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Physical Assessment > 6 - EKG #2 > Flashcards

6 - EKG #2 Flashcards

(77 cards)

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1
Q

What are the learning objectives?

A

1) Recognize three different classes of tachyarrhythmias in both the atria and ventricles (paroxysmal tachycardia, flutter and fibrillation) on an EKG
2) Recognize first, second and third-degree AV blocks on an EKG
3) List medications (or other factors) that can potentiate the above arrhythmias
4) Develop a systematic approach to analyzing lead 2 of an EKG

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2
Q

At rest:

150 - 250 bpm indicates what?

A

paroxysmal tachycardia

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3
Q

At rest:

250-350 bpm indicates what?

A

tachycardia flutter

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4
Q

At rest:

350 - 450 bpm indicates what?

A

tachycardia fibrillation

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5
Q

For Age 20:

What is the target HR zone for tachycardias?

A

100-170 bpm (50-85%)

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6
Q

For Age 20:

What is the maximum HR (average)?

A

200 bpm

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7
Q

For Age 30:

What is the target HR zone for tachycardias?

A

95-162 bpm

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8
Q

For Age 30:

What is the maximum HR (average)?

A

190 bpm

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9
Q

For Age 40:

What is the target HR zone for tachycardias?

A

90-153 bpm

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10
Q

For Age 40:

What is the maximum HR (average)?

A

180 bpm

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11
Q

For Age 50:

What is the target HR zone for tachycardias?

A

85-145 bpm

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12
Q

For Age 50:

What is the maximum HR (average)?

A

170 bpm

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13
Q

What is PSVT?

A

Paroxysmal Supraventricular Tachycardia

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14
Q

Paroxysmal Supraventricular Tachycardia:

Rate?

A

Usually 140-250 ppm and “takes off” in a single beat

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15
Q

Paroxysmal Supraventricular Tachycardia:

Rhythm?

A

regular ventricular rate

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16
Q

Paroxysmal Supraventricular Tachycardia:

P waves?

A

often absent

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17
Q

Paroxysmal Supraventricular Tachycardia:

PR interval?

A

normal

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18
Q

Paroxysmal Supraventricular Tachycardia:

QRS ?

A

narrow

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19
Q

Atrial Flutter:

Atria Rate?

A

250-350 bpm

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20
Q

Atrial Flutter:

Ventricular Rate?

A

125-175 bpm

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21
Q

Atrial Flutter:

Rhythm?

A

usually regular

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22
Q

Atrial Flutter:

P waves ?

A

saw tooth pattern

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23
Q

Atrial Flutter:

PR interval?

A

variable

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24
Q

Atrial Flutter:

QRS ?

A

normal

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25
Atrial Fibrillation: | Rate?
variable, but usually 350-450 bpm
26
Atrial Fibrillation: | Rhythm?
Irregularly irregular
27
Atrial Fibrillation: | P waves?
chaotic activity
28
Atrial Fibrillation: | PR interval?
none
29
Atrial Fibrillation: | QRS ?
normal
30
Ventricular Flutter: | Rate?
200-300 bpm
31
Ventricular Flutter: | Rhythm?
regular
32
Ventricular Flutter: | P waves?
NONE
33
Ventricular Flutter: | PR interval?
NONE
34
Ventricular Flutter: | QRS?
wide, bizarre, sine-wave appearance
35
__________ _________ = VERY BAD FOR THE PATIENT = DEATH
Ventricular Fibrillation
36
Ventricular Fibrillation: | Rate?
very hard to determine
37
Ventricular Fibrillation: | Rhythm?
chaotic
38
Ventricular Fibrillation: | P waves?
None
39
Ventricular Fibrillation: | PR interval?
None
40
Ventricular Fibrillation: | QRS?
cannot determine
41
______ __ _______ = also very bad for the patient
Torsade de Pointes
42
Torsade de Pointes can cause ?
QT Prolongation
43
Torsade de Pointes: | Rate?
200-250 bpm
44
Torsade de Pointes: | Rhythm?
Irregular
45
Torsade de Pointes: | P waves?
None
46
Torsade de Pointes: | PR Interval?
None
47
Torsade de Pointes: | QRS?
variable
48
What are some QT prolonging drugs?
- antipsychotics - antidepressants - antibiotics (fluoroquinolones) - azole antifungals - antiarrhythmics
49
What are some stimulant drugs?
- illicit drugs - caffeine - nicotine - OTC decongestants - ADHD treatments
50
______ = holiday heart syndrome
alcohol
51
1st degree heart block: | Rate?
variable (their example on page 3 is bradycardic)
52
1st degree heart block: | Rhythm?
normal
53
1st degree heart block: | P waves?
normal
54
1st degree heart block: | P:QRS ratio?
1:1
55
1st degree AV block: | PR interval?
prolonged > than 0.2 seconds (1 large square)
56
1st degree AV block: | QRS ?
normal
57
2nd degree AV block Mobitz 1 (Wenchebach): Rate?
variable (this one is ~65 bpm)
58
2nd degree AV block Mobitz 1 (Wenchebach): Rhythm?
regularly irregular
59
2nd degree AV block Mobitz 1 (Wenchebach): P waves?
normal
60
2nd degree AV block Mobitz 1 (Wenchebach): P:QRS ratio?
variable (5:4)
61
``` 2nd degree AV block Mobitz 1 (Wenchebach): PR interval? ```
increases until beat is dropped
62
2nd degree AV block Mobitz 1 (Wenchebach): QRS ?
normal
63
2nd degree AV block Mobitz 2: Rate?
variable (this one is 75-83 bpm)
64
2nd degree AV block Mobitz 2: Rhythm?
regularly irregular
65
2nd degree AV block Mobitz 2: P waves?
normal
66
2nd degree AV block Mobitz 2: P:QRS ratio
P+1:QRS (ex. 3:2, 4:3, 5:4)
67
2nd degree AV block Mobitz 2: PR interval?
normal (not the difference between Mobitz 1)
68
2nd degree AV block Mobitz 2: QRS?
Normal
69
3rd degree AV block = _____
complete
70
3rd degree AV block: | Rate?
separate rates for atria and ventricles ``` ventricles = 38 bpm atria = 115 bpm ```
71
3rd degree AV block: | Rhythm?
normal
72
3rd degree AV block: | P waves?
normal (there's usually lots of them)
73
3rd degree AV block: | P:QRS ratio ?
variable
74
3rd degree AV block: | PR interval?
variable (no pattern)
75
3rd degree AV block: | QRS ?
normal or wide
76
What drugs can cause heart block?
- beta blockers - digoxin - non-dihydropyridine calcium channel blockers (verapamil, diltiazem) - some anti arrhythmic drugs (procainamide, amiodarone, quinidine, adenosine)
77
What are other (non-drug) things can cause heart block?
- heart disease and cardiac surgery - high vagal tone (athletes) - hyperkalemia (increased K+)

Physical Assessment (6 decks)

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