface BP equation - ANSWER-BP = CO x PVR calcium and the heart - ANSWER-affects contractility, vascular tone, and excitability. is either bound to protein (albumin) or ionized normal: 8.5-10.5 mg/dL hypercalcemia: heart is spastic hypocalcemia: flaccid Calcium range - ANSWER-8.5-10.5 calculate P-R interval - ANSWER-count the number of boxes from the beginning of the P wave to the beginning of the Q wave and multiply by 0.04 seconds. capture - ANSWER-The successful conduction of an artificial pacemaker’s impulse through the myocardium, resulting in depolarization cardiac cycle - ANSWER-repetitive pumping process that include events associated with blood flow through the heart cardiac output - ANSWER-the amount of blood pumped into the aorta by the heart per minute cardiac output of R ventricle should equal how much in the L ventricle? - ANSWER-the same amount cardiac tamponade - ANSWER-pressure on the heart caused by fluid in the pericardial space Causes of atrial fibrillation - ANSWER--Coronary heart disease. -Systemic hypertension. -Heart valve disease. -Cardiomyopathy. -Pulmonary embolism. -Pericarditis. -Less than 10% of all cases is non-heart disease related i.e. alcohol and drug use, stress, electrolyte imbalance. Causes of atrial flutter - ANSWER-precipitated by AFib or AT cardiac sx, cardiac myopathy, chronic lung disease, complications of MI, digitalis, quinidine toxicity, hyperthyroidism, ischemic heart disease, mitral or tricuspid valve stenosis, pericarditis or myocarditis, PE causes of atrial tachycardia - ANSWER-common in elderly stimulant use with asthma and COPD pts. taking albuterol, theophylline, and cocaine users causes of AVNRT - ANSWER-COPD, CAD, valvular disease, HF, digitalis toxicity, hypoxia, stress, anxiety, carreine, smoking, meds causes of first degree AV block - ANSWER-- normal in hx of cardiac disease especially athletes - Acute MI - acute mydocarditis or endocarditis - cardiomyopathy - degenerative fibrosis and sclarosis - drugs - hyperkalemia - increased vagal tone - ischemia or injury to the AV node or AV bundle - rheumatic heart disease - valvular heart disease Causes of Junctional Tachycardia - ANSWER-- Kids -Acute coronary syndrome -CHF -Theophylline administration -Digitalis toxicity Causes of Multifocal Atrial Tachycardia (MAT) - ANSWER-COPD, acute coronary syndrome, valvular heart disease, hypomagnesium causes of multiform atrial tachycardia - ANSWER-normal athletes during sleep underlying heart disease digitalis toxicity causes of PAC - ANSWER-acute coronary syndrome, atrial enlargement, digitalis toxicity, electrolyte imbalance, emotional stress, mental and physical fatigue, HF, hyperthyroidism, stimulant, sympathomimetic, valvular heart disease causes of sinus arrest - ANSWER-damage of disease to SA node acute MI, rheumatic heart disease, carotid sinus pressure, sudden increase in parasympathetic, stimulation of pharynx, obstructive sleep apnea, hypothermia, rxn to CCB or beta blockers. causes of sinus bradycardia - ANSWER-sleeping adults, well conditioned athletes, some young adults MI posterior or inferior vagal stimulation: coughing, vomiting, straining BM, sudden exposure to cold SA node disease hyperkalemia or hypokalemia hypothermia