ECG/Arrhythmias

Question 1

How often should electrodes be changed?

Answer 1

every 24 hours

Question 2

How much time does one tiny box on an ECG translate to?

Answer 2

0.04 seconds

Question 3

How much time does one large box on an ECG translate to?

Answer 3

0.20 seconds

Question 4

How much time does one standard ECG strip cover?

Answer 4

6 seconds

Question 5

What does the P wave represent?

Answer 5

atrial depolarization

Question 6

What does the QRS complex represent?

Answer 6

ventricular depolarization

Question 7

What does the ST segment represent?

Answer 7

Beginning of ventricular repolarization

Question 8

What does the T wave represent?

Answer 8

ventricular repolarization

Question 9

What is the range for a HR on an ECG to be considered “normal” pace?

Answer 9

60-100 bpm

Question 10

How do you measure bpm by looking at an ECG strip?

Answer 10

count # of R waves x 10

Question 11

What should the P:QRS ratio be on an ECG?

Answer 11

1:1

Question 12

If the P waves on an ECG look different what does this mean?

Answer 12

the wave is coming from a different point of origin that is not the SA node

Question 13

What is the time range for a PR interval to be considered “normal”?

Answer 13

0.12-0.20 seconds (3-5 small boxes)

Question 14

How long should the QRS complex be to be considered “normal”?

Answer 14

</= 0.12 seconds (3 little boxes or less)

Question 15

What are the types of sinus rhythms?

Answer 15

sinus rhythm, sinus bradycardia, sinus tachycardia, and sinus arrhythmia

Question 16

What are the classifications for a sinus rhythm?

Answer 16

rate: 60-100 bpm
regular rhythm
1:1 P:QRS ratio
PR interval 0.12-0.20 seconds
QRS complex < 0.12 seconds

Question 17

What are the classifications of sinus bradycardia?

Answer 17

rate < 60 bpm
regular rhythm
1:1 P:QRS ratio
PR interval of 0.12-0.20 seconds
QRS complex less than 0.12 seconds

Question 18

What are the classifications of sinus tachycardia?

Answer 18

rate > 100 bpm
regular rhythm
1:1 P:QRS ratio
PR interval of 0.12-0.20 seconds
QRS complex less than 0.12 seconds

Question 19

What are the types of atrial rhythms?

Answer 19

PACs, atrial fibrillation, and atrial flutter

Question 20

Are PACs normal?

Answer 20

yes in healthy people- only problematic if they are frequent and/or symptomatic

Question 21

What does a PAC look like?

Answer 21

a P wave being masked by a T wave

Question 22

What are the classifications for atrial fibrillation?

Answer 22

irregular rhythm
no P waves
usually narrowed QRS complex

Question 23

What are the classifications for atrial flutter?

Answer 23

usually a regular rhythm
sawtooth pattern
3:1 or 4:1 P:QRS interval

Question 24

What are the different ventricular rhythms?

Answer 24

PVCs, ventricular tachycardia, and ventricular fibrillation

Question 25

What are the classifications for PVCs?

Answer 25

- no P wave - no PR interval - wide QRS complex - T wave is usually in the opposite direction of the QRS complex

Question 26

What are the classifications for ventricular tachycardia?

Answer 26

usually regular rhythm fast rate no P waves essentially just a lot of PVCs that don't stop

Question 27

What are the classifications for ventricular fibrillation?

Answer 27

just looks like chaos

Question 28

What can cause bradycardia?

Answer 28

lower metabolic needs, vagal stimulation, medication side effects (beta-blockers, CCBs), sick sinus syndrome, and heart disease

Question 29

When should bradycardia be treated?

Answer 29

only when it is symptomatic

Question 30

What are the treatment options for bradycardia?

Answer 30

treating the underlying cause (meds or physiological issue), medications (atropine and epinephrine), and pacemaker (only when too low to maintain good CO)

Question 31

What can cause tachycardia?

Answer 31

stress to the body (blood loss, shock, anxiety, exercise, etc.), meds and illicit drugs, autonomic dysfunction (POTS)

Question 32

What are the treatment options for tachycardia?

Answer 32

meds (beta-blockers, CCBs), vagal maneuvers

Question 33

What is SVT?

Answer 33

any HR greater than 150

Question 34

What is the treatment for SVT?

Answer 34

- synchronized cardioversion (in unstable/symptomatic cases) - adenosine per ACLS guidelines

Question 35

What causes PACs?

Answer 35

atrial dilation, cardiac ischemia/infarct, anxiety/stress, substances, electrolytes (low K)

Question 36

What causes PVCs?

Answer 36

ischemia/infarct, increased workload to heart, substances, electrolytes (low K and Mg)

Question 37

What are the treatments for PACs and PVCs?

Answer 37

treat underlying cause, meds (amiodarone and betablockers)

Question 38

When should premature contractions be treated?

Answer 38

only when symptomatic

Question 39

What causes atrial flutter/fibrillation?

Answer 39

impairment to cardiac system, age, diabetes, obesity, OSA, ETOH abuse, smoking, genetics

Question 40

A-fib increases the risk of what complication?

Answer 40

emboli due to pooled blood

Question 41

What are possible treatments of a-fib/flutter?

Answer 41

procedures (TEE/cardioversion, ablation, pacemaker), meds for rate management (beta-blockers and CCBs), meds for rhythm management (antiarrythmics), clot prevention meds (anticoagulants, antiplatelets)

Question 42

What causes ventricular fibrillation?

Answer 42

cardiac damage, acid-base and electrolyte imbalances, medication AEs

Question 43

What is the treatment for ventricular fibrillation?

Answer 43

defibrillation