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358: exam 1 > EKG > Flashcards

EKG Flashcards

(45 cards)

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1
Q

depolarization = ___________

A

contraction

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2
Q

What is the function of the SA node, and what heart rate does it typically set?

A

It initiates the electrical impulse, setting the pace of 60–100 bpm. It causes atrial depolarization (P wave).

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3
Q

What does the AV node do in the conduction system?

A

It delays the impulse to allow ventricular filling (seen as PR interval), protecting the ventricles from rapid atrial rates.

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4
Q

What is the function of the Purkinje fibers?

A

They rapidly distribute the impulse to the ventricular muscle, resulting in ventricular contraction (QRS complex).

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5
Q

What is the difference between depolarization and repolarization?

A

Depolarization = contraction
Repolarization = relaxation.

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6
Q

What does the P wave represent?

A

Atrial depolarization.

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7
Q

What is the normal range for the PR interval?

A

0.12 – 0.20 seconds.

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8
Q

What does the QRS complex represent and what is its normal duration?

A

Ventricular depolarization (and atrial repolarization)
<0.12 seconds.

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9
Q

What does the T wave represent?

A

Ventricular repolarization.

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10
Q

What do ST elevation and ST depression indicate?

A

ST elevation = MI (injury)
ST depression = ischemia.

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11
Q

What are the 5 steps for interpreting an EKG rhythm?

A
  1. Is the rhythm regular or irregular?
  2. What is the rate?
  3. Is there a P wave for every QRS?
  4. What is the PR interval?
  5. What is the QRS duration?
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12
Q

How do you estimate HR on a 6-second strip?

A

Count the QRS complexes and multiply by 10.

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13
Q

What are the characteristics of Normal Sinus Rhythm (NSR)?

A

Rate: 60–100 bpm
regular rhythm
P wave before every QRS
PR 0.12–0.20 sec
QRS <0.12 sec.

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14
Q

What causes Sinus Tachycardia and how is it treated?

A

Causes: stress, fever, pain, hypovolemia, etc.

Treatment: Treat cause, metoprolol, adenosine, cardioversion if unstable.

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15
Q

What defines Sinus Bradycardia and how is it managed?

A

Rate <60 bpm, regular rhythm.

Treatment: IV atropine, pacing if symptomatic.

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16
Q

What is Atrial Flutter and how does it appear on EKG, treatment?

A

Sawtooth flutter waves, no P wave.

Treatment: beta-blockers, CCBs, anticoagulants, ablation.

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17
Q

What is Atrial Fibrillation (A-Fib) and why is it dangerous?

A

Irregular rhythm, no P waves, risk for thrombi and stroke.

Treatment: rate control (CCBs, beta-blockers), anticoagulation, cardioversion.

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18
Q

What is a PAC and what causes it?

A

Premature atrial contraction due to ectopic focus; triggered by stress, fatigue, caffeine, etc.

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19
Q

What is a PVC and when is it dangerous?

Study These Flashcards
A

Premature ventricular contraction, wide QRS. Dangerous if it falls on T wave or is frequent.

Treatment: Treat cause, beta-blockers, amiodarone.

20
Q

repolarization = ___________

21
Q

5 lead EKG placement

Study These Flashcards
A

white on right
clouds over grass
smoke over fire
chocolate close to heart

22
Q

how many seconds is a small box on an EKG?

23
Q

how many seconds is a big box (5 small squares)?

24
Q

what is the total time for 5 large boxes?

