Flashcard Set Preview
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dysrhysthmias
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disorders of formation or donduction (or both) of electrical impulses within heart
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dysrhythmias can cause disturbances of...
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1. rate
2. phythm
3. both rate, rhythm
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Dysrhythmias is dx by..
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analysis of electrographic waveform
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ablation
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purposeful destruction of heart muscle cells, usually in an attemt to comtrol a dysrhythmia
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| 5 |
cardioversion
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electrical curent administered in synchrony with the patient's own QRS complex to stop a dysrhythmia
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| 6 |
chronotropy
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rate of impulse formation
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defibrillation
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electrical current administered to stop a dysrhythmia, not synchronized with the patient's...
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dromotropy
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conduction velocity
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| 9 |
elective replacement indicator (ERI)
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a signal produced by a pacemaker when it is interrogated to indicate a near-depleted battery
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| 10 |
implatable cardioverter defibrillator (ICD)
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a device implanted into the chest to treat dysrhythmias
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| 11 |
inhibited
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in reference to pacemakers, term used to descrive the pacemaker withholding an impulse (not...
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inotrophy
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force of myocardial contraction
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| 13 |
paroxysmal dysrhythmia
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a dysrhythmia that has a sudden onset and/or termination and is usually of short duration
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| 14 |
triggered
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term used to describe the release of an impulse in response to some stimulus
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| 15 |
proarrhythmic
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an agent that causes or exacerbates a dysrhythmia
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| 16 |
ssupraventricular tachycardia (SVT)
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a rhythm that originates in the conduction system above the ventricles
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ventricular tachycardia (VT)
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a rhythm that originates in the ventricles
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| 18 |
dysrhythmias: how is it named?
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1. according to the site of origin of the impulse
2. mechanism of formation or conduction...
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| 19 |
site of orgin of the impulse can be... (4)
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1. SA node
2. atria
3. AV node
4. ventricles
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| 20 |
categories of mechanisms of formation or conduction (9)
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1. normal (idio) rhythm
2. bradycardia
3. tachycardia
5. dysrhythmia
6. flutter
7. fibrillation
8....
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| 21 |
SA node electrical impulse occurs at...
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60-100
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| 22 |
atrial kick
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atrial contraction that accounts for near 1/3 of the volume ejected during ventricular contraction.
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| 23 |
normal conduction pathway
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SA node - atria - AV node - bundle of His - right and left bundle branches - purkinje fibers
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| 24 |
stimulation of the synpathetic system causes...
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1. + chronotropy
2. + dromotropy which means that it causes conduction through AV node
3....
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| 25 |
list the factors that will increase sympathetic stimulation which may increase the incidence...
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1. exercise
2. anxiety
3. fever
4. administration of catecholamines
- dopamine, aminophylline,...
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| 26 |
how many electrodes are used for 12 lead ECG?
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10
6 on the chest
4 on the limbs
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where do you apply the limb electrodes?
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places that are not body and that do not have significant movement
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| 28 |
limb electrodes provide how many and which leads?
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6/ leads I, II, III, aVR, a VL, and a VF
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| 29 |
chest electrodes provide how many and which?
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6, V or V1 ~ V6
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| 30 |
how to place ECG electrodes?
1. V1?
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1. fourth intercostal space, right sternal border
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| 31 |
how to place ECG electrodes?
1. V2?
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2. fourth intercostal space, left sternal border
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placement of V3?
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diagonally between V2-V4
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placement of V4
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fifth intercostal space, left midclavicular line
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placement of V5?
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same level as v4, anterior axillary line
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placement of V6?
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same level as V4 and V5, midaxillary line
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| 36 |
ECG waveforms reflects...
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the fuction of the heart's conduction system
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| 37 |
P wave represents?
normal in ECG?
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the electrical impulse starting in the sinus node and spreading through the atria
- atrial...
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| 38 |
1. QRS complex represents?
2. Q wave is shown on ECG as...
3. Q values
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1. ventricular depolarization
2. first negative deflection after the P wave
3. normally less...
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R wave is shown on ECG as..
S wave ...
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1. first positive deflection after the P wave
2. first negative deflection after the R wave
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what does qrs mean?
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the height is less than 5 mm
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| 41 |
Normal duration of QRS complex?
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0.12 seconds
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| 42 |
T wave represents..?
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ventricular repolarization (when the cells regain a negative charge)
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why is atrial reporlarization not seen on ECG?
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because it occurs at the same as the QRS
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| 44 |
U wave represents
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thought to represent repolarization of the purkinje fibers
- show seen with pt with hypokalemia
-...
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| 45 |
PR interval is measured from...?
What does it represent?
what are normal duration?
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measured from the beginning of the P wave to the beginning of the QRS compex
- represents...
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| 46 |
ST segment represents
how is it measured?
