EKG Rhythm Interpretation Basics

Question 1

What are the steps to EKG rhythm interpretation?

Answer 1

• Regular or Irregular rhythm
• Rate
• Is it Sinus rhythm? - does it start in the SA node?
• are P-Waves present
• PR Interval
• QRS Complex

Question 2

How do you determine the regularity of a cardiac rhythm?

Answer 2

measure and compare the R-R intervals across the entire strip

Question 3

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Answer 3

Delete this

Question 4

What are the characteristics of a Regularly – Irregular cardiac rhythm?

Answer 4

pattern of irregularity

Question 5

What are the characteristics of an Irregular – Irregular cardiac rhythm?

Answer 5

has no pattern

Question 6

What type of rhythm (reg or irregular) is seen with Atrial fibrillation?

Answer 6

Irregular – Irregular rhythm or no pattern

Question 7

What type of rhythm is seen with Sinus arrhythmia?

Answer 7

• Regularly – Irregular rhythm or pattern of irregularity

- may be an example of normal variation of rate (rates of inc and decreases)

Question 8

What type of rhythm (reg or irregular) is seen with Atrial bigeminy?

Answer 8

• Regularly – Irregular rhythm or pattern of irregularity

Question 9

How do you calculate the HR on an EKG strip?

Answer 9

1) Count the number of “small” squares b/t 2 consecutive R-waves and divide into 1500
2) Count # of R-waves in a 6-second strip (30 lg boxes) and multiply by 10
3) Count the # of large squares between 2 consecutive R-waves then divide into 300
4) use standard scale

Question 10

Which method would you use to calculate the HR if the rhythm is irregular?

Answer 10

Count # of R-waves in a 6-second strip (30 lg boxes) and multiply by 10

Question 11

What are the BPM values when using the standard scale to estimate the HR on an EKG strip?

Answer 11

• 1 lg square = 300 bpm
• 2 lg square = 150 bpm
• 3 lg square = 100 bpm
• 4 lg square = 75 bpm
• 5 lg square = 60 bpm
• 6 lg square = 50 bpm

Question 12

How do you use the standard scale to estimate the HR on an EKG strip?

Answer 12

count the # of lg boxes between 2 consecutive R-waves, then refer to scale values

Question 13

What are the characteristics of a P-wave that originates in the SA node?

Answer 13

• wave is upright in leads I, II, V4-6
• negative in aVR because the impulse is moving away from the lead
• Uniform across the strip

Question 14

The P-wave in rhythms that originate outside the SA node will have what configuration?

Answer 14

Inverted, flattened, notched, peaked, or diphasic

Question 15

How do you measure the PR-interval on an EKG strip?

Answer 15

Measure from the beginning of the P-wave to the beginning of the QRS complex

Question 16

What is a normal PR-Interval?

Answer 16

• 3 to 5 small boxes or
• 120 – 200 msec or
• 0.12 – 0.20 sec

Question 17

Which part of the EKG strip is used to determine what type of AV block is present, if any?

Answer 17

The PR-Interval

Question 18

What are the rules/characteristics of Sinus Rhythm?

Answer 18

• Originate in the sinoatrial node
• P-wave normal, uniform, & upright in lead II ( will also be I, & V4-6)
• Regularity: regular (R-R are =)
• Rate: vary 60-100 bpm for “normal” sinus rhythm
• P-wave: one P-wave in front of every QRS
• PR interval: 120 – 200 msec (0.12- 0.2 sec) 3-5 blocks and constant
• QRS: < 120 msec ( less than 3 blocks)