EKG FINAL

Question 1

Atrial depolarization (contraction)

Answer 1

P wave

Question 2

Ventricular depolarization, atrial repolarization

Answer 2

QRS complex

Question 3

Ventricular repolarization (resting phase)

Answer 3

T wave

Question 4

Each tiny box equals

Answer 4

0.04 seconds

5 tiny boxes = 1 big box (0.20 seconds)

Question 5

Each big box equals

Answer 5

0.20 seconds

5 big boxes = 1 second

Question 6

Normal PR interval should be

Answer 6

0.12 to 0.20 seconds

Question 7

Normal QRS interval should be

Answer 7

0.04 to 0.10 seconds

Question 8

Questions to ask

Answer 8

1) Is there a P-wave before every QRS?
2) Is each QRS the same distance apart? Do they march out?
3) It is regular or irregular?
4) Is it fast or slow?

Question 9

Normal sinus rhythm

Answer 9

HR 60-100 bpm
Regular rhythm
P wave for every QRS
PR interval & QRS complex are normal

Question 10

Sinus bradycardia

Answer 10

HR<60 bpm

Causes: Normal in athletes, response to carotid massage, Valsalva, increased ICP
Sx: pale, cool skin, hypotension, angina, SOB, dizziness, confusion
Treatment: pacing, atropine

Question 11

First Degree Heart Block

Answer 11

PR interval > 0.20 seconds

MI, CAD, hypothyroid, vagal stim, meds- digoxin, BB, CCBs
Watch/monitor
Precursor to lethal heart blocks

Question 12

Second Degree Heart Block
Type I - Wenckebach

Answer 12

Progressive prolonged PR interval until P wave is blocked

Dig, BB, CCBs can cause.
May not need treatment, but could progress

Question 13

Second Degree Heart Block
Type II

Answer 13

Blocked P wave
(Fixed PR, dropped QRS complex)

Ischemia, myocarditis, post cardiac surgery, meds- CCBs & digoxin
May progress to complete heart block
Treat w/ pacemaker

Question 14

Third Degree Heart Block (Complete)

Answer 14

P wave no relation to QRS

Ischemia, MI, fibrosis, cardiomyopathy
Treat w/ pacemaker

Question 15

Sinus Tachy

Answer 15

Normal, but fast
HR >100-180

Causes: SNS stim, anxiety, pain, fever, caffeine, alcohol, nicotine, dehydration
Sx: Dizzy, SOB, low BP, pallor
Treatment varies, fix the problem. BB, anxiety meds, etc.

Question 16

A-fib

Answer 16

P wave can’t be distinguished
Looks like jello or spaghetti, disorganized
Leads to clots if untreated
Treat w/ cardioversion, meds- heparin, BB, CCBs, digoxin

Question 17

Atrial flutter

Answer 17

P wave is methodic and saw tooth, organized

Causes: atrial fibrosis, drop in muscle mass, HTN, CAD, CMO/HF, pericarditis
Treat w/ cardioversion, BB, CCBs, digoxin, heparin

Question 18

Supraventricular Tachy (SVT)

Answer 18

P waves not visible, fast & regular, lots of spears
Eliminate cause, treat w/ ablation, vagal, adenosine, CCBs, and cardioversion

Question 19

Premature Ventricular Contractions (PVCs)

Answer 19

QRS wide & bizarre

Non-perfusing beats, no pulse
Causes: stimulants, fluid & electrolyte imbalance, emotional stress, exercise, hypoxia
Eliminate cause. Treat with Potassium and amio

3 PVCs = VTACH

Question 20

Ventricular tachycardia

Answer 20

QRS >0.12 seconds, Tombstone pattern
Probably no pulse

Check pt, start CPR, defib if no pulse, cardioversion if pulse is present, epi/vasopressin, amiodarone

Question 21

Ventricular fibrillation

Polymorphic VTACH / Torsades de Pointes

Answer 21

Looks like grass, fibrillary waves noted

Check pt, start CPR, defib if no pulse, cardioversion if pulse is present, epi/vasopressin, amiodarone

Question 22

Ventricular Asystole

Answer 22

Flatline

Epi & CPR