Term
| How long is the P wave interval? |
|
Definition
|
|
Term
| How long is the QRS complex? |
|
Definition
|
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Term
| What does ST elevation indicate? |
|
Definition
STEMI.
Firefighter hats/ tombstones |
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Term
| What are the steps to interpreting EKG's? |
|
Definition
-Rate?
Normal
Bradycardia, Tachycardia
-Rhythm?
Regular or Irregular
-Are there P waves?
-Is each P wave related to a QRS with 1:1 impulse conduction?
-QRS normal or wide? |
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Term
| What is the rate of normal sinus rhythm? |
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Definition
|
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Term
| What is the ratio of P to QRS in normal sinus? |
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Definition
|
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Term
| What is the rate of sinus brady? |
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Definition
|
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Term
| What is the rhythm of sinus brady? |
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Definition
|
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Term
| How is bradycardia treated? |
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Definition
|
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Term
|
Definition
beta-blockers, digoxin, amiodarone
May occur as the result of vagal stimulation – such as vomiting or performing Valsalva’s maneuver
Being athletic |
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Term
| What is the rate of sinus tachycardia? |
|
Definition
|
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Term
| What is the rhythm of sinus tacky? |
|
Definition
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Term
| What can cause sinus tach? |
|
Definition
| hypovolemia, hemorrhage, decreased oxygen levels and pain. |
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Term
| What can sinus tach cause? |
|
Definition
| hypotension, syncope…Patient may experience chest pain, palpitations, sense of skipped heartbeats. |
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Term
|
Definition
Premature Atrial Contraction.
P Wave comes too quickly |
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Term
|
Definition
| A quivering of the atrium. |
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Term
| What does an A. Fib EKG look like? |
|
Definition
| normal P waves are absent and the rhythm is irregularly irregular |
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Term
|
Definition
| CAD, MI, CHF, Cor pulmonale(chronic pulmonary hypertension resulting is right atrial hypertrophy), hypoxia, |
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Term
| What are the complications of A. Fib? |
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Definition
| Pulmonary Embolism, thromboembolism, stroke etc. |
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Term
| What are people in A. Fib almost always on? |
|
Definition
| Anticoagulation therapy such as coumadin or xarelto. |
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Term
| What is the goal of A. Fib therapy? |
|
Definition
| Control ventricular contraction rate! |
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Term
| What is uncontrolled a. fib? |
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Definition
| when ventricular rate is >100 (significantly impaired CO) |
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Term
| What is the rate of atrial flutter? |
|
Definition
| Atrial rate 250-400/min (often 300) |
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Term
| What is supra ventricular tachycardia? |
|
Definition
| Tachycardia where P-Waves are NOT visible! You know it is not the ventricles fault because the QRS complex is narrow and happening at a regular rate, but the P waves are missing. |
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Term
|
Definition
|
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Term
|
Definition
Can occur in patients with normal hearts in response to sympathetic nervous system stimulation, bronchodilator therapy, overexertion, emotional factors, hyperventilation, coffee, smoking.
However, it is usually associated with primary or secondary cardiac disease:Heart failure, MI, rheumatic heart disease, HTN, PE, |
|
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Term
|
Definition
| varapamil, beta blockers, adenosine |
|
|
Term
| What is the difference between Paroxysmal SVT and SVT? |
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Definition
| Paroxysmal - happens or ends suddenly |
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Term
| How do you know when the ventricles are to blame? |
|
Definition
WIDE AND BIZARRE QRS!
P WAVES ARE NORMAL! |
|
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Term
|
Definition
Premature Ventricular Contraction.
P waves occur at normal interval, QRS happens to quickly. |
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Term
| Which is more dangerous, a unifocal or multifocal PVC? |
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Definition
| Multifocal - means more than 1 area of the heart is damaged |
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Term
| When are PVC's dangerous? |
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Definition
|
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Term
|
Definition
| Two PVC's that happen back to back |
|
|
Term
|
Definition
PVC that happens every 3rd beat
PVC…BEAT…BEAT…PVC |
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|
Term
|
Definition
PVC that happens every other beat
PVC…BEAT…PVC |
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Term
|
Definition
Atrial contraction is normal, Ventricles are contracting rapidly.
3 or more PVC's = V. TACH |
|
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Term
| What are the only shockable rhythms? |
|
Definition
|
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Term
|
Definition
Antiarrhythmic agent, cardioversion,
high-energy (defibrillation dose) shock |
|
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Term
|
Definition
| CPR, vasopressor, atropine |
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Term
|
Definition
Pulseless Electrical Activity
not a single rhythm but any
organized rhythm without a pulse |
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|
Term
| What is a first degree heart block? |
|
Definition
Underlying sinus rhythm
One P wave for each QRS
PR interval >0.20 sec
The impulse is delayed at the AV node.
