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G270 MS Exam #1 > ECG Bootcamp > Flashcards

ECG Bootcamp Flashcards

(71 cards)

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1
Q

What is plan A?

A

SA node

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2
Q

What is plan B?

A

AV node

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3
Q

What is Plan C?

A

AV bundle

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4
Q

What is plan D?

A

Purkinje Fibers

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5
Q

SA node inherent rate

A

60-100bpm

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6
Q

AV node inherent rate

A

40-60 bpm

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7
Q

Bundle of HIS inherent rate

A

20-40 bpm

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8
Q

Cardiac Monitoring where leads go

A

“White over Right”
“Clouds over grass”
“Smoke over Fire”
“Chocolate close to the heart”

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9
Q

Small box seconds

A

0.04 seconds

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10
Q

Large box seconds

A

0.2 seconds

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11
Q

Large box=___small boxes

A

5

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12
Q

PR interval length

A

0.12-0.20 seconds

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13
Q

QRS complex length

A

0.06-0.12 seconds

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14
Q

ST segment length

A

0.08-0.12 seconds

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15
Q

Q length

A

< 0.04 seconds

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16
Q

Normal Sinus rhythm rate

A

60-100 bpm

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17
Q

P-wave in NSR

A

Normal

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18
Q

Sinus Tachycardia rate

A

100-150 bpm

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19
Q

Causes of sinus tachycardia (9)

A
  • hyperthyroidism
  • hypovolemia
  • HF
  • anemia
  • exercise
  • use of stimulants
  • fever
  • pain
  • anxiety
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20
Q

What to assess for in sinus tachycardia?

A

Low cardiac output

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21
Q

Treatment for sinus tachycardia (4)

A

Treat cause—> pain med, antipyretics, hydration, etc

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22
Q

Sinus Bradycardia rate

A

Bpm less than 60

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23
Q

Causes of sinus bradycardia (7)

A
  • vagal response
  • drugs
  • ischemia
  • disease of the nodes
  • ICP
  • hypoxemia
  • athletes
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24
Q

Difference between asymptomatic and symptomatic sinus Brady

A

Symptomatic —> decreased CO

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25
What to do for symptomatic Brady
Assess and tx cause
26
Interventions for sinus brady
- atropine - transcutaneous pacing - dopamine or epinephrine infusion
27
When to not use atropine to tx sinus bradycardia
When the bradycardia is associated with hypothermia
28
What is sinus arrhythmia?
Sinus rhythm but the rate varies with inspirations
29
Rate changes with sinus arrhythmias
Inspire=increase in rate | Expire=decrease in rate
30
Does sinus arrythmia affect hemodynamics status?
Very rarely
31
What happens in sinus arrest/pause?
SA node fails to fire —> no PQRST complex
32
Causes of sinus arrest (5)
- MI - hyperkalemia - digoxin - OD - physiological response to increased vagal tone
33
For atrial dysrhythmias, where is it seen on the EKG?
Changes in the p wave
34
Premature Atrial Contraction —> what is seen in the EKG?
Early p wave..may be seen in the t wave
35
Rate of Supraventricular tachycardia or paroxysmal SVT
150-250 bpm and regular
36
Rate of atrial tachycardia
150-250 bpm
37
Main difference between SVT and AT
1:1 conduction for AT —> ventricle responds to every atrial impulse……SVT —> abrupt onset and cessation
38
Pattern of atrial flutter
Sawtooth pattern
39
Causes of atrial flutter (6) and intervention
- lung disease - ischemic heart disease - Hyperthyroidism - hypoxemia - HF - alcoholism Intervention —> address cause
40
A fib characteristics (3)
- no discernible p wave - irregular ventricular rate - results in loss of atrial kick
41
What is someone with a fib at risk for
Pulmonary or systemic emboli
42
What are junctional rhythms?
When the AV node takes over as the conduction system “gate keeper”
43
What is the junctional escape rate
40-60 bpm
44
Accelerated junctional rate
60-100 bpm
45
Junctional bradycardia rate
Less than 40 bpm
46
Since the location of the AV node is in the center of the heart, what happens to the impulses that are generated from it?
They may be conducted forward, backward, or both
47
What happens to the EKG in the junctional escape rhythm?
P-wave changes —> may be inverted, absent, or may follow QRS
48
Rate and rhythm of junctional escape rhythm
Regular (not from SA node) usually 40-60 bpm
49
Accelerated junctional rate
60-100bpm
50
Patient response to accelerated junctional
Decrease in CO and hemodynamic instability, depending on the rate
51
Causes of accelerated junctional- 6
- SA node disease - ischemic heart disease - electrolyte imbalances - dig. Toxicity - acute MI - hypoxemia
52
Treatment of accelerated junctional
-treat tachycardia if hemodynamically unstable and alert the provider to change the rhythm
53
What happens to EKG in ventricular dysrhythmias?
Wide and bizarre QRS
54
Characteristics of premature ventricular contractions-3
- wide irregular QRS - QRS complex greater than 0.12 sec - absent p waves
55
Types of PVCs-5-and what they are
- pairs (couplets): 2 sequential pvc - runs or bursts: 3 or more sequential PVCs (aka vtach) - bigeminy PVC: every other beat is a PVC - trigeminy PVC: every third beat is a PVC - Quadrigeminy PVC: every 4th beat is a PVC
56
WHen are PVCs dangerous?-4
- frequent, multi focal - two or more in a row - PVC falls into the vulnerable period of the T wave - may lead to Vtach (pulse less VT) or ventricular fib.
57
What is Vtach?-5
- 3 or more PVCs in a row - greater than 100 bpm (may go up to 300) - wide QRS complexes - pulse and pulse less VT - treatment pulse less same as v fib
58
Causes of VT-10
- hypoxemia - acid-base imbalances - exacerbation of HF - ischemic heart disease - cardiomyopathy - hypokalemia - hypomagnesemia - valvular heart disease - genetic abnormalities - QT prolongation
59
Torsades de Pointes aka…
“Twisting about the point”
60
Torsades de pointes is a type of ____ and what needs to be done
- type of VT | - lethal and treated as pulseless VT—> CPR!!!!!!
61
Cause of torsades de pointes
Magnesium deficiency
62
V fib characteristics-4
- chaotic pattern - no discernible P, Q, R, S or T - coarse or fine - no CO
63
What to do first for V fib
Check pt-make sure not a loose lead
64
What needs to be done after the patient is checked for a loose lead with v fib (if its not a loose lead)?
IMMEDIATE CPR AND DEFIBRILLATION
65
What is an idioventricular rhythm?
Escape ventricular rhythm from purkinje fibers
66
Rate for idioventricular rhythm
15-40 bpm, regular rhythm
67
Characteristics of idioventricular rhythm
- wide QRS | - no p waves
68
Pulseless electrical activity —> what is it?
Looks like a normal rhythm, but no pulse
69
Pulseless electrical activity —> what to assess
- apical and carotid pulses | - quick cardio assessment
70
PEA causes 5 H’s
- hypoxia - hypovolemia - hypothermia - H+ ions (acidosis) - Hypo or hyperkalemia
71
PEA causes 5 T’s
- Tablets (OD) - tamponade (cardiac) - tension pneumothorax - thrombosis (coronary) - Thrombosis (pulmonary

G270 MS Exam #1 (6 decks)

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