Topic 4: Heart Dysrhythmias & ECG/EKG Flashcards

1
Q

What does the P wave represent?

A

atrial depolarization

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2
Q

What does the QRS complex represent?

A

ventricular depolarization and atrial repolarization

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3
Q

What does the T wave represent?

A

ventricular repolarization

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4
Q

P-R interval is how many seconds

A

0.12 - 0.20 sec (3 - 5 small squares)

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5
Q

QRS width is how many seconds

A

0.08 - 0.12 sec (2 - 3 small squares)

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6
Q

Q-T interval is how many seconds

A

0.35 - 0.43 sec

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7
Q

5 lead EKG placement

A

White lead - right sternum / clavicle area
Black lead - Left sternum / clavicle area
Red lead - Left lower thoracic area
Green lead - Right lower thoracic area
Brown lead - just below and to the right of the bottom of the sternum

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8
Q

normal rhytms are considered ______

A

sinus (originating from the SA node)

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9
Q

what conducts first in a “normal” heart

A

SA node

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10
Q

Sinus Rhythm (SR, NSR) characteristics

A

*P waves are present & appear at regular time intervals
*P wave rate is constant
*Each P wave is followed by a QRS complex
*QRS complexes are of normal width (slim)
*The intervals between QRS complexes are equal
*The heart rate is between 60 and 100 beats per minute

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11
Q

Sinus Tachycardia characteristics of ECG and rate

A

same a normal siuns rhythm EXCEPT HR is 101-180 bpm

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12
Q

s/s of sinus tachycardia

A

SOB, dyspnea, diaphoresis
decrease CO, decrease BP
rapid, regular pulse, possible palpitation

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13
Q

cause of sinus tachycardia

A

exercise, fever, pain, stimulants. hyper/hypovolemia, anxiety, and CVD (anemia, HF, or valvular heart diseases can increase the heart’s workload.), hypotension

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14
Q

treatment for sinus tachycardia

A

TREAT cause
VALSALVA MANEUVER
fever- antipyretic
reduce stimulant
reduce pain

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15
Q

drug therapy for sinus tachycardia

A

B-blocker
CCB
adenosine

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16
Q

sinus bradycardia characteristics if ECG and rate

A

same as normal sinus rhythm EXCEPT HR < 60 bpm

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17
Q

s/s of sinus bradycardia

A

fatigue, lightheadedness, syncope, symptomatic

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18
Q

cause of sinus bradycardia

A

vagal maneuver (bearing down)
> responsible for the “rest and digest” activities in the body.
Vagal maneuvers, such as bearing down (as if having a bowel movement), can stimulate the vagus nerve = a reduction in HR
meds (CCB, B-blockers)
> These drugs are often used to treat hypertension and certain heart rhythm disorders. They work by relaxing the muscles of your heart and blood vessels.
vomiting, hypothermia
> Forceful or repeated vomiting can also stimulate the vagus nerve, leading to a reflex decrease in heart rate.
common in trained athletes

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19
Q

treatment of sinus bradycardia

A

try to arouse the patient
head of the bed FLAT
fall preacutions
atropine

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20
Q

drug therapy of sinus bradycardia

A

ATROPINE only if showing decreased perfusion (cool, pale, clammy)

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21
Q

atrial fibrillation

A

rapid, random, ineffective contractions of the atrium

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22
Q

Causes of atrial fibrillation

A

CAD, HTN, HF (any underlying heart disease)
surgery

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23
Q

treatment/drug therapy for atrial fibrillation

A

CCB (Diltiazem!!!), B-Blockers, amiodarone, digoxin (all for rate control)
anticoagulants

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24
Q

what is a big concern with A-fib

A

BLOOD STASIS!! can lead to clots

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25
Q

what drug is used for clots in A-fib

A

Warfarin

26
Q

what is important to know about warfarin

A

monitor INR
Vit K is the antidote
moderate green leafy veggies

27
Q

what needs to be checked before giving digoxin

A

apical pulse (60 or greater)
toxicity: 0.5-2.0, visual changes, N/V, anorexia
potassium below 3.5 increases the risk for toxixity

28
Q

s/s of atrial fibrillation

A

usually asymptomatic
if symptomatic: dizzy, faint, fatigue, SOB, chest pain, fluttering in chest, irregular pulse, change in LOC, dyspnea, asymptomatic or syncope

