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ECG 7150/7220 > midterm updated > Flashcards

midterm updated Flashcards

(58 cards)

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1
Q

sinus arrhythmia:

conduction prob-

A

none present. no potential

originate at SA node, but firing is variable. Related to resp pattern. HR increases when PT breaths in (from changes in intrathoracic pressure)

rate is firing irreg but conduction of impulse is normal

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2
Q

sinus arrhythmia:

cause

A

not associated with being a problem. occasional type associated with heart disease

R-R interval irreg by resp pattern

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3
Q

sinus arrhythmia:

implication O2 sup and demand

A

not a problem

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4
Q

sinus arrhythmia:

interventions

A

document but no intervention required unless HR <60

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5
Q

sinus arrhythmia:
rate-
rhythm-
P-wave-

A

rate - reg

rhythm- irreg

P wave norm

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6
Q

Sinus Brady:

conduction prob

A

SA node normal path of conduction atria to vents

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7
Q

Sinus Brady:

cause

A

athlete, dig, BB

slower = increased vent filling time = better coronary perfusion time = decreased myocardial consumption

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8
Q

Sinus Brady:

implication O2 sup and demand

A

decreased HR = decreased CO. need to assess PT to see if signs

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9
Q

Sinus Brady:

Intervention

A

If signs of decreased CO then intervene

Atropine or temp pacemaker

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10
Q

Sinus Brady:

rate-
rhythm-
P wave-

A

rate < 60

rhythm - reg

P wave +

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11
Q

Sinus arrest/ Pause

conduction prob

A

when SA node fires NP. When it doesnt fire = problem

lacks a P-QRS-T

pause/arrest can cause rate to be too slow

If pause long. back up pacemaker in junction or vents take over.

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12
Q

Sinus arrest/ Pause

cause

A

depression from automaticity of SA node

hypoxia
hypothermia, 
drug toxicity, 
vagal stimulation, 
electrolyte imbalance, 
infection/myocarditis, 
ischemia to conduction system
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13
Q

Sinus arrest/ Pause

implication O2 sup and demand

A

If transient - NP. The backup pacemakers will kick in

If protective pacemaker doesnt take over then act quick

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14
Q

Sinus arrest/ Pause

intervention

A

Symptom support

Atropine

temp pacemaker

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15
Q

Sinus arrest/ Pause

rate
rhythm
P wave

A

rate norm

rhythm- irreg. underlying could be reg

P wave +

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16
Q

Sinoatrial Block

conduction prob

A

Primary SA node. Period of time when impulses are prevented from depolarizing atrial tissue and there is a block in conduction to atria and vents

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17
Q

Sinoatrial Block

cause

A

Ischemia

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18
Q

Sinoatrial Block

implication O2 sup and demand

A

If the block is a long enough period of time can cause signif impact on CO. HR would decrease if prolonged and decrease CO

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19
Q

Sinoatrial Block

intervention

A

assess CO impact

atropine

temp external pacemaker

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20
Q

Sinoatrial Block

rate
rhythm
P wave

A

rate normal

rhythm irreg but can be underlying reg

P wave +

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21
Q

Sinus Tacky

Conduction

A

SA node fast > 100

< 180

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22
Q

Sinus Tacky

cause

A 
exercise
exertion
stimulant
fever
anemia
hypovolemia
CHF
PE
myocardial
ischemia
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23
Q

Sinus Tacky

Implications O2 sup and dem

A

Healthy - NP

increased HR = increased myocardial consumption = further ischemia.

shortens diastolic filling time = decreased preload and SV = decreased CO

decreased coronary artery perfusion time = decreased O2 supply to heart muscle = decreased contractility = decreased CO

