CH9 Ventricular Dysrhythmias

Question 1

ventricular pacemaker cells are found within ___

Answer 1

Purkinje Fibers

Question 2

inherent rate of the purkinje fibers

Answer 2

20-40 bpm

Question 3

Ventricular rhythms occurring within the range of the Purkinje network (20-40 bpm) are occasionally referred to as ____

Answer 3

Ventricular Escape Rhythms

Question 4

What does PVC stand for

Answer 4

Premature Ventricular Complex

Question 5

What is a PVC

Answer 5

An ectopic impulse that occurs early in the cycle and originates from the ventricles

Question 6

How to identify a PVC

Answer 6

Early QRS complex that measures 0.12 secs or longer, and has a wide and bizarre appearance.
No P wave

Question 7

Unifocal PVC

Answer 7

rhythm strip shows multiple PVCs have a similar shape
Suggests only one irritable focus present

Question 8

Multifocal PVC

Answer 8

PVCs have varied shapes and forms
suggests more than 1 irritable focus

Question 9

Interpolated PVC

Answer 9

PVC occurs during the normal R-R interval without interrupting the rhythm

Question 10

Occasional PVC

Answer 10

Less than 6 PVCs per minute

Question 11

Frequent PVC

Answer 11

6 or more PVCs per minute

Question 12

Bigeminy PVC

Answer 12

Every other complex is a PVC

Question 13

Trigeminy PVC

Answer 13

Every 3rd complex is a PVC

Question 14

Quadgeminy PVC

Answer 14

Every 4th complex is a PVC

Question 15

R-on-T PVC

Answer 15

PVC occurs on the T wave

Question 16

Coupling PVC

Answer 16

2 PVCs that occur back to back

Question 17

Run of Ventricular Tachycardia

Answer 17

3 or more PVCs in a row at 100+ bpm

aka. triplet PVC

Question 18

Paroxysmal event

Answer 18

Witnessed change in any cardiac rhythm

ex. change from sinus rhythm to SVT (supraventricular tachycardia)

Question 19

Agonal Rhythm

Answer 19

occur when essentially all of the pacemakers in the heart have failed.

Question 20

How to identify an agonal rhythm

Answer 20

absence of P waves
ventricular rate of less than 20 bpm
wide and bizarre QRS complexes

Question 21

Are patients unconscious when an agonal rhythm is seen

Answer 21

yes

Question 22

idioventricular rhythm

Answer 22

occur when the SA and Junctional pacemakers fail to initiate an impulse and all that remains is the slow ventricular pacemaker (20-40 bpm)

Question 23

how to identify an idioventricular rhythm

Answer 23

absence of p waves
slow ventricular rate of 20-40 bpm
wide and bizarre QRS complexes

Question 24

accelerated ventricular rhythm

Answer 24

occur when SA and junctional pacemakers fail to initiate an impulse and all that is remaining is the slow ventricular pacemaker, which is now faster at a range of (40-100 bpm)

Question 25

how to identify an accelerated idioventricular rhythm

Answer 25

the accelerated idioventricular rhythm has an absence of P waves
ventricular rate of 40-100 bpm
wide and bizarre QRS complexes

Question 26

Ventricular Tachycardia

Answer 26

occurs when 3 or more PVCs occur in a row and the ventricular rate is greater than 100 bpm

Question 27

Torsades de pointes

Answer 27

type of ventricular tachycardia where the morphology of the PVCs change and look like a twisty ribbon

Question 28

How to identify Ventricular Tachycardia

Answer 28

Wide and bizarre QRS complexes with a Sawtooth appearance
100+ bpm. And No P Waves

Question 29

Ventricular Fibfrillation

Answer 29

Chaotic, asynchronous electrical activity within the ventricular tissue
The entire myocardial quivers

Question 30

How to identify Ventricular Fibrillation

Answer 30

Absence of organized electrical activity
Tracing is disorganized or chaotic in appearance

Question 31

Will every patient experiencing V Fib be unconscious, unresponsive, and apneic?

Answer 31

Yes

Question 32

Asystole

Answer 32

Absence of ventricular activity and depolarization. Straight line or flat line rhythm

Question 33

How to identify asystole?

Answer 33

No waveforms. Flat.
No P, QRS, T, U