LONG P-QRS interval |
|
|
Term
| What is second degree heart block, type 1? |
|
Definition
Each impulse is delayed at AV node for slightly longer than previous, until impulse is completely blocked……
P-QRS interval gets longer and longer until it eventually drops completely. Then it will begin again.
WENKEBACH |
|
|
Term
| What is second degree heart block, type 2? |
|
Definition
When there are dropped QRS complexes.
P-R invterval is normal, then QRS suddenly drops.
MOBITZ |
|
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Term
| What is a third degree heart block? |
|
Definition
Impulses from the atria are completely blocked at the AV node and cannot be conducted through to the ventricles. The SA node continues to fire impulses usually at a normal rate, but the Ventricles do not receive any impulses,and so the inherent pacemakers within the ventricles begin to take over. This causes a complete dissociation between atria and ventricles.
The AV and SA node are BOTH firing, so the P's and QRS's do not match up! |
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Term
| What are the types of pacemakers? |
|
Definition
-Transcutaneous
-Transvenous
-Atrial
-Ventricular
-Dual Chamber |
|
|
Term
|
Definition
Heart sandwich.
Pacing the heart from the pads on the defibulator. |
|
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Term
| How do you know what type of pacemaker? |
|
Definition
Whatever the spike comes before.
For example. spike before P-wave, it's atrial. Spike before QRS, it's ventricular. |
|
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Term
|
Definition
Synchronized
Transcutaneous |
|
|
Term
|
Definition
| recommended to treat (1) unstable SVT, (2) unstable atrial fibrillation, (3) unstable atrial flutter, and (4) unstable monomorphic (regular) VT. |
|
|
Term
| What are the electrical joules used for each shock? |
|
Definition
Atrial Fibrillation 120-200 J Initial
Atrial Flutter & SVT 50-100 J Initial
Monomorphic VT 100 J Initial |
|
|
Term
| What are the nursing considerations for cardioversion? |
|
Definition
Sedation
Monitoring – vital signs, cardiac rhythm
Clear
Sync button
Post procedure
Monitor v/s, airway
Emotional support
Documentation |
|
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Term
|
Definition
The delivery of a direct unsynchronized, shock to the heart.
Defibrillation stops all electrical activity in the heart to allow the SA node to take over and re-establish a perfusing rhythm. |
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Term
|
Definition
| 2nd Degree Type 1 - Wenkebach |
|
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Term
|
Definition
| 2nd Degree Type 2 - Mobitz |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Failure of pacemaker to capture |
|
|
Term
|
Definition
| Failure of pacemaker to fire |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| Premature atrial contraction |
|
|
Term
|
Definition
|
|
Term
|
Definition
| Supraventricular Tachycardia |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the #1 treatment for sinus brady? |
|
Definition
|
|
Term
| What are the causes of A.Fib? |
|
Definition
| CAD, heart failure, cardiomyopathy, HPT, valvular disorders, COPD |
|
|
Term
|
Definition
• Cardioversion if not in afib longer than 48 hrs, otherwise pt must be on anti-coagulation for 3-4 weeks prior
• Ablation of abnormal tissue causing the arrhythmia
• Can use medications to convert rhythm including adenosine |
|
|
Term
| What are the risk factors for a.flutter? |
|
Definition
| HPT, MVP, COPD, stress, hyperthyroid |
|
|
Term
| What is the treatment for a. flutter? |
|
Definition
beta blockers, digoxin, antiarrhythmics, cardioversion
• If chronic, remain on blood thinners |
|
|
Term
|
Definition
| hypervolemia, anxiety, hypokalemia, ischemia of heart muscle |
|
|
Term
|
Definition
| SNS stimulation, bronchodilator therapy, stress, hyperventilation, CAD, HF, HTN, PE |
|
|
Term
| What are the treatments for SVT? |
|
Definition
| Aimed at lowering heartrate, can use try vagal maneuvers first, adenosine, cardioversion |
|
|
Term
|
Definition
| failure of SA and AV node or irritable foci in ventricles, CAD |
|
|
Term
|
Definition
|
|
Term
| What happens if you have vtach w/ no pulse? |
|
Definition
START COMPRESSIONS!
Defibulate once you can get a defibulator |
|
|
Term
| What if vfib has no pulse? |
|
Definition
| • No pulse, begin compressions, defibrillate ASAP |
|
|
Term
| What is the treatment for asystole and PEA? |
|
Definition
| • Treatment epinephrine IVP, treat underlying causes |
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