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- early ventricular repolarization
- from end of the QRS complex to the beginning of the T...
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| 47 |
QT interval represents
- how is it measure?
- it may vary by what factors?
- normal...
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the total time for ventricular depolarization and repolarization
- measured from the beginning...
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| 48 |
TP interval represents
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1. an isoelectric period - no electricity is detected, the line is flat.
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PP interval is used to determine what?
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- atrial rhythm and atrial rate.
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| 50 |
RR interval is used to determine what?
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- rate and rhythm of ventricles
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| 51 |
1 minutes strips contain how many
- large boxes?
- small boxes
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- 500 large boxes
- 1500 small boxes
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| 52 |
determining HR for irregular HR
steps..
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1. count the number of RR intervals in 6 seconds
2. multiply the number by 10 (for 60 seconds:...
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each small boxes are how many seconds? and how many mV?
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- 0.04 seconds
- 0.1 mV
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the rhythm is regular if the intervals are...
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same or the difference between which intervals are less than 0.8 seconds throughout the strip
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| 55 |
systematic analysis of the electrocardiogram
(what are you asking when you are looking at...
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1. determine the ventricular rate
2. determine the ventricular rhythm? (reg/irreg?)
3. determine...
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| 56 |
Bachmann's bundle
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tracts of tissue extending from the SA node to the left atrium
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| 57 |
AV node -
what is it? where is it?
pulse rate
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site of delay
located in the inferior right atrium
- rate of 40-60 times/min
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| 58 |
left anterior fascicle
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- anterior LV
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| 59 |
Left posterior fascicle
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posterior LV (faster conduction than the anteior LV)
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| 60 |
rate of the purkinje fibers
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20-40 times/min
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| 61 |
in 6 second strips there is how many
- large boxes?
- small boxes?
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- 30 lg
-150 sm
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| 62 |
characteristics of sinus bradycardia
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1. ventricular and atrial rate: less than 60 in adults
2. ventricular and atrial rhythm: regular
3....
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| 63 |
characterstics of normal sinus rhythm
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1. 60-100
2. regular rhythm
3. QRS shape and duration: usually normal, but may be reglarly...
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| 64 |
possible causes for sinus bradycardia
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1. lower metabolic needs (hypothyroidism, sleep, athletic training)
2. vagal stimulation (from...
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| 65 |
stop the vagus nerve stimulation which causes dec in HR.. what are some interventions?
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the pt to not bear down when defecating, stop the vomitting
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| 66 |
what can sinus bradycardia may result in pt?
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1. decreased exercise capacity
2. fatigue
3. unexplained confusion
4. memory loss
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| 67 |
some of interventions for sinus bradycardia
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1, admin IV bolus of Atropine 0.5mg. every 3-5min to a maximum total does of 3 mg
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| 68 |
atropine is the choice for sinus bradycardia for what reasons?
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1. blocks vagus stimulation
2. increases HR
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| 69 |
Sinus tachycardia may be caused by...
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1. physiologic or psychological stress (acute blood loss, anemia, shock, hypervolemia, hypovolemia,...
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| 70 |
characteristics of sinus tachycardia
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1. >100 but usually <120bpm
2. regular rhythm
3. QRS shape usually normal but may be...
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| 71 |
sinus syncope may cause pt to experience
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1. syncope
2. low blood pressure
3. may develop acute pulmonary edema .. why?
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| 72 |
the treatment of the sinus tachycardia depends on..?
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1. severity of symptoms and directed at identiffying and abolishing its cause.
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| 73 |
what are some interventions for sinus tachycardia?
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1. admin. beta-blockers, calcium chnnel blockers
2. catheter ablation of SA node incases of...
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| 74 |
postural orthostatic tachycardia syndrome
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pt experience tachycardia with no hypotension within 5-10minutes of steanding or with head-upright...
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| 75 |
how does Sinus arrhythmia?
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- when the sinus node creates an impulse at an irregular rhythm ; the rate usually increases...
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| 76 |
possible causes of sinus arrhythmia
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1. heart disease and valvular disease (rare)
2. respiratory causes
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| 77 |
characteristics of sinus arrhythmia
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1. rate: 60-100 in the adult
2. irregular rhythm
3. QRS shape and duration - usually normal,...
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| 78 |
premature atrial complex (PAC) occurs when..
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1. when the impulse starts in the atrium before the next normal impulse of the sinus node....
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PAC is may be caused by...
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1. caffeine, alcohol, nicotine, stretched atrial myocardium, anxiety, hypokalemia, hypermetabolic...
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PAC is usually seen with
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sinus tachycardia
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characteristics of PAC
1. rate and rhythm
2. QRS shape and duration
4:....
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1. ventricular and atrial rate: depends on the underlying rhythm
2. ventricular and atrial...
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