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28 Cards in this Set
- Front
- Back
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Which parasympathetic nervous system response may cause dysrhythmias?
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Increased sympathetic stimulation INCREASES the incidence of dysrhythmias, Increased parasympathetic stimulation DECREASES the incidence of dysrhythmias
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What is the P wave?
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* ATRIAL MUSCLE DEPOLARIZATION
* should only be 1 P Wave * should be less than 0.12 s |
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What are P wave abnormalities?
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* if p wave is inverted and pt is asymptomatic, no problem-just an alternate conduction pattern
* if p wave is absent, may be a problem, you lost your atrial kick = risk of clot formation; may indicate POTASSIUM EXCESS * if p and t wave are both inverted, electrodes need to be placed differently |
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What is QRS complex?
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* VENTRICULAR MUSCLE DEPOLARIZATION
* should be less than 0.12 s |
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What are QRS abnormalities?
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*prolonged QRS can indicate mag or potassium excess
*when a QRS is less than 5mm on the strip the letters "qrs" are used instead of capitals |
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What are T waves?
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* represents ventricular repolarization follwing QRS
* often greater in amplitude than the P wave |
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What are T wave abnormalities?
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* flat T waves = potassium or magnesium deficit
* tall T waves = potassium excess * inverted T wave is a problem unless P waves are also inverted (which would just indicated bad electrode placement) |
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What is ST segment?
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*Early ventricular repolarization; should be isoelectric
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What are ST segment abnormalities
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* elevated ST = ischemia
* depressed ST = necrosis (MI) or potassium imbalance * lengthened ST = hypocalcemia |
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What is the U wave?
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*Thought to be repolarization of the purkinje fibers
* sometimes seen in pts with Hypokalemia Hypertension Heart disease |
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What is the PR interval?
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*Beginning of the P wave to the beginning of the QRS complex
* Time needed for sinus node stiumlation, atrial depolarization, and conduction thru the AV node before ventricular depolarization * normally 0.12 - 0.2 |
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What are PR interval abnormalities?
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* prolonged PR = mag excess OR potassium deficit or excess
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What is the QT interval?
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* The total time for ventricular depolarization and repolarization
* measured from the beginning of the QRS to the end of the T wave * time varies with heart rate, but usually 0.34-0.4 in duration * |
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What are QT interval abnormalities
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* short QT = calcium excess
* long QT = calcium deficit, risk of lethal ventricular dysrhthmia called torsades de points |
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What is the TP interval?
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measured from the end of the T wave to the beginning of the next P wave
* isoelectric baseline |
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What does the PP and RR interval measure?
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PP interval measures atrial rhythm and rate
RR interval measures ventricular rhythm and rate |
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Determine the ventricular heart rate from EKG if HR is regular
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Count small boxes in an RR interval and divide by 1500
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Determine the ventricular heart rate from EKG if HR is irregular
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Count the number of RR intervals in 6 seconds and multiply by 10
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Describe Normal sinus Rhythm
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
IMPULSE STARTS AT A REG RATE IN SINUS NODE, TRAVELS DOWN NORMAL CONDUCTION PATHWAY
P to Q = 1:1 P WAVES normal PR INTERVAL 0.12 - 0.20 QRS COMPLEX normal 0.08 - 0.12 ATRIAL RATE 60 - 100 VENTRICULAR RATE 60- 100 |
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Describe Sinus Bradycardia
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
SINUS NODE IMPULSE SLOWER THAN NORMAL
P to Q 1:1 P WAVES normal PR INTERVAL 0.12 - 0.2 QRS COMPLEX 0.08 - 0.12 ATRIAL RATE below 60 VENTRICULAR RATE below 60 |
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Describe Sinus Tachycardia
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
SINUS NODE IMPULSE FASTER THAN NORMAL RATE
P to Q 1:1 P WAVES NORMAL OR MAY BE BURIED IN PREVIOUS T WAVE PR INTERVAL 0.12 - 0.2 QRS COMPLEX 0.08 - 0.12 ATRIAL RATE > 100 VENTRICULAR RATE > 100 |
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Describe Premature Atrial Contractions (PAC)
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
WHEN AN ELECTRICAL IMPULSE STARTS IN THE ATRIUM BEFORE THE NEXT NORMAL IMPULSE OF THE SINUS NODE. OFTEN SEEN WITH SINUS TACHYCARDIA.
P to Q 1:1 P WAVES may be early, different or buried in the T waves PR INTERVAL the early p wave will have a shorter than normal PR interval, but still 0.12 - 0.2 s QRS COMPLEX may be normal, decreased or absent ATRIAL RATE depends on underlying rhythm (if tachyc), but may be WNL VENTRICULAR RATE same as atrial rate, may be irregular |
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Describe ATRIAL FIBRILLATION
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
RAPID DISORGANIZED TWITCHING OF ATRIAL MUSCLES . MAY START AND STOP SUDDENLY. COMMON IN ELDERLY.
P to Q many : 1 P WAVES none discernable PR INTERVAL cannot be measured QRS COMPLEX may be normal or abnormal ATRIAL RATE 350 - 600 VENTRICULAR RATE 120 - 200 (almost a 3:1 ratio atrial to ventricular rate) |
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Describe V-TACH
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
FREQUENT (MORE THAN 3 IN A ROW)PREMATURE VENTRICULAR CONTRACTIONS (BEFORE THE NEXT NORMAL SINUS CONDUCTION) AT A RATE > 100 BPM--PT USUALLY PULSELESS AND UNRESPONSIVE
P to Q absent P WAVES none PR INTERVAL none QRS COMPLEX > 0.12 s ATRIAL RATE absent VENTRICULAR RATE 150 - 200 |
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Describe V-FIB
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
RAPID DISORGANIZED VENTRICULAR RHYTHM--NO ATRIAL ACTIVITY.
P to Q NONE P WAVES NONE PR INTERVAL NONE QRS COMPLEX NONE RECOGNIZABLE ATRIAL RATE NONE VENTRICULAR RATE > 300 PER MIN |
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Describe Atrial Flutter
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
Impulses at an atrial rate between 240 - 400 bpm--too fast to go through AV node causing block
P to Q 2:1, 3:1, 4:1 P WAVES saw-toothed, referred to as F waves PR INTERVAL can't really measure QRS COMPLEX usually normal but may be abnormal or absent ATRIAL RATE 250 - 300 VENTRICULAR RATE > 100 |
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Describe 3rd Degree Heart Block
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
P to Q
P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
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Describe PVC
P to Q P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
P to Q
P WAVES PR INTERVAL QRS COMPLEX ATRIAL RATE VENTRICULAR RATE |
