EKGs

Question 1

Where is the P, QRS, and T wave?

Answer 1

Question 2

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

Answer 2

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

Example: 7 peaks X 10 = about 70 beats per minute

Question 3

What are the common signs and symptoms for most dysrhythmias?

Answer 3

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

Question 4

Identify this rhythm:

Answer 4

normal sinus rhythm

70 beats per minute

Question 5

Identify this rhythm:

Answer 5

sinus bradycardia

50 beats per minute

Question 6

Identify this rhythm:

Answer 6

sinus tachycardia

130 beats per minute

Question 7

Identify this rhythm:

(immediate complication)

Answer 7

asystole

Question 8

Identify this rhythm:

(immediate complication)

Answer 8

ventricular fibrillation

Question 9

Identify this rhythm:

(immediate complication)

Answer 9

ventricular tachycardia

Question 10

Identify this rhythm:

(immediate complication)

Answer 10

myocardial infarction

Question 11

Identify this rhythm:

Answer 11

atrial fibrillation

Question 12

Identify this rhythm:

Answer 12

atrial flutter

Question 13

Identify this rhythm:

Answer 13

1st degree AV block

PR interval is elongated.

Question 14

Identify this rhythm:

Answer 14

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

PR interval gets longer and longer and then it drops.

Question 15

Identify this rhythm:

Answer 15

2nd degree AV block Type 2 (Mobitz II)

PR interval stays the same and then QRS is missing.

Question 16

What is common about most heart blocks?

Answer 16

• 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.

Question 17

Identify this rhythm:

(Immediate complication)

Answer 17

3rd degree heart block (complete heart block)

Question 18

Identify this rhythm:

(Immediate complication)

Answer 18

supraventricular tachycardia

Question 19

Identify this rhythm:

(Immediate complication)

Answer 19

torsades de pointes

Question 20

Identify this rhythm:

Answer 20

normal sinus rhythm with premature ventricular contractions (PVCs)

Question 21

Medications:

sinus tachycardia

Answer 21

Give meds to decrease the heart rate:

• Beta blockers
• Calcium channel blockers
• Digoxin

Question 22

Interventions:

asystole

(Immediate complication)

Answer 22

• start CPR
• epinephrine
• NO defibrillation

Question 23

Interventions:

ventricular fibrillation

(Immediate complication)

Answer 23

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

Question 24

Interventions:

ventricular tachycardia

(Immediate complication)

Answer 24

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

Question 25

# Medications: atrial fibrillation and atrial flutter

Answer 25

1. **high risk for blood clots** * antiplatelets * anticoagulants 2. **to decrease heart rate** * beta blockers * calcium channel blockers * digoxin

Question 26

# Interventions: myocardial infarction | (Immediate complication)

Answer 26

1. give **"OANM"** * oxygen * aspirin * nitroglycerin * morphine 2. **"clot busters"** if caused by a clot: T-PA 3. **cardiac catheterization** if caused by plaque

Question 27

# Interventions: supraventricular tachycardia

Answer 27

* **vagal maneuvers** (carotid sinus massage, beardown/valsalva) * **cardiovert with adenosine**

Question 28

# Interventions: normal sinus rhythm with pre-ventricular contractions

Answer 28

**If getting 6 PVCs in a row or more than 6 in a minute treat with:** * beta blockers * amiodarone * catheter ablation

Question 29

What is a **pacemaker**?

Answer 29

Uses batteries to send electric signals to the heart to help it pump correctly. ## Footnote The pacemaker is connected to the heart by one or more wires.

Question 30

# Teaching: Pacemakers

Answer 30

* 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

Question 31

What is **defibrillation** and **cardioversion**?

Answer 31

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

Question 32

What is the **difference between defibrillation** and **cardioversion**?

Answer 32

* _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.*

Question 33

What is **catheter ablation**?

Answer 33

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

Question 34

What are some common causes of dysrhythmias?

Answer 34

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

Question 35

# Signs and Symptoms: Myocardial infarction

Answer 35

* chest pain * left arm pain * gastric reflux pain * jaw pain * nausea/vomiting * upper back/shoulder pain * shortness of breath

Question 36

What is the lead placement for an ECG?

Answer 36

Question 37

What is the order of electrical activity in the heart?

Answer 37

1. SA node 2. AV node 3. bundle of HIS 4. bundle branches (left and right) 5. purkinje fibers

Question 38

What is an implantable cardio defibrillator?

Answer 38

It sends a shock to reset the heart. ## Footnote Shock may be felt by others, but is not harmful.