Junctional, Ventricular Dysrhythmia & AV Blocks

Question 1

If P waves can be seen in a junctional rhythm, they would appear inverted in which leads?

Answer 1

II, III, aVF (inferior leads)

Question 2

Inverted P waves with a short or absent PR interval is indicative of…

Answer 2

junctional dysrhythmia

Question 3

a single early impulse arriving from the AV junction…

Answer 3

premature junctional contraction

Question 4

Rhythm: Irregular, one premature beat

P Wave: inverted, may be after or in the QRS

P-R Interval: short ( < 0.12s)

Answer 4

premature junctional contraction

Question 5

If you can’t decide whether a rhythm is atrial or junctional arrhythmia, what can determine it as junctional?

Answer 5

shortened PR (impulse was generated lower down, so therefore shorter duration)

Question 6

Rate: 40 - 60 bpm

P waves: inverted in leads II, III, aVF

PR Interval: short (< 0.12s)

Answer 6

Junctional Escape Rhythm

Question 7

Rate: 60 - 100 bpm

P waves: inverted or absent in leads II, III, aVF

PR Interval: short (< 0.12s)

Answer 7

Accelerated junctional rhythm

Question 8

Rate: 100 - 180

P waves: inverted, may be hidden in or occur after QRS

PR: shortened

Answer 8

Junctional Tachycardia

Question 9

What class of dysrhythmias?

Wide, bizarre QRS complexes > 0.12s

T waves in opposite direction of R wave

No P waves

Answer 9

ventricular dysrhythmias

Question 10

Rhythm: Irregular due to one premature beat

P waves: not visible

QRS: wide, bizarre ( > 0.12s)

T waves: opposite direction of R wave

Answer 10

Premature Ventricular Complex

Question 11

Is there a full compensatory pause after a PVC?

Answer 11

yes

Question 12

PVCs that look the same are called ______ and are (more/less) dangerous

Answer 12

unifocal, more dangerous

Question 13

PVCs that look different from one another are called…

Answer 13

multifocal

Question 14

What is it called when 2 PVCs occur in a row, what does this signify?

Answer 14

couplet, extremely irritable ventricles

Question 15

a couplet of PVCs can cause…

Answer 15

lethal arrhythmia

Question 16

PVCs that fall between two regular complexes and don’t disrupt the normal cycle are called…

Answer 16

interpolated PVCs

Question 17

PVCs occurring on or near the previous T wave are called _______. they may precipitate (2)

Answer 17

R-on-T PVCs

precipitate V tach or V fib

Question 18

Rate: 20 - 40 bpm
Rhythm: Regular

P waves: not visible

QRS: wide, bizarre, ( > 0.12s)

T waves: opposite direction of R wave

Answer 18

idioventricular rhythm

Question 19

What is the rhythm of last resort?

Answer 19

idioventricular rhythm

Question 20

if there is one idioventricular beat, what is it called?

Answer 20

ventricular escape beat

Question 21

Rate: 40 - 100 bpm
Rhythm: regular

P waves: absent

QRS: wide, bizarre, ( > 0.12s)

T waves: opposite direction of R wave

Answer 21

accelerated idioventricular rhythm

Question 22

Rate: 100 - 250

P waves: absent

QRS: wide, bizarre, ( > 0.12s)

T waves: opposite direction of R wave

Answer 22

Ventricular tachycardia

Question 23

3 or more PVCs in a row indicates…

Answer 23

ventricular tachycardia

Question 24

VT may come in a burst of 6 to 10, or may persist. Persistant VT is called

Answer 24

sustained VT

Question 25

if the appearance of each QRS complex in VT are similar, it is called...

Answer 25

monomorphic

Question 26

If the QRS appearance varies considerably among complexes in VT, it is called

Answer 26

polymorphic

Question 27

This is a unique polymorphic VT associated with prolonged QT from dugs or lyte imbalances

Answer 27

Torsades de Pointes

Question 28

torsades (TdP) is managed via ______ if cardiac arrest, or ______ if not in cardiac arrest.

Answer 28

cardiac arrest = defibrilation non-cardiac arrest = magnesium sulfate

Question 29

Ventricular fibrillation has what physical three characteristics

Answer 29

cardiac arrest unresponsive pulseless

Question 30

Rate: 300 - 500 Rhythm: totally chaotic QRS: illogical wavy, chaotic

Answer 30

ventricular fibrillation

Question 31

complete cessation of cardiac output represented by a flat line

Answer 31

asystole

Question 32

organized electrical rhythm on ECG, but pulseless, apneic patient

Answer 32

PEA

Question 33

The below are reversible causes of... hypovolemia, pericardial tamponade, tension pneumothorax, massive acute MI, drug overdose,

Answer 33

PEA

Question 34

What type of AV block? consistent delay in AV node conduction

Answer 34

1st degree

Question 35

What type of AV block? intermittent block at AV node, progressive P-R interval lengthening

Answer 35

2nd degree Type I

Question 36

What type of AV block? intermittent block at the bundle of his or bundle branches some atrial impulses don't get conducted to ventricles

Answer 36

2nd degree Type II

Question 37

What type of AV block? complete block of conduction at or below the AV node. Atrial impulses never reach the ventricles

Answer 37

3rd degree AV block

Question 38

Regular rhythm P Waves: normal QRS: normal P-R interval: prolonged ( > 0.20s)

Answer 38

1st degree AV block

Question 39

Rate: normal (atria) Rhythm: patterned irregularity P waves: present normal looking. Not all followed by QRS PR Interval: Progressive lengthening until a complex is dropped

Answer 39

2nd Degree AV Block Type I "Wenckebach" or "Mobitz I"

Question 40

PR interval prolonged, but the duration of PR interval remains constant More P waves than QRS complexes

Answer 40

2nd degree AV Type II

Question 41

PR interval is prolonged every other p wave is conducted

Answer 41

2:1 AV block

Question 42

Is type 1 or type 2 AV block more serious?

Answer 42

Type II

Question 43

3rd degree AV block is also called...

Answer 43

complete heart block

Question 44

QRS complexes in 3rd degree AV block would appear wide under what condition?

Answer 44

escape focus is ventricular

Question 45

Rate: normal (atria) rhythm: normal in atria and ventricles, but not related P waves: normal, but not related to QRS March thru QRS complexes

Answer 45

3rd degree AV block

Question 46

If ventricular rhythm in a 3rd degree AV block is between 40-60, where is the focus/

Answer 46

Junction

Question 47

If ventricular rhythm in 3rd degree AV block is 20-40, where is the focus?

Answer 47

ventricles