ECG Rhythms (Module 4) Flashcards by Gabriella Arias

To Treat or Not to Treat

assess/treat the pt and not the monitor

is pt symptomatic?
give O2 and monitor saturation
monitor BP and HR
start IV if not already established
notify MD

How well did you know this?

Not at all

Perfectly

Five Steps to Identify HR

rate?
rhythm? irregular (varies more than 0.08 s)
P wave before each QRS? Are P waves upright and uniform in lead II
what is length of PR interval? 0.12-.2 s (3-5 small squares)
do all QRS complexes look alike? 0.06-.12s (1.5-3 small squares)

How well did you know this?

Not at all

Perfectly

P wave

atrial depolarization

How well did you know this?

Not at all

Perfectly

PRI

the time it takes for the impulse to reach the ventricles

How well did you know this?

Not at all

Perfectly

QRS complex

ventricular depolarization and atrial repolarization (masked by QRS)

How well did you know this?

Not at all

Perfectly

T wave

ventricular repolarization

How well did you know this?

Not at all

Perfectly

U wave

Purkinje fiber repolarization (if visible)

How well did you know this?

Not at all

Perfectly

PLEASE REVIEW ECG STRIPS OF ARRHYTHMIAS

How well did you know this?

Not at all

Perfectly

Sinus Bradycardia

normal in some athletes
response to carotid massage, Valsalva, hypothermia, parasympathetic drugs, increased ICP, hypothyroidism, inferior wall MI

How well did you know this?

Not at all

Perfectly

Sinus Bradycardia ECG Characteristics

HR less than 60

normal and inverted QRS??

How well did you know this?

Not at all

Perfectly

Sinus Bradycardia Significance and Treatment

pale
cool skin
hypotension
angina
dizziness/syncope
SOB
confusion
disorientation

pacing, atropine

How well did you know this?

Not at all

Perfectly

Sinus Tachycardia

SNS stimulation
anxiety
pain
fever
caffeine
alcohol
nicotine
dehydration

How well did you know this?

Not at all

Perfectly

Sinus Tachycardia ECG Characteristics

HR >100 but <180

How well did you know this?

Not at all

Perfectly

Sinus Tachycardia Significance and Treatment

SPB
dizziness
low BP

beta blockers, anxiety meds

How well did you know this?

Not at all

Perfectly

SVT

may occur in healthy person and stop on its own
angina
HF
cardiogenic shock

How well did you know this?

Not at all

Perfectly

SVT ECG Characteristics

atrial rate 100-280 BPM (>150)
regular rhythm
P waves not visible
PR interval and QRS normal

How well did you know this?

Not at all

Perfectly

SVT Significance and Treatment

palpitations
hypotension
dizziness
anxiety
CP
weakness

ablation, vagal, adenosine, CCBs, cardioversion

How well did you know this?

Not at all

Perfectly

A Fib/A Flutter

atrial fibrosis; loss of muscle mass
HTN
HF
CAD
ETOH

How well did you know this?

Not at all

Perfectly

A Fib ECG Characteristics

atrial rate as high as 350-600
ventricular rate 50-180
p wave indiscernible
irregular

How well did you know this?

Not at all

Perfectly

A Fib/A Flutter Significance and Treatment

loss of atrial kick=loss of CO

decrease ventricular rate, CCB, BB, Dig, Amio, Cardioversion, heparin

A Flutter ECG Characteristics

atrial rate 2:1,3:1, etc.
ventricular rate 50-180
p wave methodic and saw tooth

First Degree AV Block

MI
CAD
hypothyroid
vagal stimulation drugs (digoxin, BB, CCBs)

First Degree AV Block ECG Characteristics

HR normal
reg rhythm
p wave normal
PR interval >.20 s and constant
QRS normal

First Degree AV Block Significance and Treatment

precursor to lethal HBs

watch/monitor, med changes

Second Degree AV Block Type I (Wenckebach or Mobitz 1)

BB CCBs Dig

Second Degree AV Block Type I (Wenckebach or Mobitz 1) ECG Characteristics

progressive prolonged PRI until P wave is blocked normal QRS

Second Degree AV Block Type I (Wenckebach or Mobitz 1) Treatment

may not need treatment but may progress

Second Degree AV Block Type 2 (Mobitz 2)

ischemia myocarditis post cardiac surgery CCBs dig

Second Degree AV Block Type 2 (Mobitz 2) ECG Characteristics

blocked P wave

Second Degree AV Block Type 2 (Mobitz 2) Significance and Treatment

may progress to complete block **PPM**

Third Degree AV Block (AV Dissociation)

ischemia MI fibrosis cardiomyopathy

Third Degree AV Block (AV Dissociation) ECG Characteristics

P wave no relation to QRS atrial rate higher than ventricular rate

Third Degree AV Block (AV Dissociation) Treatment

PPM

PVC

stimulants electrolyte imbalances (K, Mg) emotional distress exercise, hypoxia

PVC ECG Characteristics

HR varies, regular rhythm P wave absent QRS wide/bizarre, distorted, >.12s, bigeminy/trigeminy/quageminy

PVC Significance and Treatment

nonperfusing beats, no pulse **K, amio**

Ventricular Tachycardia (monomorphic)

almost always in diseased hearts MI ischemic heart disease HF cocaine

Ventricular Tachycardia ECG Characteristics

ventric rate 100-200 QRS > .12s

Ventricular Tachycardia Significance and Treatment

slower rates may be tolerated better **check pt, start CPR, pulse less v tach, defibrillate cardioversion if pulse, epi/vasopressin, amiodarone**

Torsade de Pontes (Polymorphic V-Tach)

review ECG strip but looks like a bunch of squiggles

V Fib

CAD MI hypokalemia hypomagnesemia hemorrhage drug therapy shock

V Fib ECG Characteristics

ventric rate >300 fibrillary waves noted

V Fib Significance and Treatment

no coordinated atrial or ventricular contraction **check pt, start CPR, pulse less v tach, defibrillate cardioversion if pulse, epi/vasopressin, amiodarone**

Asystole

myocardial hypoxia advanced HF severe hyperkalemia and acidosis PM failure

Asystole ECG Characteristics

flat line

Asystole Significance and Treatment

cardiac arrest than respiratory arrest **epi, CPR**

Pulseless Electrical Activity

**hypovolemia #1 cause** hypoxia acidosis hypo/hyperkalemia hypothermia MI toxins tamponade tens pneumo thrombosis trauma overdose of tricyclic antidepressants

Pulseless Electrical Activity ECG Characteristics

normal

Pulseless Electrical Activity Significance and Treatment

no pulse; loss of consciousness; no BP **CPR**