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Advanced Dysrhythmias exam with correct answers
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Advanced Dysrhythmias exam with correctanswers
P nnwave:
PR nninterval:
QRS nncomplex:
(ST nnsegment)
T nnwave:
QT nninterval: nn- nncorrect nnanswer-• nnP nnwave nn- nnatrial nndepolarization nnand nncontraction
• nnPR nninterval nn- nntime nnof nntravel nnfrom nnthe nnSA nnnode nnto nnAV nnnode nn(.12-.2)
• nnQRS nn- nnventricular nndepolarization nnand nncontraction nn(.08-.12)
- nnNote: nnAtrial nnrepolarization nnoccurs nnduring nnthis nntime, nnbut nncannot nnbe nnseen nnon nnEKG
• nnT nnwave nn- nnventricular nnrepolarization
• nnQT nninterval nn- nnstart nnof nnventricular nncontraction nnto nnend nnof nnrelaxation
Systematic nnApproach nnto nnanalyzing nnEKG nn(7 nnsteps) nn- nncorrect nnanswer-1. nnDetermine nnatrial nn&
nnventricular nnrate nnand nnrhythm.
2. nnIdentify nnP nnwaves nnand nnshape, nnand nnif nnthere nnare nnP nnwaves nnfor nnevery nnQRS.
3. nnDetermine nnPR nninterval nn(0.12-.2), nnand nnif nnconsistent, nnirregular nnbut nnwith nnpattern nnto nnirregularity,
nnor nnjust nnirregular.
4. nnDetermine nnQRS nnduration, nnconsistency, nnand nnshape. nn(<0.12)
5. nnIdentify nnT nnwave nnand nnshape.
6. nnIdentify nnST nnsegment, nnand nnany nnelevation/depression.
7. nnIdentify nnany nnectopic nnbeats nnoccurring nnoutside nnunderlying nnrhythm.
Determining nnHR nnfrom nnEKG nnstrip nn- nncorrect nnanswer-Typical nnheart nnrhythm nnstrips nnwill nncontain nn6
nnseconds nn(30 nnbig nnboxes)
• nnRates nnin nna nn6 nnsecond nnstrip nncan nnbe nnobtained nnby
, - nnVentricular nnrate nn= nnQRS nn(QRS nnto nnQRS-the nngaps) nnx nn10
- nnAtrial nnrate nn= nnP nnwaves nnx nn10
OR nnVentricular nnrate nn= nn1500 nn/ nn# nnof nnsmall nnboxes nnbetween nn2 nnQRS; nnAtrial nnrate nn= nn1500 nn/ nn# nnof
nnsmall nnboxes nnbetween nn2 nnP nnwaves
• nn1 nnsmall nnbox nn= nn.04sec, nn5 nnboxes/large nnbox nn= nn0.2sec; nn5 nnlarge nnboxes nn= nn1 nnsecond, nn15 nnlarge nn=
nn3sec
To nnimprove nnlead nnconduction... nn(4) nn- nncorrect nnanswer-- nnClean nnand nndry nnskin nnwith nnsoap nnand nnwater
- nnRemove nnexcess nnhair
- nnGentle nnabrasion nnof nnskin nnwith nnclean nngauze nnto nnexpose nnepidermis nn(dry nngauze, nnnot nnalcohol
nnwhich nnacts nnas nnbarrier, nnskin nnis nna nnnatural nnconductor)
- nnHave nnpatient nnremain nnstill nnand nnsupine
Normal nnSinus nnRhythm nn- nncorrect nnanswer-• nnVentricular nnand nnatrial nnrate: nn60 nnto nn100 nnbpm
• nnVentricular nnand nnatrial nnrhythm: nnRegular
• nnQRS nnshape nnand nnduration: nnUsually nnnormal, nnbut nnmay nnbe nnregularly nnabnormal
• nnP nnwave: nnNormal nnand nnconsistent nnshape; nnalways nnin nnfront nnof nnthe nnQRS
• nnPR nninterval: nnConsistent nninterval nnbetween nn0.12 nnand nn0.20 nnseconds
• nnP:QRS nnratio: nn1:1
Sinus nnBradycardia nn- nncorrect nnanswer-• nnAtrial/ventricular nnrate nnand nnrhythm: nn< nn60 nnand nnregular
• nnP nnwave: nnNormal nnand nnconsistent nnshape; nnalways nnin nnfront nnof nnQRS
• nnPR nninterval: nnConsistently nnbetween nn0.12 nnand nn0.2 nnseconds
• nnQRS nnshape nnand nnduration: nnUsually nnnormal, nnbut nnmay nnbe nnregularly nnabnormal
• nnConcern nn- nndecreased nncardiac nnoutput nnand nntissue nnperfusion
Etiology nnof nnSinus nnBrady nn(causes) nn- nncorrect nnanswer-• nnLower nnmetabolic nnneeds nn- nnSleep, nnAthletes,
nnHypothyroidism
• nnVagal nnstimulation nn(triggers nnparasympathetic) nn- nnVomiting, nnSuctioning, nnPain
• nnMedications nn- nnCCB, nnBB, nnAmiodarone
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