EKG

Helpfulness: 0
Set Details Share
Page to share:
Embed this setcancel
COPY
code changes based on your size selection
Size:
X
Show:
1

EKGs are useful to evaluate all of the following, except?

Pumping ability of the heart

2

What clinical findings are most significant of the need for an EKG?

B. Orthopnea & Chest pain

3

For an adult, what is the normal intrinsic rate of the hearts primary pacemaker?

60-100 bpm

4

What does the P wave on the EKG recording represent?

Atrial depolarozation

5

What does the QRS complex on the EKG recording represent?

Ventricular depolarization & Atrial repolarization

6

What does the T wave on the EKG recording represent?

Ventricular repolarization

7

Which of the following is within the normal range for a PR interval?

0.20 seconds

8

What is the upper limit of a normal QRS complex?

< 0.10 seconds

9

The complexes are equally spaced w/ three large boxes between each complex. What is the heart rate?

100 bpm

1500/15=100

(5 small boxes X 3 large boxes= 15)

10

A prolonged RP interval is indicative of which of the following?

AV block

11

An early, widened QRS complex with an inverted T wave and no associated P wave is consistent with which of the following?

PVC

12

What EKG finding is suggestive of an acute MI?

Elevated ST segments

13

What EKG finding is suggestive of cor pulmonale?

Right-Axis deviation

14

Which of the following statements is true regarding Sinus tachycardia?

It may be caused by fever, fear, or pain

15

For a pt experiencing severe CP and other acute cardiac symptoms, the immediate role of the RT is to do which of the following?

Notify the nurse & Dr and be ready to assist the cardiac arrest team

16

What are the two types of Cardiac cells?

Myocardial cells

Pacemaker cells

17

What is the purpose of the myocardial cells?

These are the working cells they contain contractile filaments to help contract the heart

18

What is the purpose of the pacemaker cells?

They are specialized cells of the electrical conduction system and they are responsible for spontaneous generation/conduction of electrical impulses.

19

What are the 4 properties of the cardiac cells?

Excitability

Automaticity

Conductivity

Contractility

20

What is the purpose of excitability?

Muscles cells can respond to outside stimilus

21

What is the purpose of automaticity?

pacemaker cells spontaneously initiate an electrical impulse w/out being stimulated from another source

22

What is the purpose of conductivity?

Cardiac cells can receive an electrical stimulus and conduct it to adjacent cardiac cells

23

What is the purpose of Contractility?

muscle contraction in response to electrical stimulus

24

EKG paper small boxes

0.04 seconds

25

EKG paper large bozes

0.20 seconds (made up of 5 small squares)

26

What is happening in the cardiac cells when the heart is firing?

It is exchanging CA+ and NA+ in and out of the cells

27

PR interval

  • Atrium firing
  • onset of P wave to onset of QRS complex
  • 0.12-0.20 seconds long
28

QRS complex

  • Ventricles firing (depolarization)
  • Follows each P wave
  • spread of electrical impulse through the ventricles
  • 0.04-0.12 seconds
29

ST segment

  • begins w/ the end of the QRS complex
  • ends w/ onset of the T wave
  • on the same line as the PR interval
30

T wave

  • represents ventricular repolarization
  • beginning of T wave is the point where the slope of the ST segment appears to become steeper
  • ends when it returns to baseline
31

what does a Depressed ST segment represent?

Myocardial ischemia (lack of blood flow)

32

what does an elevated ST segment represent?

myocardial injury (pericarditis)

33

What are two ways to calculate heart rate?

  1. 1500/#of small boxes
  2. 10 x # of R complexes in a 6 sec strip
34

What are SA node arrhythmias?

Bradycardia and tachycardia

35

What are Atrial tissue arrhythmias?

Flutter and Fibrillation

36

What are AV node arrhythmias?

Blocks and junctional

37

What are ventricular tissue arrhythmias?

Tachycardia and fibrillation

38

what can Tachy-arrhythmias affect?

  • coronary artery blood flow occurs during diastole
  • shorter diastolic time= decreased coronary artery perfusion time
  • increased workload of heart, increased myocardial O2 demand
  • CAD (decreased blood flow)
39

What are some causes of sinus tachycardia?

