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Adult Health 1 - (Josh) > ECG Interpretation Part 1 (Josh) > Flashcards

ECG Interpretation Part 1 (Josh) Flashcards

1
Q

What is Ejection Fraction (EF)?

A

ratio of the SV ejected from the left ventricle with each beat to the volume of blood at the end of diastole (LVEDV)

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2
Q

What is a normal Ejection Fraction?

A

greater than 50%

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3
Q

What does an Ejection Fraction less than 35% indicate?

A

Poor Ventricular Function

Poor Ventricular Filling

Obstruction to Outflow

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4
Q

Which heart node fires off first?

A

SA node fires before AV node

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5
Q

What is LVEDV?

A

Left Ventricular End Diastolic Volume

What SV is compared with to get the Ejection Fraction

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6
Q

Ejection Fraction is a good indicator of — —

A

heart function

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7
Q

Which node is the Pacemaker?

A

SA node

**starts the spontaneous conduction of the heart

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8
Q

Cardiac Conduction:

What is the P-wave indicative of?

A

Atrial Contraction

  • Depolarization of Atrium
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9
Q

Cardiac Conduction:

What does the PR Interval show us?

A

If there is any difficulty between conduction between the SA Node and the AV Node

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10
Q

If there is a problem with the AV node, where would we see it on ECG?

A

PR Interval

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11
Q

What does the QRS Complex represent?

A

Ventricular Depolarization

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12
Q

What QRS Complex is considered normal?

Abnormal?

A

Normal = Narrow

Abnormal = Wide

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13
Q

What does the ST Segment represent?

A

Beginning of repolarization

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14
Q

What does the T Wave represent?

A

Repolarization of Ventricle

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15
Q

What is a normal SA Node rate?

A

60 -100 bpm

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16
Q

What is a normal AV Node rate?

A

40- 60 bpm

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17
Q

What is contraction of AV Node called?

A

Atrial Kick

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18
Q

AV Node contraction is signified by — —

A

PR Segment

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19
Q

SA Node contraction is signified by — —

A

P Wave

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20
Q

What is normal rate of Bundle of His contraction?

A

20 - 40 bpm

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21
Q

What is the normal rate of contraction in the Perkunjie Fibers?

A

less than 15 bpm

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22
Q

Reading an ECG:

How much time does each 1 mm square count?

A

0.04 seconds

***5 mm square is 0.2 seconds

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23
Q

Reading an ECG:

How is amplitude measured?

A

milimeters

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24
Q

Reading an ECG:

How is duration measured?

