EKG

Question 1

P wave

Answer 1

atrial depolarization

Question 2

QRS complex

Answer 2

ventricular depolarization and atrial repolarization

Question 3

T wave

Answer 3

ventricular repolarization

Question 4

PR interval

Answer 4

movement of electrical activity from atria to ventricles

Question 5

normal PR interval

Answer 5

0.12 - 0.20

Question 6

what is happening in the PR interval

Answer 6

time impulse travels from SA node through internodal pathways in atria toward ventricles

Question 7

long PR interval

Answer 7

greater then 0.20 seconds
indicates the impulse was delayed as it passed through atria, AV node, or AV bundle

Question 8

short PR interval

Answer 8

less than 0.12 seconds
may be seen when the impulse originates in the atria close to the AV node or in the AV bundle

Question 9

QRS complex represents

Answer 9

conduction of impulse form Bundle of HIS through ventricular msucle

Question 10

normal QRS complex

Answer 10

0.12 seconds

Question 11

0.12 seconds = ___ small boxes

Answer 11

3

Question 12

R-R interval

Answer 12

ventricular rate and regularity

Question 13

QT interval

Answer 13

time take from ventricles to depolarize, contract, and repolarize; represents total ventricular activity

Question 14

ST segment

Answer 14

time between ventricles depolarized and repolarization of ventricles begins (ventricular contraction)

Question 15

T waves

Answer 15

“resting phase” of cardiac cycle

Question 16

Most important assessment other or while doing ECG

Answer 16

looking at your patient and there presentation

Question 17

8 step ECG interpretation

Answer 17

(1) measure HR
(2) examine R-R interval
(3) examine P wave
(4) measure PR interval
(5) determine if each P wave is followed by QRS
(6) examine and measure QRS
(7) examine and measure QT
(8) diagnose the rhythm

Question 18

six-second method

Answer 18

count the number of complete QRS complexes within a period of 6 seconds and multiply it by 10 to determine the number of QRS complexes in 1 min

Question 19

Sinus Bradycardia

Answer 19

HR less than 60
originates from SA node

Question 20

treatment for sinus bradycardia

Answer 20

atropine / pacemaker

Question 21

sinus tachycardia

Answer 21

rate greater than 100bpm and less than 150bpm

Question 22

what causes sinus tachycardia

Answer 22

sympathetic stimulation, fever, hypovolemia, pain

Question 23

treatment for sinus tachycardia

Answer 23

beta blockers, calcium channel blockers, vagal nerve stimulus, antipyretics, pain management, antianxiety measures, carotid artery massage

Question 24

sinus node dysfunction

Answer 24

impulses originate elsewhere in atria
- premature atrial contractions
- SVT
- may decrease cardiac output secondary to tachycardia

Question 25

Atrial dysrhythmias

Answer 25

characterized by rapid atrial rate - rapid ventricular response to symptoms

Question 26

PAC's

Answer 26

often benign but may be warning sign for something else - enhanced automaticity of cardiac cells

Question 27

sinus arrhythmia

Answer 27

rate 63-81 bpm

Question 28

who is sinus arrhythmia common in

Answer 28

athletes and children

Question 29

atrial fibrillation

Answer 29

atria contracting very rapidly, unable to empty, discharging greater than 400bpm - absent P waves

Question 30

what happens in afib

Answer 30

- atrial chambers are unable to refill before contraction - inadequate ventricular filling - decreased stroke volume by 25% - blood in atria prone to form clots - increase risk for thrombotic stroke

Question 31

supraventricular tachycardia (SVT)

Answer 31

- rate between 150 and 250 bpm - regular rhythm - undistinguishable P wave - QRS complex normal - R-R irregular

Question 32

treatment for SVT

Answer 32

valsalvas maneuver, calcium channel blockers, digoxin, beta blockers, adenosine, cardioversion

Question 33

atrial flutter

Answer 33

- rate greater than 250 (up to 350) - ventricular rate regular or irregular - atrial oscillations appear as saw tooth or flutter waves -ventricular rate ~80, atrial rate ~375 - QRS complex 0.10

Question 34

treatment for atrial flutter

Answer 34

cardioversion, calcium channel blockers to regulate HR, digoxin, beta blockers

Question 35

heart blocks are like __________

Answer 35

relationships

Question 36

first degree AV block

Answer 36

- PR interval > 0.20 seconds - delayed conduction through AV node - pt usually asymptomatic; no treatment necessary - related to acute MI, CAD

Question 37

second degree AV block

Answer 37

SA node impulse conduction is delayed or completely blocked - occurs in AV nodal area - P wave is present - PR interval is irregular or not measurable

Question 38

difference between second degree AV block type 1 and type 2

Answer 38

Type 1 - P and QRS are far apart and then close together again Type 2 - P and QRS are normal, but P sometimes moves father or closer

Question 39

junctional dysrhythmias

Answer 39

- SA node fails to fire - intrinsic rate 40-60 bpm - AV node become pacemaker - inverted or absent P wave

Question 40

ventricular dysrhythmias

Answer 40

- life threatening - inadequate ventricular ejection - insufficient stroke volume - decrease cardiac output - decrease tissue perfusion

Question 41

ventricular bigeminy

Answer 41

- beats originate in the ventricles - regular pattern - may lead to v tach or v fib

Question 42

treatment for ventricular bigeminy

Answer 42

O2, antiarythmatics

Question 43

ventricular tachycardia

Answer 43

- 3 or more PVC's occurring at a rapid rate, usually greater than 100bpm - may deteriorate into ventricular fibrillation

Question 44

ventricular fibrillation

Answer 44

- most common cause of sudden cardiac arrest

Question 45

treatment for ventricular fibrillation

Answer 45

defibrillation is treatment of choice and epinephrine

Question 46

asystole

Answer 46

- represents complete cessation of electrical impulses - terminal rhythm