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NCLEX-RN® > NCLEX-RN (5) Adult Health > EKGs > Flashcards

EKGs Flashcards

Review the most important EKGs and medications.

1
Q

Where is the P, QRS, and T wave?

A
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2
Q

Using the rhythm below, how would you calculate the heart rate?

A

Count the peaks (the R waves) and multiply times 10.

Example: 5 peaks X 10 = 50 beats per minute

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3
Q

What are the common signs and symptoms for most dysrhythmias?

A
  • heart palpitations
  • tachycardia
  • short of breath
  • anxiety
  • dizziness
  • decreased level of consciousness
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4
Q

Identify this rhythm:

A

normal sinus rhythm

70 beats per minute

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5
Q

Identify this rhythm:

A

sinus bradycardia

50 beats per minute

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6
Q

Identify this rhythm:

A

sinus tachycardia

130 beats per minute

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7
Q

Identify this rhythm:

(immediate complication)

A

asystole

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8
Q

Identify this rhythm:

(immediate complication)

A

ventricular fibrillation

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9
Q

Identify this rhythm:

(immediate complication)

A

ventricular tachycardia

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10
Q

Identify this rhythm:

(immediate complication)

A

myocardial infarction

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11
Q

Identify this rhythm:

A

atrial fibrillation

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12
Q

Identify this rhythm:

A

atrial flutter

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13
Q

Identify this rhythm:

A

1st degree AV block

PR interval is elongated.

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14
Q

Identify this rhythm:

A

2nd degree AV block Type 1 (Wenkebach/Mobitz I)

PR interval gets longer and longer and then it drops.

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15
Q

Identify this rhythm:

A

2nd degree AV block Type 2 (Mobitz II)

PR interval stays the same and then QRS is missing.

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16
Q

What is common about most heart blocks?

A
  • typically less than 60 beats per minute
  • have an elongated PR interval
  • will receive atropine if showing symptoms
  • if atropine doesn’t work, client will either get cardioversion or a pacemaker.
17
Q

Identify this rhythm:

(Immediate complication)

A

3rd degree heart block (complete heart block)

18
Q

Identify this rhythm:

(Immediate complication)

A

supraventricular tachycardia

19
Q

Identify this rhythm:

(Immediate complication)

A

torsades de pointes

20
Q

Identify this rhythm:

A

normal sinus rhythm with pre-ventricular contractions (PVC’s)

21
Q

Medications:

sinus tachycardia

A

Give meds to decrease the heart rate:

  • Beta blockers
  • Calcium channel blockers
  • Digoxin
22
Q

Interventions:

asystole

(Immediate complication)

A
  • start CPR
  • epinephrine
  • NO defibrillation
23
Q

Interventions:

ventricular fibrillation

(Immediate complication)

A
  • “defib the V-fib”
  • CPR
  • epinephrine
  • amiodarone (or lidocaine)
24
Q

Interventions:

ventricular tachycardia

(Immediate complication)

A
  • Pulseless V-tach
    • CPR
    • defibrillate
    • epinephrine
    • amiodarone (or lidocaine)
  • With a pulse: amiodarone (or lidocaine)
25
Q

Medications:

atrial fibrillation and atrial flutter

A
  1. high risk for blood clots
    • antiplatelets
    • anticoagulants
  2. to decrease heart rate
    • beta blockers
    • calcium channel blockers
    • digoxin
26
Q

Interventions:

myocardial infarction

(Immediate complication)

A
  1. give “OANM”
    • oxygen
    • aspirin
    • nitroglycerin
    • morphine
  2. “clot busters” if caused by a clot: T-PA
  3. cardiac catheterization if caused by plaque
27
Q

Interventions:

supraventricular tachycardia

A
  • vagal maneuvers (carotid sinus massage, beardown/valsalva)
  • cardiovert with adenosine
28
Q

Interventions:

normal sinus rhythm with pre-ventricular contractions

A

If getting 6 PVCs in a row or more than 6 in a minute treat with:

  • beta blockers
  • amiodarone
  • catheter ablation
29
Q

What is a pacemaker?

A

Uses batteries to send electric signals to the heart to help it pump correctly.

The pacemaker is connected to the heart by one or more wires.

30
Q

Teaching:

Pacemakers

A
  • take pulse daily and report abnormalities
  • avoid contact sports
  • inform airport security about pacemaker (can set off security detector)
  • most electrical devices are OK to use: move back 5 - 10 feet if experience unusual feelings
  • use cell phone on opposite side of pacemaker site
31
Q

What is defibrillation and cardioversion?

A

Giving the client a controlled electric shock in order to put the client back into a normal sinus rhythm.

32
Q

What is the difference between defibrillation and cardioversion?

A
  • Cardioversion is an administered shock synchronized with the QRS complex.
  • Defibrillation is a randomly administered shock anytime during the cardiac cycle. It is always done in emergencies.
33
Q

What is catheter ablation?

A

A procedure where a part of cardiac tissue is burned off to prevent dysrhythmias.

34
Q

What are some common causes of dysrhythmias?

A
  • electrolyte imbalances
  • CAD/blocked arteries
  • heart damage from an MI
  • cardiomyopathy
  • increased blood pressure
  • hyperthyroidism
  • smoking
  • caffeine/alcohol
  • meds/illegal drugs
  • genetics
35
Q

Signs and Symptoms:

Myocardial infarction

A
  • chest pain
  • left arm pain
  • gastric reflux pain
  • jaw pain
  • nausea/vomiting
  • upper back/shoulder pain
  • shortness of breath
36
Q

What is the lead placement for an ECG?

A
37
Q

What is the order of electrical activity in the heart?

A
  1. SA node
  2. AV node
  3. bundle of HIS
  4. bundle branches (let and right)
  5. purkinje fibers
38
Q

What is an implantable cardio defibrillator?

A

It sends a shock to reset the heart.

Shock may be felt by others, but is not harmful.

NCLEX-RN (5) Adult Health (13 decks)

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