  • Increased CNS response: Fever, pain, anxiety, anemia, meds
  • Compensatory: hypovolemia
40

What are some interventions for sinus tachycardia?

  • Goal: decrease HR to normal
  • Aspirin, Beta blockers, ACE inhibitors, CA+ channel blockers
41

What can Brady-arrhythmias affect?

  • decreased myocardial O2 demand
  • prolonging of diastole
  • coronary perfusion pressure may decrease if HR is too slow to provide adequate CO and BP
  • May lead to MI if BP isn't adequate
42

What are some causes of sinus bradycardia?

  • PNS dominant: Excessive vagal (Valsalva) stimulation to heart
  • Decreased SA node discharge=decreased HR, and conduction
43

What are some interventions to sinus bradycardia?

  • Atropine
  • volume replacement
  • pacemaker placement
44

what are some causes of atrial flutter?

  • AV node selectively blocks # of impulses that reach ventricles
  • Rheumatic Heart disease, CHF, AV valve disease, post cardiac surgery
45

what are some Interventions for atrial flutter?

  • O2
  • Amiodarone, Cardizem, verapalim
46

What are some causes of A-Fib?

  • aging, MI, HR, MS, Cardiomyopathy
  • can lead to formation of multiple thrombi in cardiac champers (Stroke, DVT, atrial thrombi)
47

What are some interventions for A-Fib?

  • if initial A-Fib is < 48 hrs: decrease ventricular response and convert to NSR
  • if > 48 hrs: anticoagulant therapy
  • Beta blockers, CA+ channel blockers, antiarrhythmics, cardioversion
48

What are some symptoms of A-Fib?

  • SOB, Fatigue, weakness, distended neck veins, anxiety, syncope, palpitations, chest discomfort, irregular pulse
49

What are some things that can cause PVCs?

  • Aging, MI, HF, caffeine, decreased K+
  • can be a warning sign of new onset VT, VF, R on T phenomenon
50

What are some interventions for PVCs?

  • O2, antiarrhythmics (lidocaine)
  • MONA (morphine, O2, Nitro, Aspirin)
51

What are some things that can cause V-TACH?

  • Acute MI, CAD, K+ imbalance
  • decreased QT interval, cardiac surgery
  • digoxin toxicity
52

What are some interventions for V-Tach?

Sustained: O2, EKG, antiarrhythmics (amiodarone), cardioversion

Unstable: Emergency cardioversion, O2, antiarrhythmics

Pulseless: Defibrillation (Epinephrine/Defibrillator)

With pulse: Adenosin and Defibrillator

53

What are some causes of V-FIB?

  • Acute MI, decreased K+, decreased Mg
  • (ventricles quiver, consume lots of O2, No CO, no perfusion)
54

What are some interventions for V-FIB?

  • Defribriilation
  • amiodarone, lidocaine, Magnesium sulfate (for hypomagnesemia or Torsades de pointes)
55

What are some causes of Asystole?

  • no electrical impulses, no depolarization, No CO, no VS, no impulses reach ventricles if SA node fires
  • Cardiac arrest, unresponsive
56

What is Cardioversion?

  • Timed (shocks on R wave) electrical current.
  • syncronizes w/ EKG so it discharges during V depolarization
57

What is defibrillation?

  • trx of choice for pulseless VT and V-Fib
  • electrical current is not timed
  • current discharges immediately when charged
58

What are heart blocks?

delay in the conduction of the impulse through the AV node

59

What is a 1st degree AVB?

  • PR interval >0.20 seconds
  • All impulses reach ventricles
60

What is a 2nd degree type 1

  • each impulse takes longer to conduct until one is blocked and a QRS is dropped followed by a pause
61

What is a 2nd degree type 2

  • Impulses are dropped at a regular interval causing dropped QRS compleses
62

What is a 3rd degree AVB?

  • none of the atrial impulses reach the ventricles
  • atria and ventricles are divorced
  • results in inadequate CO
  • requires a pacemaker