25
Causes of Sinus Bradycardia (7)
Vagal stimulation (e.g., vomiting, suctioning) Hypothermia Hypothyroidism drugs: Beta-blockers, calcium channel blockers, digoxin Inferior wall MI Increased intracranial pressure Athletic conditioning
26
Treatments for Sinus Bradycardia
Only treat if symptomatic Atropine 0.5 mg IV push Transcutaneous pacing
27
Causes of Sinus Tachycardia (6)
Fever, pain, anxiety Hypovolemia, dehydration Hypoxia Stimulants (caffeine, nicotine, cocaine, norepi/epi) Hyperthyroidism Heart failure, shock
28
Treatments for Sinus Tachycardia
Treat underlying cause Beta-blockers or calcium channel blockers (e.g., metoprolol, diltiazem, adenosine) if rate control needed Fluids for hypovolemia Oxygen for hypoxia synchronized cardioversion
29
Causes of Atrial Fibrillation (6)
Hypertension, heart failure, valvular heart disease Coronary artery disease (CAD), MI Hyperthyroidism Alcohol ("holiday heart") Post-cardiac surgery Advanced age
30
A FIB: Total __________ of atrial electrical activity Caused by multiple ______ foci Loss of ______ atrial contraction Can be ______ (comes and goes) or persistent (continuous) _____ common, clinically significant dysrhythmia Usually occurs in patient with __________ heart disease
disorganization ectopic effective paroxysmal Most underlying
31
Treatments for Atrial Fibrillation
Rate control: beta-blockers (metoprolol), calcium channel blockers (diltiazem), digoxin, amiodarone Rhythm control: amiodarone, electrical cardioversion Anticoagulation: warfarin, DOACs (e.g., apixaban) to prevent stroke Ablation
32
Causes of Atrial Flutter (3)
Same as A-Fib: structural heart disease, CAD, valve disease, post-surgery Chronic lung disease Thyrotoxicosis
33
Treatments for Atrial Flutter (4)
Rate control: beta-blockers, calcium channel blockers Rhythm control: cardioversion, antiarrhythmic drugs (amiodarone) Anticoagulation to prevent thromboembolism Catheter ablation for long-term management
34
A FLUTTER Identified by recurring, regular, _____________ flutter waves Originate from a ______ ectopic focus in atrium _____ occurs in healthy heart Loss of atrial _____ Increased risk for ______ Anticipate initiating an _______
sawtooth-shaped single Rarely “kick” stroke anticoagulant
35
Causes of PACs (4)
Stress, fatigue, caffeine, alcohol, tobacco Electrolyte imbalance (low K+, Mg++) Hypoxia Atrial enlargement
36
Treatments for PACs (3)
Usually no treatment required Eliminate triggers (e.g., caffeine, alcohol) Beta-blockers if frequent and symptomatic
37
Causes of PVCs (5)
Electrolyte disturbances (hypokalemia, hypomagnesemia) Hypoxia MI, ischemia Stimulants (caffeine, drugs) Heart failure
38
Treatments for PVCs (5)
Treat underlying cause Correct electrolytes Oxygen if hypoxic Beta-blockers or antiarrhythmics if frequent and symptomatic Monitor for progression to VT if frequent or multifocal
39
EKG findings of Sinus Bradycardia (5)
Rate: <60 bpm Rhythm: Regular P wave: Normal, upright, before each QRS PR interval: Normal (0.12–0.20 sec) QRS: Normal (<0.12 sec)
40
EKG findings of Sinus Tachycardia (5)
Rate: >100 bpm (usually 100–150 bpm) Rhythm: Regular P wave: Normal, upright, before each QRS PR interval: Normal QRS: Normal
41
EKG findings of Atrial Fibrillation
Rate: Variable (often rapid if uncontrolled) Rhythm: Irregularly irregular P wave: Absent; fibrillatory (f) waves instead PR interval: Not measurable QRS: Usually normal No identifiable atrial activity
42
EKG findings of Atrial Flutter
Atrial rate: ~250–350 bpm Ventricular rate: Variable (depending on conduction ratio) Rhythm: Regular or irregular P wave: "Sawtooth" flutter waves (especially in leads II, III, aVF) PR interval: Not measurable QRS: Normal
43
EKG findings of Premature Atrial Contractions
Rhythm: Irregular due to early beats P wave: Abnormal shape (may be hidden in previous T wave) PR interval: May be normal or prolonged QRS: Usually normal PAC interrupts the regular rhythm with an early beat
44
EKG findings of Premature Ventricular Contractions
Rhythm: Irregular due to early beats P wave: Absent before PVC QRS: Wide (>0.12 sec), bizarre shape T wave: Opposite direction of QRS Compensatory pause often follows PVC May occur as isolated, couplets, bigeminy, trigeminy, etc.
45
What unique EKG features help identify each arrhythmia?
Sinus Bradycardia: Slow but regular rhythm with normal P-QRS-T Sinus Tachycardia: Fast but regular rhythm with normal waveforms Atrial Fibrillation: Irregularly irregular; no P waves; chaotic baseline Atrial Flutter: Sawtooth flutter waves; regular or irregular PACs: Early beat with abnormal P wave; resets rhythm PVCs: Early wide QRS without P wave; compensatory pause follows

358: exam 1 (4 decks)

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