Exam (elaborations)
Advent Health EKG 2024/2025 graded A+ by experts
- Course
- Institution
Advent Health EKG 2024/2025 graded A+ by experts
[Show more]
Content preview
Advent Health EKGAfib - ANSThe impulse originates in the Atria
• The Atrial rate is > 300 and unable to measure [N/A]
• No discernable P waves - PRI & Atrial rhythm cannot be measured [N/A]
• The Ventricular rhythm is irregular
• QRS within normal limits
• If the Ventricular rate is <100 the rhythm is controlled A-fib;
if the Ventricular rate is > 100 the rhythm is uncontrolled A-fib
• This is a chronic rhythm for some patients
Treatment: controlled patients: anticoagulants and antiarrythmics; uncontrolled but stable
patients: Beta blockers, calcium channel blockers, or digoxin; Unstable patients: cardioversion
Junctional Rhythm - ANSImpulse starts in the AV junction
• P waves are absent, short, inverted or retrograde
• Ventricular Rhythm: Regular
• Ventricular Rate: 40-60 bpm
• QRS is usually within normal limits
Accelerated Junctional Rhythm - ANSAccelerated Junctional
Same criteria as Junctional Rhythm, except the Ventricular rate is 60-100
For stable patients: IV access, vagal maneuvers, adenosine, O2, Beta blockers, calcium
channel blockers
Idioventricular Rhythm (IVR) - ANSImpulse originates in the ventricles
▪ Rhythm: Ventricular is usually regular
▪ Rate: Ventricular between 20-40
▪ QRS: ≥ 0.12
▪ Atrial rate, rhythm, and PRI: N/A
- Treatment: assess pt, check for DNR in chart, transcutaneous pacing, atropine. NEVER GIVE
ANTI-ARRYTHMICS MEDICATIONS
Accelerated Idioventricular Rhythm - ANSFollows the same criteria as IVR, except Ventricular
rate is 40-100.
• If no intervention happens, the patient will deteriorate.
- Treatment: assess pt, atropine, transcutaneous pacing. NEVER GIVE ANTI-ARRHYTHMIC
MEDICATIONS
Ventricular Pacing - ANS• The pacemaker lead is placed in to right ventricle.
• The pacemaker generator fires an impulse Initiating ventricular activity.
• The right ventricle will contract first followed by the left ventricle. This results in a wide QRS
• Atrial activity is typically absent. Therefore, Atrial rhythm, rate, and PRI are non- measurable
, • Rhythm: Ventricular regular
• Rate: Ventricular within set pacer limits. Measured from pacer spike to pacer spike
• QRS: Wide; Pacer spike seen before each QRS. Measured from pacer spike to end
of QRS
Atrial-ventricular Pacing - ANSOne pacemaker lead is placed into the right atria and another is
placed into the right
ventricle.
• The pacemaker generator fires an impulse to the atria and then to the ventricle sequentially
causing atrial then ventricular contraction.
• Rhythm: Atrial and Ventricular regular
• Rate: Atrial and Ventricular same & within set limits
• P waves: Pacer spike seen at beginning of atrial activity P waves may or may not be seen
(lead type dependent)
• PRI: WNL - Measured from atrial spike to ventricular spike
• QRS: Wide - Measured from ventricular spike to end of QRS
Failure to capture - ANSA pacer spike note followed by the appropriate atrial or ventricular
response
• Can be a potentially lethal situation!
Failure to pace - ANSAbsence of pacer activity (spikes) when the pacemaker generator should
have fired an impulse.
• Typically seen when the patient's intrinsic heart rate falls less than the pacemaker's low HR
limit and
the pacer fails to fire.
normal sinus rhythm (NSR) - ANSImpulse starts in the SA Node
• Rate: Atrial & Ventricular 60-100 [WNL]
• Rhythm: Atrial and Ventricular are regular
• P waves: Normal; each followed by QRS
• PRI: 0.12 - 0.20 [WNL]
• QRS: 0.04 - 0.10 [WNL]
Sinus Tachycardia - ANSThese rhythms follow all the criteria for NSR except for the rate.
• Rate: Atrial and Ventricular 100-150
Sinus Bradycardia - ANSThese rhythms follow all the criteria for NSR except for the rate.
• Rate: Atrial and Ventricular < 60
Sinus Arrythmia - ANS• Impulse starts in the SA Node but activity varies with respirations
• Rate: Atrial and Ventricular are 60-100, but varies (slower or faster)
• Rhythm: Atrial and Ventricular is irregular (P-P and R-R intervals are irregular)
• P waves: Normal and each is followed by a QRS
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Ascore. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $11.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81113 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now