EKG
Terms
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- A-fib P value
- none defined
- A-fib Ventricular Rate
- varies
- A-fib: PR interval length
- unable to measure
- A-fib QRS interval length
- 0.6-0.12
- A-fib: dx factor
- ALWAYS irregular
- A-fib risk for pts
- slower atrial/ventricular filling Loss of atrial kick drops CO by 15-25% Development of clots
- A-fib: TX
- digoxin cardizem coumadin cardioversion if symptomatic
- a-flutter: P
- none defined: >150
- A-flutter: ventricular rate
- varies
- A-flutter: PR
- no consistent PR
- A-flutter: QRS
- 0.06-0.12
- A-flutter: Dx factor
- ALWAYS has flutter waves
- A-flutter: risk for pts
- Slower A/V filling Drop in CO Develompment of clots
- A-flutter: TX
- Same as A-Fib (digoxin cardizem coumadin cardioversion if symptomatic)
- Supraventricular Tachycardia: P
- unable to define
- Supraventricular Tachycardia: Rate
- >150 BPM
- Supraventricular Tachycardia: PR
- unable to measure
- Supraventricular Tachycardia: QRS
- <0.12
- Supraventricular Tachycardia: Definition
- A tachycardia originating from area above the ventricles; Often confused with v-tach; Can cause symptoms from drop in cardiac output due to high rate
- Supraventricular Tachycardia: TX
- ADENOSINE or cardioversion if unstable
- Ventricular Tachycardia: P
- none
- Ventricular Tachycardia: Rate
- > 100 BPM
- Ventricular Tachycardia: QRS
- wide; >0.12
- Ventricular Tachycardia: Common causes
- caused from electrolyte imbalance, MI or prolonged QT interval. It may be stable or unstable, with a pulse or with out a pulse. Stability is determined by the pt's ability to maintain a CO.
- Ventricular Tachycardia: TX
- Stable: Amiodorone, Lidocaine Unstable: Cardioversion/Defibrillation
- V-fib: P
- none
- V-fib: Rate
- None
- V-fib: PR
- None
- V-fib: QRS
- None
- V-fib: info
- ventricular are twitching; rhythm chaotic
- V-fib: common causes
- caused from untreated V-Tach, or MI. It is ALWAYS life threatening as there is no cardiac output. Immediate intervention is necessary.
- V-fib: TX
- code with early Defibrillation
- Premature Atrial Contraction: definition
- a beat originating from the SA node that is coming early.
- PVC
- A beat originating from the ventricles that is coming early. Distinctively: wide and bizzare; may be single beats, in pairs (couplet), or runs of 3 or greater (V-tach). Arise from one focus (unifocal) or many focus (multifocal). May be every other beat (bigeminal), every third beat (trigeminal).
- PVC: Area of concern
- Be concerned when there are >6/min, bigeminal, R on T, coupletes or triplets, or when they are increasing in #.
- Heart Block: First Degree AV Block: definition
- slowing of conduction from teh SA node to the AV node.
- Heart Block: First Degree AV Block: Determined with...
- a PR interval > 0.20.
- Heart Block: First Degree AV Block: Causes
- heart disease, digitalis or beta-blocker effect, Inferior MI
- Heart Block: First Degree AV Block: TX
- just watch it, confirm that it does not progress
- 2nd Degree AV Block: Type I: Definition
- progressive delay of conduction from teh SA node to the AV node until a beat is dropped.
- 2nd Degree AV Block: Type I: Determined with...
- A PR interval that lengthens with each beat.
- 2nd Degree AV Block: Type I: Causes
- Inferior MI
- 2nd Degree AV Block: Type I: TX
- just watch it, confirm that it does not progress
- 2nd Degree AV Block: Type II: (definition)
- every other or every 3rd beat travels from the SA node to the ventricles, the blocked beat stops at the AV node.
- 2nd Degree AV Block: Type II: (causes)
- Anterior MI High chance of progression to 3rd degree heart block.
- 2nd Degree AV Block: Type II: TX
- temporary pacemaker
- Complete Heart Block:
- no electrical conduction is occurring between the atria and ventricles, both are beating independently
- Complete Heart Block: P waves (firing)
- SA node fires- atrial rate 80
- Complete Heart Block: QRS complexes
- ventricles fire - rate 40
- Complete Heart Block: common cause
- anterior MI
- Complete Heart Block: TX
- pacemaker
- Does the pacemaker pace the atria or ventricles?
- Either, depending on reason for pacing.
- Pacemaker: Sense (definition)
- a pacemaker's ability to sense the pt's intrinsic rhythm, shutting off with the pt's heart beats.
- Cardiac output equation
- CO= HR x SV
- Sinus rhythm: QRS
- 0.06-0.12
- Extended QRS indicates what?
- bundle branch blockage
- Sinus Rhythm: PR interval
- 0.12-0.20 (3-5 boxes)
- inconsistency of PR interval indicates what?
- AV block rhythms
- QT interval norm
- < 0.44 (up to 11 boxes)
- Sinus Bradycardia: Rate:
- < 60 BPM
- Sinus Bradycardia: common causes
- may be normal in young adults, or athletes; vomiting, vagal stimulation, MI (esp. inferior), reperfusion with thrombolytic agents
- Sinus Bradycardia: TX
- Nothing unless symptomatic. ATROPINE or pacemaker.
- Sinus Tachycardia: Rate:
- >100 BPM
- Sinus Tachycardia: common causes
- excessive sympathetic stimulation hypermatabolic states fever acute blood loss anemia exercise anxiety hypovolemia congestive heart failure hypotension
- Sinus Tachycardia: TX
- eliminate the cause
- A-fib: S/S
- A/R deficit
- Supraventricular tach: TX (repeat but more info)
- Adenosine (rapid IVP over 3 sec)
- Ventricular Tachycardia: info
- SA & AV not pacemakers; ventricles pacemakers
- Ventricular Fibrillation: Always what?
- A lethal rhythm; SA, AV, and ventricles NOT pacemaking
- Pacemaker term: Rate: Fixed vs. demand
- If pt has inherent rhythm, pacer may only fire if the rate falls below a set rate, often 70 BPM
- Pacemaker term: Capture:
- The ventricle contracts in response to stimulation by pacemaker (as seen on EKG)
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