ECG part 2

Question 1

PAT/PSVT is a sudden recurrence of ________.

Answer 1

atrial tachycardia

Question 2

With PAT/PSVT what wave is often hidden?

Answer 2

P wave

Question 3

What are the S&S for PAT/PSVT? (Hint: HOPE CRMP)

Answer 3

Hyperventilation
Overexertion
Potassium depletion
Emotional factors (ex. very anxious)
Caffeine, nicotine, and aspirin sensitivity
Rheumatic heart disease
Mitral valve dysfunction
PE

Question 4

If rapid rate continues for a period of time with PAT/PSVT what are 3 symptoms that occur?

Answer 4

Dizziness
Weakness
SOB

Question 5

Atrial flutter is a rapid succession of atrial ______ caused by ______ in the atria.

Answer 5

depolarization
ectopic focus

Question 6

What is the depolarization rate for atrial flutter?

Answer 6

250-350 times/min

Question 7

What do the P-waves look like in atrial flutter and why?

Answer 7

uniform and sawtooth
due to 1 ectopic focus

Question 8

What are the causes for A-fib? (Hint: RC DID CARS)

Answer 8

Renal failure
CHF
Digoxin toxicity
Ischemia or infarction (secondary to SA node MI)
Drug use
Cardiomyopathy
Advanced age
Rheumatic heart disease
Stress or pain

Question 9

When is A-fib considered life threatening?

Answer 9

when HR is elevated at rest

Question 10

What happens to CO when atrial kick occurs?

Answer 10

dec by 15-30%

Question 11

If an individual has atrial kick, what do they have the potential for developing?

Answer 11

mural thrombi

Question 12

How do you calculate irregular rhythm HR?

Answer 12

count R waves and x 10

Question 13

When do PVC’s occur?

Answer 13

when an ectopic focus originates an impulse from somewhere else in the ventricles

Question 14

What do the QRS complex look like with PVCs??

Answer 14

wide and bizarre and occur earlier than the normal sinus beat would have occurred

Question 15

What wave is absent with PVCs?

Answer 15

P wave

Question 16

When are PVCs considered life threatening?

Answer 16

when they are paired together
multifocal in origin
> 6 per min
land directly on T wave
present in triplets or more

Question 17

If PVCs are too frequent what can they lead to?

Answer 17

Vtach

Question 18

Vtach is a series of _______ in a row

Answer 18

3+ PVCs

Question 19

Why does Vtach occur?

Answer 19

due to rapid firing by a single ventricular focus with inc automaticity

Question 20

What wave is absent and what wave is prolonged in Vtach?

Answer 20

P wave
QT interval

Question 21

What is the ventricular rate for Vtach and what should you do if you see this?

Answer 21

100-250 bpm
call rapid response

Question 22

Vtach can be a precursor to _____.

Answer 22

Vfib

Question 23

What are the causes for Vtach (Hint: RICH)

Answer 23

Reaction to meds
Ischemia or acute infarction
CAD
Hypertensive heart disease

Question 24

What are the 5 treatments for Vtach?

Answer 24

Cardioversion
Defibrillation
Lidocaine
Bretylium tosylate (Bretylol)
Procainamide (Pronestyl)

Question 25

What is severely diminished with Vtach?

Answer 25

CO

Question 26

What is absent with Vfib?

Answer 26

CO

Question 27

What causes Vfib/Vtach to occur?

Answer 27

multiple ectopic foci fire creating asynchrony

Question 28

What 3 ECG abnormalities are medical emergencies?

Answer 28

Vfib Vtach 3rd degree block

Question 29

What will your pt be like with Vfib?

Answer 29

passed out with no or a thready pulse

Question 30

What typically causes Vfib?

Answer 30

MI

Question 31

Treatment for Vfib?

Answer 31

Defibrillation followed by CP resuscitation, supplemental O2 and injection of meds