Class 1 Flashcards
1
Q
major pacemaker of the heart
A
sinoatrial node
2
Q
intrinsic rate of SA node
A
60-100 bpm
3
Q
second to take over if SA node fails as pacemaker
A
atrioventricular node
4
Q
intrinsic rate of AV node
A
40-60 bpm
5
Q
third to take over if SA node and AV node fail as pacemaker
A
purkinje fibers
6
Q
intrinsic rate of purkinje fibers
A
30-40 bpm
7
Q
in a 3rd degree AV block, what is the expected HR
A
30-40 bpm
8
Q
what is the J point
A
where the S wave comes back to the isoelectric line
9
Q
isoelectric line AKA
A
baseline
10
Q
T or F: at the isoelectric line there is no electrical current flowing
A
true
11
Q
should the Q wave be above or below the isoelectric line
A
below
12
Q
should the R wave be above or below the isoelectric line
A
above
13
Q
the S wave must do this
A
return to the isoelectric line
14
Q
where is the normal ST segment
A
at the isoelectric line
15
Q
should the T wave be above or below the isoelectric line
A
above
16
Q
a low/flat T wave can indicate what
A
ischemia
17
Q
a peaked T wave can indicate what
A
high potassium
18
Q
a visible U wave can indicate what
A
low potassium
19
Q
according to the AHA, how long do you have to intervene after an EKG shows an elevated or depressed ST segment
A
30 mins
20
Q
a deep or wide Q wave can indicate what
A
necrosis/MI
21
Q
what does a notch in the R wave indicate
A
bundle branch block
22
Q
largest muscle in heart
A
left vent
23
Q
pacing spike
A
pacemaker has discharged an electrical impulse
24
Q
capture (pacemaker)
A
pacemaker has successfully depolarized the chamber
25
asynchronous/fixed (pacemaker)
pacemaker not programmed to sense intrinsic electrical activity
26
synchronous/demand (pacemaker)
pacemaker programmed to sense intrinsic electrical activity
27
this type of pacemaker is not programmed to fire unless electrical activity is not sensed
synchronous/demand
28
this type of pacemaker fire's when it is programmed even if it does not need to fire based off of the intrinsic electrical activity
asynchronous/fixed
29
type of pacemaker that is across the skin and can cause painful electric shocks
transcutaneous
30
T or F: the nurse should wear gloves when caring for a patient with a transcutaneous pacemaker
TRUE
31
with this type of pacemaker BP should be taken only in the R arm or lower extremity and pulses may need to be taken with the carotid artery
transcutaneous
32
this type of pacemaker is used only in an emergency situation for someone who does not have an implanted pacemaker
transcutaneous
33
this type of pacemaker is threaded through an vein similar to a central line and goes into an artery in the heart
epicardial
34
pacemaker that has a probe attached to the heart during surgery
epicardial
35
important for positioning pt with endocardial pacemaker
HOB not too high
| keep legs straight (if inserted in femoral)
36
you must assess for this after the placement of a permanent pacemaker
pneumothorax
37
type of pacemaker that is placed for recurrent/chronic dysrhythmias
permanent
38
holter monitor
can be worn at home and data can be looked at in office at any time
39
telemetry monitor
in hospital monitoring, no monitor in room, someone looks at screen outside of room
40
cardiac monitor
monitor is in the pts room
41
indicators of a pacemaker malfunction
pacing at inappropriate rate
| s/s that were present prior to pacemaker placement
42
issue when pacemaker fires an impulse but the myocardium does not depolarize
failure to capture
43
issue when pacemaker fails to sense P wave or QRS complex
undersensing
44
which pacemaker issue can result in overpacing
undersensing
45
issue when pacemaker sense other electrical activity as a P wave or QRS complex
oversensing
46
which pacemaker issue can result in underpacing
oversensing
47
what can cause a pacemaker to oversense
increased potassium
48
normal appearance of QRS complex
peaked
49
normal appearance of P wave
rounded, upright
50
normal duration of PR interval
0.12-0.20
51
normal duration of QRS complex
0.12 or less
52
what can an elevated or depressed ST segment indicate
injury to myocardium
53
T or F: normal is no Q wave
TRUE
54
a synchronized cardioversion is done when there is an issue with which wave
R wave
55
what does a synchronized cardioversion do
depolarize myocardial cells
| stop chaotic heart activity
56
pt gets this due to dysrhythmia that requires emergent attention
implantable cardio defibrillator
57
delivers a very strong shock that can cause pt to fall over, shake, etc
