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Apex Review > Cardiac rhythm monitors & equipment 2 > Flashcards

Cardiac rhythm monitors & equipment 2 Flashcards

1
Q

The heart depolarizes from the

A

base–> apex and the endocardium to epicardium

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2
Q

The heart repolarizes from the

A

apex–> base and epicardium–> endocardium

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3
Q

Which leads monitor the septum?

A

V1 & V2

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4
Q

The mean electrical vector tends to point: (select 2)
a. towards areas of hypertrophy
b. towards areas of myocardial infarction
c. away from areas of myocardial infarction
d. away from areas of hypertrophy

A

a. towards areas of hypertrophy
c. away from areas of myocardial infarction

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5
Q

The easiest way to determine axis deviation is to examine

A

lead I & aVF

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6
Q

Normal axis shows lead 1 & aVF as

A

both positive

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7
Q

Left axis deviation shows lead 1 & aVF as

A

lead 1= +
lead aVF= -

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8
Q

Right axis deviation shows lead 1 & aVF as

A

lead 1= -
lead aVF= +

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9
Q

Extreme right axis deviation shows lead 1 & aVF as

A

both negative

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10
Q

Right axis deviation is typically caused by things that

A

affect the right heart
COPD
acute bronchospasm
cor pulmonale
pulmonary embolus

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11
Q

Left axis deviation is typically caused by things that

A

affect the left heart
chronic HTN
left bundle branch block
aortic stenosis
aortic insufficiency
mitral regurgitation

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12
Q

Normal axis is between

A

-30 and +90 degrees

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13
Q

Left axis deviation is more

A

negative than -30 degrees

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14
Q

Right axis deviation is more

A

positive than 90 degrees

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15
Q

All of the following are effective for the treatment of atrial fibrillation EXCEPT:
a. verapamil
b. digoxin
c. metoprolol
d. adenosine

A

d. adenosine

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16
Q

Sinus bradycardia is defined as

A

HR <60 bpm

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17
Q

Sinus bradycardia is usually due to

A

increased vagal tone

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18
Q

The first-line treatment for sinus bradycardia is

A

atropine

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19
Q

Other treatments of sinus bradycardia include

A

external pacing or glucagon (useful for beta-blocker or CCB overdose)

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20
Q

Sinus arrhythmia is usually the result of

A

SA node’s pacing rate varying with respiration

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21
Q

Sinus tachycardia is defined as

A

HR >100 bpm

22
Q

Tachycardia reduces ___________ while increasing _________________

A

myocardial oxygen supply while increasing oxygen demand

23
Q

Causes of sinus tachycardia includes

A

SNS stimulation
hypovolemia
hypoxemia
infection
pain
thyrotoxicosis
malignant hyperthermia

24
Q

Treatment for sinus tachycardia includes

A

addressing the underlying cause and providing rate control with beta-blockers or calcium channel blockers

25
Q

Atrial fibrillation is the result of

A

chaotic electrical activity in the atrium conducted to the ventricle at a varied and irregular rate

26
Q

Atrial fibrillation results in _________________ which can reduce cardiac output in patients with poor ventricular compliance

A

loss of atrial kick

27
Q

Acute onset a-fib is treted with

A

cardioversion (start at 100 joules)

28
Q

If the onset of a-fib is >48 hours, then ___________ must be performed prior to cardioversion.

A

cardiac ultrasound such as TEE to rule out atrial thrombus

29
Q

Atrial flutter is an

A

organized supraventricular rhythm characterized by a “saw tooth” pattern

30
Q

Patients with atrial fibrillation are at risk for

A

atrial thrombus formation and stroke

31
Q

Treatment for atrial flutter includes

A

rate control medications and cardioversion

32
Q

Premature ventricular contractions originate from

A

foci below the AV node

33
Q

A PVC that lands on the second half of the T wave (during the relative refractory period) can precipitate

A

the R on T phenomenon

34
Q

Symptomatic PVCs can be treated with

A

lidocaine

35
Q

Treatment for PVCs includes the

A

reversal of hypoxia/hypercarbia, correction of electrolyte imbalances, discontinuation of QT-prolonging drugs, and repositioning a central line that’s tickling the right atrium

36
Q

The initial dose of glucagon to treat sinus bradycardia is __________- followed by__________

A

50-70 mcg/kg q3-5 min
followed by an infusion at 2-10 mg/hr.

37
Q

____________ is the most common postoperative tachydysrhythmia usually occurring between post-op day 2 and 4.

A

atrial fibrillation

38
Q

Junctional rhythm occurs when the

A

AV node functions as the dominant pacemaker

39
Q

Junctional rhythm can be caused by

A

SA node depression (volatile anesthetics), SA node block, or prolonged conduction at the AV ode

40
Q

Treatment for junctional rhythm includes

A

Atropine if hemodynamics are impacted by the slow rate

41
Q

Development of PVCs can include many things including

A

SNS stimulation
myocardial ischemia and/or infarction
valvular heart disease
cardiomyopathy
prolonged QT interval
hypokalemia
hypomagnesemia
digitalis toxicity
caffeine
cocaine
alcohol
mechanical irritation (central line insertion)

42
Q

PVCs should be treated when

A

they are frequent (>6/min), polymorphic, or when they occur in runs of 3 or more

43
Q

The most common cause of sudden cardiac death is

A

ventricular fibrillation

44
Q

Treatment for ventricular fibrillation is

A

CPR with defibrillation

45
Q

Brugada syndrome is a

A

sodium ion channelopathy in the heart

46
Q

Brugada syndrome is the most common cause of

A

sudden nocturnal death due to ventricular tachycardia or fibrillation

47
Q

Diagnostic EKG findings of Brugada syndrome includes

A

a right bundle branch block and ST-segment elevation in the precordial leads (V1-V3)

48
Q

Patients with brugada syndrome may require

A

ICD or pad placement during surgery

49
Q

During sinus arrhythmia, heart rate increases during:

A

inhalation–> decreased intrathoracic pressure–> increased venous return–> increased heart rate

50
Q

What reflex may initiate sinus arrhythmia?

A

Bainbridge reflex

Apex Review (224 decks)

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