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24
Q

Sinus Tacky

interventions

Study These Flashcards
A

determine impact. correct cause and deal with symptoms

BB

25
Sinus Tacky rate rhythm P wave
rate > 100 and < 180 rhythm- reg P wave +
26
Premature Atrial Contractions (PAC's) conduction
site of impulse is both SA node and atrial tissue **premature impulses in atrial tissue not the SA node = ectopic P focus when ectopic impulses fire faster than SA node
27
Premature Atrial Contractions (PAC's) cause
alcohol caffeine tobacco narcotics ** dig toxicity, hypoxia, electrolyte imbalance, heart disease (HF can cause atrial tissue to stretch = PAC
28
Premature Atrial Contractions (PAC's) Implications O2 sup and dem
Heathy = NP If heart disease then increased HR = increased demand could convert to A.fib A.flutter
29
Premature Atrial Contractions (PAC's) Intervention
treat the causes: pain, hypovolemic, myocardial ischemia, CHF document, notify MRP
30
Premature Atrial Contractions (PAC's) rate rhythm P wave
rate normal underlying regular P wave +, but looks different bc it doesnt fire from SA node. They dont always look the same, vary depend on where they come from QRS normal
31
atrial tissue doesnt like to fire faster than? But can fire at?
150-180 250-300
32
which is related to resp pattern?
sinus arrhythmia
33
which drugs slow HR?
amiodarone, digoxin, BB. adenosine, vagal maneuver, electrical
34
which drugs increase HR and conduction?
Atropine pacemaker
35
what is the difference between sinus arrest and sinus pause?
arrest gap between QRS = > 3 sec pause gap between QRS = < 3 sec
36
what is the difference between sinus pause/arrest and sinus block?
pause/arrest = SA node does not generate impulse. There is no P when starts back up. backup can take over or a P is terminated by normal sinus beat. sinus block = SA node does generate an impulse but blocked from entering atria. multiple QRS missing
37
Atrial tachy conduction
Atrial tissue - irritable atrial ectopic focus robs SA node of its power > 180 BMP (110-250)
38
Atrial tachy cause
heart disease: ischemic and valvular tissue hypoxia dig toxicity cor pulmonale resp failure d/t atrial distension
39
Atrial tachy Implication O2 sup and dem
increased HR = increased consumption = increased ischemia = tissue damage short diastolic filling = decreased CO and decreased coronary perfusion = decreased O2 supply increased demand no P wave= no atrial kick = decreased preload, and CO possible clot formation
40
Atrial tachy Intervention
assess PT. depend on degree of compromise Decreased BP, chest pain, SOB, dizzy, palpatations medication interventions: BB, CCB electrical/cardioversion- to attempt to terminate cardiac dysrhythmia
41
Atrial tachy rate rhythm P waves
rate > 180 (150-250) rhythm reg P waves - might not be able to see them. BC they travel diff pathway than those coming from SA node. BC atrial and vent depolarization fast, P wave blurred in QRS or T wave. normal QRS (vent tachy is very wide QRS)
42
Paroysmal atrial tachy
sudden onset and abrupt cessation (short lived)
43
Atrial Flutter conduction
irritable ectopic atrial focus. 250-350 BPM rapid reg rate of atrial depolarization. The AV junction protects (blocks) the vents from rapid rate of fire (<150/min) d/t long refractory period (rest) that prevents conduction of all impulses from atria. Less QRS complexes Called physiologic AV block can be: atria 240 BPM, vents 78 BPM Atrial flutter 3:1 block
44
Atrial Flutter cause
heart disease ischemic or valvular, hypoxia dig tox cor pulmonale resp failure
45
Atrial Flutter implication O2 sup and dem
depends on PT and how long they can tolerate No P wave = Loss atrial kick = loss 20-30 % CO = decreased preload and decreased CO possible clot formation
46
Atrial Flutter Intervention
assess PT. depend on degree of compromise Decreased BP, chest pain, SOB, dizzy, palpatations medication interventions: BB, CCB, amiodarone* electrical/cardioversion- to attempt to terminate cardiac dysrhythmia (if dramatic)
47
Atrial Flutter rate rhythm P wave
rate 250-350 atrial, vent variable give reange** rhythm- atrial reg, vent mostly reg P wave - flutter (saw tooth) PR/T/QT - NA
48
Amiodarone
A,fib/A.flutter
49
Atropine
bradycardia/ sinoatrial block
50
what is SVT?
supraventricular tachycardia -- Or Atrial tachy
51
how do you know if it's controlled or uncontrolled A.Flutter? or A. fib
controlled = HR vent response <100 BPM uncontrolled = HR vent response > 100 BPM
52
Atrial Fibrillation conduction
site of impulse formation is the atrial tissue wavy baseline is from multiple ectopic pacemaker sites generating impulses at a very fast and irregular rate> 350 BPM Atrial kick lost Ventricles are irreg but AV junction cause AV block to protect against v. rapid vent rate in A.fib
53
Atrial Fibrillation cause
heart disease ischemic or valvular, hypoxia dig tox cor pulmonale resp failure
54
Atrial Fibrillation Implications O2 sup and demand
loss atrial kick and rapid vent response can seriously impact preload. potential clot formation in atria
55
Atrial Fibrillation intervention
assess PT. depend on degree of compromise Decreased BP, chest pain, SOB, dizzy, palpitations medication interventions: BB, CCB, amiodarone* electrical/cardioversion- to attempt to terminate cardiac dysrhythmia (if dramatic)
56
Atrial Fibrillation rate rhythm P wave QRS
rate 300-500, vent variable rhythm- vent usually irreg P wave - fibrillary waves , cant ID P waves QRS - usually normal appearance
57
what are the two characteristics of A.Fib?
- the baseline is wavy and chaotic looking | - the ventricular response is always grossly irregular
58
what does it mean for CO to have an uncontrolled vent rate in A.fib/flutter
higher rate allows for less time for vents to fill = decreased preload and CO

ECG 7150/7220 (6 decks)

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