A

seconds

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25
Reading an ECG: What is baseline?
isoelectric line
26
Reading an ECG: What is the length of a typical measurement strip?
6 seconds
27
How do you estimate HR with ECG Waveform strip?
count number of QRS complexes in each 6 six second interval and multiply by 10 ex: if there are 9 QRS in 6 secs, then the HR is 90 bpm
28
Reading an ECG: What is PR Segment?
the time required for impulse to travel through AV node, where it is delayed, and through the bundle of His, perkunjie fibers, just before Ventricular depolarization end of P wave to beginning of QRS
29
Reading an ECG: What is PR Interval?
Beginning of P-Wave to beginning of QRS (end of PR segment) ***represents time required for Atrial depolarization as well as impulse travel through BoH and Perkunjie.
30
Reading an ECG: What does QRS Complex represent?
ventricular depolarization
31
Reading an ECG: What is the J Point?
the junction where the QRS ends and the ST segment begins
32
Reading an ECG: What is the ST Segment?
early part of ventricular repolarization
33
Reading an ECG: What is the T Wave?
ventricular repolarization
34
Reading an ECG: What is the U Wave?
late part of ventricular repolarization
35
Reading an ECG: What is the QT Interval?
represents total time required for ventricular depolarization and repolarization
36
Reading an ECG: How is QT Interval measured?
beginning of QRS to the end of T-Wave
37
P-Wave: What is normal duration?
0.12-0.2 secs ****3-5 blocks (each block is 0.04 secs)
38
What should shape of P-Wave look like?
upright rounded ***should all look the same because there is only one SA Node
39
Abnormal P Waves: What is a tall, peaked P Wave?
P Pulmonale ***indicates right atrial hypertrophy
40
Abnormal P Waves: What is an M-shaped P Wave?
P Mitrale * **indicates left atrial hypertrophy * **Mitral valve goes with left side of heart
41
QRS: What is normal QRS duration?
0.06 - 0.1 seconds or less than 0.12
42
Which part of ECG shows ventricular excitation, contraction, and recovery?
QT Interval
43
What does length of QT Interval depend on?
HR * **faster HR = short QT * **slower HR - long QT
44
What are normal upper limits on QT Interval?
0.39 - 0.43 secs ***dependent upon HR
45
How long should QT Interval be in relation to the R to R Interval?
QT should be half of R-R Interval ***if more than that it is PROLONGED
46
A normal QT Interval should be --- of the RR Interval.
half
47
What is a Corrected QT Interval (QTc)?
adjusts QT Interval to account for HR ***Normal QTc = less than 0.44 secs
48
What is a normal QTc?
less than 0.44 secs
49
Why are we worried about QT Interval?
prolonged can lead to V-tach (lethal)
50
Reading an ECG: Which part of ECG is the time of no electrical activity?
ST Segment ***don't measure LENGTH ***MEASURE HEIGHT ONLY
51
How is an ST Segment described?
by height - isoelectric (flat) - elevated - depressed
52
Reading an ECG: Which part indicates Ventricular Repolarization?
T-wave **do NOT measure duration
53
How is a T-wave described?
upright, round and smooth, inverted, peaked or depressed
54
Reading an ECG: What is the U Wave?
repolarization of His-Perkunjie * **normal in kids * **not normal in adults
55
What does U Wave signify in adults?
Hyperthyroidism or Hypokalemia
56
When doing ECG Rhythm analysis, what are we assessing?
Regularity Rate P-wave PR Interval QRS duration Interpret Rhythm
57
ECG Rate Determination: How do we determine rate if it is regular? How do we determine rate if it is irregular?
Regular: count number of small boxes between 2 R waves and divide into 1500 Irregular: count number of R waves in a 6 second strip
58
What is Normal Sinus Rhythm?
Regular Rate = 60-100 P Wave = normal and upright with 1:1 with QRS PR Interval = 0.12 - 0.2 secs and constant QRS = 0.04 - 0.1 and constant
59
What rate is Sinus Tachycardia?
101-150 ***treat by correcting underlying cause not to decrease the rate
60
What is Sinus Bradycardia?
less than 60 bpm
61
What are causes of Sinus Bradycardia?
Increased Parasympathetic Tone in Athletes (Lance Armstrong) SA Nodal disease (Sick Sinus Syndrome) Medications VAGAL STIMULATION
62
What is the hemodynamic effect of Sinus Bradycardia?
Decreased CO Hypotension - orthostatic - syncope
63
What is the management for Symptomatic Bradycardia?
Atropine (DOC) Pacemaker ***only treat sinus bradycardia if it is symptomatic
64