29
Q

atrial fibrillation characteristics of ECG and rate

A

-absence or inconsistent (fibrillary) p wave
-Appears irregular, often changes speed of the heart rate
350-600bpm

30
Q

Transcutaneous Pacemaker

A

external pacemaker used as a temporary emergency measure for maintaining adequate heart rate

31
Q

Cardioversion

A

restoration of a normal heart rhythm by electric shock

32
Q

Transcutaneous Pacemaker & Cardioversion is used with what type of dysrhythmia

A

atrial fibrillation

33
Q

normal digoxin range

A

0.5-2ng/mL

34
Q

Premature Ventricular Contraction (PVC) characteristics of ECG and rate

A

underlying rhythm can be any rate, regualr or irregular, PVCs can occur at variable rates
-wide and distorted QRS complex, Pwave barely visible

35
Q

what is Premature Ventricular Contraction (PVC) caused by

A

*Caused by the hearts demand for O2
-stimulants (caffiene, alcohol, nicotine, epi, etc), electrolyte imbalance, hypoxia, fever, exercise, emotional stress

36
Q

s/s Premature Ventricular Contraction (PVC)

A

*Almost always *asymptomatic, noticed on tele strip

37
Q

Premature Ventricular Contraction (PVC) treatment:

A

treat the cause
O2 therapy for hypoxia
elecrolyte replacement

38
Q

3 or more PVC’s occur consecutively

A

indicates Ventricular Tachycardia

39
Q

Ventricular Tachycardia characteristics of ECG and rate

A

*Ventricular rate is 150-250bpm
*Regular to slightly irregular rhythm
p wave and Pr interval not visible, ORS wide and distorted

40
Q

causes of ventricular tachycardia

A

post MI, CAC, hypoxemia, electrolyte imbalance (decrease K and Mg), drug toxicity

41
Q

s/s ventricular tachycardia

A

*asymptomatic if it lasts a short amount of time due to anxiety
*If it happens for an extended amount of time death can occur

42
Q

a patient in V-tach is a patient that is trying to….

A

CODE!

43
Q

a patient in V-tach may or may not have

A

a pulse

44
Q

treatments for a patient in V-tach: IV antidyrhythmics

A

-Procainamide
-Lidocaine
-Adenosine

45
Q

what is done if the pulse is present in v-tach

A

assess VS, call rapid response, prepare to call code, give IV dysrhythmias

46
Q

what is done if no pulse is present in v-tach

A

CALL CODE, begin CPR, early D-fib

47
Q

v-tach with no pulse

A

defibrillation

48
Q

v-tach with pulse

A

cardioversion

49
Q

Torsades de Points

A

-Lethal heart rhythm. Occurs if QT interval is prolonged greater than 0.50 seconds……this is why it is importnt to monitor for a prolonged QT interval.
-Treated with IV magnesium sulfate, cardioversion, correct causative factors

50
Q

the quivering of te ventricles in v-tach means

A

NO CARDIAC OUTPUT, MEDICAL EMERGENCY IF THERE IS NO PULSE

51
Q

cause of ventricular fibrillation

A

untreated v-tach, MI, hyperkalemia, electric shock, hypoxemia, acidosis, drug toxicity

52
Q

s/s ventricular fibrillation

A

-Poor to no cardiac output
-loss of consciousness
-no pulse
-BP and respirations leading to brain damage
-death if not reversed

53
Q

V FIB

A

D FIB

54
Q

V tach treatment

A

*check pulse, Call a CODE, start CPR, & early defibrillation
*Amiodarone, Epinephrine, Lidocaine
*Best results if ACLS is started in the first 30 seconds

55
Q

if a patient goes into cardiac arrest

A

-check pulse
-Call a Code
-Start CPR
-Start ACLS when trained ACLS professional arrives (rapid response or code team)

56
Q

defibrillator

A

a device that delivers an electric shock to the heart to restore its normal rhythm

57
Q

Digoxin toxicity symptoms

A

nausea, vomiting, diarrhea, vision changes, arrythmias, electrolyte imbalance

58
Q

asystole

A

flatline

59
Q

rate of asystole

A

none

60
Q

asystole is ___

A

FATAL- client is clinically DEAD (unresponsive, no respiration or heart beat)

61
Q

causes of asytole

A

long cardiac Hx, HF, MI

62
Q

treatment for asystole

A

NO DEFIBRILLATION (no pulse)
-epi, atropone, CPR w/ ACLS