implantable cardio defibrillator
58
pt should not drive until they know the effect the shock of this device has on them
implantable cardio defibrilator
59
make sure there is a ___ for every QRS complex
P wave
60
common causes of sinus bradycardia
```
well conditioned athlete
vagal stim
decreased metabolic rate
heart disease
medications
```
61
dysrhythmia in which the sinus node creates an impulse at a below normal rate
sinus bradycardia
62
meds that can cause sinus bradycardia
amiodarone
beta blockers
CA channel blockers
digoxin
63
interventions/meds to correct sinus bradycardia
atropine
pacing
dopamine
epinepherine
64
dysrhythmia in which the PR interval is >0.20 seconds but all impulses are conducted to the ventricles
first degree AV block
65
the PR interval is greater than normal in these dysrhythmias
AV block
66
dysrhythmia in which the PR interval is progressively prolonged until the impulse is not conducted to the vents
second degree AV block type I
67
dysrhythmia in which the PR interval is constant but not all impulses are conducted to the ventricles
second degree AV block type II
68
dysrhythmia in which there is a complete block of all impulses to the ventricles
third degree AV block
69
junctional rhythm
the AV node is the pacemaker instead of the SA node
70
dysrhythmia in which the sinus node creates an impulse at a faster than normal rate
sinus tachycardia
71
common causes of sinus tachycardia
increased sympathetic tone
| increased metabolic demands (fever, exercise)
72
interventions used to treat sinus tachycardia
indentify, correct, and eliminate underlying cause
73
dysrhythmia in which an electrical impulse starts in the atrium before the next normal impulse of the SA node occurs
premature atrial contraction (PAC)
74
dysrhythmia in which there is uncoordinated electrical activation that causes a rapid, disorganized twitching of the atrial muscles
a fib
75
common causes of PAC and SVT
increased catecholamine levels
heart disease
caffeine
76
interventions/meds used to treat PAC/SVT
```
vagal maneuvers
synchronized cardioversion
adenosine
beta blockers
CA channel blockers
```
77
T or F: in supraventricular tachycardia, there is an abnormal QRS complex
false, the QRS complex is normal
78
risk when giving adenosine
can cause absent HR for around 2 mins
| can cause bronchospasm
79
pts with these issues should not be given adenosine
asthma
| COPD
80
have this ready when giving adenosine
crash cart
81
common causes of a-fib/flutter
advanced age
| heart disease
82
interventions/meds used to treat a fib/flutter
```
vagal maneuvers
synchronized cardioversion
beta blockers
CA channel blockers
if HF present: amiodarone and digoxin
```
83
these meds are used to treat a-fib/flutter only if HF is present
amiodarone
| digoxin
84
more than 3 PVCs in a row
v tach
85
2 areas of the ventricle with abnormal activity
PVCs
86
common causes of PVCs
electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires
87
what can happen as a result of frequent PVCs
decreased cardiac output leading to v tach/v fib
88
interventions used to treat PVCs
search for possible reversible causes
89
common causes of v tach
electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires
90
interventions used to treat v tach w/ pulse
```
synchronized cardioversion (only for monomorphic)
amiodarone
lidocaine
pronestyl
sotalol
```
91
tx for polymorphic v tach
defibrillation
92
interventions used to treat v tach w/ no pulse
```
PT IS IN CARDIAC ARREST
CPR
defibrillation
epinepherine
amiodarone
lidocaine
```
93
dysrhythmia in which there is a rapid disorganized ventricular rhythm that causes ineffective quivering of the ventricles and no atrial activity
v fib
94
common causes of v fib
electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires
95
interventions used to treat v fib
```
PT IS IN CARDIAC ARREST
CPR
defibrillation
epinepherine
amiodarone
lidocaine
```
96
dysrhythmia in which there is an absent QRS complex confirmed by 2 leads
asystole
97
interventions used to treat asystole
PT IS IN CARDIAC ARREST
CPR
epinepherine
ID and treat reversible causes
98
dysrhythmias in which the pt is in cardiac arrest
asystole
v fib
v tach w/ no pulse
99
examples of pulses electrical activity
pericarditis
| cardiac tamponade
100
s/s of cardiac tamponade
SOB
muffled heart sounds
JVD
pulsus paradoxus
101
T or F: you should shock a pt with asystole and a pulseless electrical activity
false