Sinus Bradycardia: What is PR Interval? QRS?
PRI = 0.12 to 0.20 QRS = less than 0.12
65
Which is a Sinus Arrhythmia?
normal rate with irregular rhythm ***not normal for adults
66
What is cause of Sinus Arrhythmia?
HR varies with respiration due to fluctuations in parasympathetic outflow
67
What is a PAC?
Premature Atrial Contraction: single beat originates in atria and comes early in cardiac cycle ***Cyclic ***Bigeminy (every other beat) ***Trigeminy (every other beat)
68
What is difference between Atrial Tachycardia and Sinus Tachycardia?
the rate is more in Atrial Tach (150-250) than in Sinus Tach (101-150)
69
What would the rate of an Atrial Flutter be and what would P Wave look like?
250-350 bpm P-Wave has a 'sawtooth' appearance
70
What is the hemodynamic effect of Atrial Fibrillation?
lose Atrial Kick decreased SV ***CO can decrease by 20-30%
71
What is the most common dysrhythmia?
A-fib ***Can be compensated for if Ventricular Response is high enough (80 bpm or something like that)
72
What is the main problem with A.Fib?
atria is quivering and not pumping blood good so.... STASIS of BLOOD in atria that can lead to PE, VTE, etc
73
Management for A.Fib?
Get them out of the rhythm Control Ventricular Response Prevent complications from stasis of blood
74
What is a Junctional Rhythm?
AV node takes over when a higher pacemaker fails to initiate AV node
75
How do you tell difference between Junctional Rhythm and Sinus Bradycardia?
inverted P Wave in Junctional Rhythm ***both have slow rate of 40-60
76
If they have a Symptomatic Junctional Rhythm, what med do we give?
Atropine
77
Why does the Junctional Rhythm have an inverted P Wave?
electrical rhythm is going back up the heart
78
What can Dig Toxicity cause?
Premature Junctional Contractions
79
What is Supraventricular Tachycardia?
a broad term for a group of rhythms originating ABOVE the ventricle ***any fast rhythm not coming form ventricle
80
What does the QRS look like in a Premature Ventricular Contraction (PVC)?
wide and bizarre ***can be positive (going up) or negative (going down)
81
What is an R on T?
a Preventricular Contraction that happens on top of T wave ***QRS will be on top of T Wave
82
What is danger with an R on T?
Can cause V-tach
83
If V-tach is with a pulse, treat with ---- If V-tach is without a pulse, treat with ----
meds defibrillation ***always check for a pulse with V-tach
84
V-tach caused by prolonged QT Interval?
Torsades do Pointe **correct cause and give IV Mag
85
What is an Idioventricular Rhythm?
QRS is wide and bizarre (greater than 0.12) with a slow rate (20-40 bpm)
86
What meds with Idioventricular Rhythm?
Atropine PPM ***not Amiodarone or Lidocaine because it's the only rhythm we have
87
Nursing mgmt for Vfiv or Pulseless Vtach?
Check for pulse (if none, then) Shock CPR for 5 cycles (about 2 mins) Check for Pulse
88
What are shockable rhythms?
Pulseless Vtach Vfib
89
What is Ventricular Asystole?
no electrical activity and a flat line on ECG monitor
90
Mgmt for Ventricular Asystole?
Check diff. lead CPR (NOT SHOCKABLE) Epi every 3-5 mins
91
Can you shock | Ventricular Systole?
NO give CPR and Epi q 3-5 mins
92
What is PEA?
Pulseless Electical Activity ***electical activity with no corresponding contraction, which means no PULSE
93
What are the 5 H's of PEA?
Hypovolemia Hypoxia Hydrogen ions (acidosis) Hyper or Hypokalemia Hypothermia
94
What are teh 5 T's of PEA?
Tables (drug overdose) Tamponade Tension Pneumothorax Thrombosis (coronary or pulmonary)
95
What is the Compression/Ventilation ratio for CPR?
30:2
96
Which AV Block? All sinus impulses eventually reach ventricles.
First Degree
97
Which AV Block? Some sinus impulses reach ventricles but some do not
Second Degree
98
Which AV Block? No sinus impulses reach ventricles.
Third Degree
99
What does P Wave look like with Wenckebach (Type 1) Second Degree AV Block?
progressively lengthens until one P Wave is blocked ***blocked means you have a P Wave with no corresponding QRS
100
What are the two types of Second Degree AV Blocks?
Type 1 (Weckebach) ``` Type 2 (Mobitz) *** no warning with this one ```
101
Which type of Second Degree block is worse?
Type 1 is usually benign Type 2 is MORE OMINOUS
102
What do P Waves and QRS look like in Complete (Third Degree) AV Block?
not connected P Waves regular to themselves QRS regular to themselves

Adult Health 1 - (Josh) (26 decks)

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