Relias Ekg Test Answers

normal sinus rhythm

heart rhythm originating in the sinoatrial node with a rate in patients at rest of 60 to 100 beats per minute

Sinus Arrhythmia

Appearance is ALMOST NORMAL:
Respiratory - Circulatory interaction
Rate INCREASES with INSPIRATION (IN=IN)

Sinus Bradycardia

<60
normal sinus rhythm

Sinus Tachycardia

>100 (100-150)
normal sinus rhythm

Premature Atrial Contraction (PAC)

Heart Rate: Depends on underlying rhythm
Regularity: Interrupts the regularity of underlying rhythm
P-Wave: can be flattened, notched, or unusual. May be hidden within the T wave
PRI: measures between .12-.20 seconds and can be prolonged; can be different from other complexes
QRS: <.12 seconds

Sinus Arrest/Pause

- SA node doesn't fire
- notice absence of P-wave for a complete cycle (a missed cycle)
length of pause ≠ multiple of normal rate (block)

Atrial Fibrillation (A-Fib)

an irregular and often very fast heart rate originating from abnormal conduction in the atria

Atrial Flutter

irregular beating of the atria; often described as "a-flutter with 2 to 1 block or 3 to 1 block"

Junctional Rhythm

40-60 Regular!
-impulse from AV node w/ retro/antegrade transmission
- P wave often inverted/buried/follow QRS
- slow rate
- narrow QRS (not wide like ventricular)

Junctional Tachycardia

>60 bpm (ms. K; 150-250)
- KEY: will be regular (consistent)
- AV junction produces a rapid sequence of QRS-T cycles
- p-wave often inverted/buried/follow QRS

Premature Junctional Contraction

Inverted p wave or hidden p wave
PRI<0.12 or none
Normal QRS

Supraventricular Tachycardia (SVT)

an abnormal heart rhythm arising from aberrant electrical activity in the heart; originates at or above the AV node

First degree heart block

atrioventricular (AV) block in which the atrial electrical impulses are delayed by a fraction of a second before being conducted to the ventricles

2nd degree heart block type 1 (Wenkebach)

Progressively longer PR interval until the P wave is not followed by a QPR

2nd Degree Heart Block (Mobitz II)

Rare, but more serious
Sudden appearance of a nonconducted P-wave
P-waves are nl, but some aren't followed by a QRS complex
PR & RR intervals are constant

3rd degree heart block

no obvious correlation between p and qrs, need pace maker

premature ventricular contraction (PVC)

a ventricular contraction preceding the normal impulse initiated by the SA node (pacemaker)

Bigeminy PVC

every other beat is a PVC

PVC couplets

PVC occurring in pairs, no adequate C.O. when this occurs

monomorphic ventricular tachycardia

presents with wide QRS complexes of a common shape.

Torsades de pointes

Rate: 120 - 200 usually
P wave: Obscured by ventricular waves
QRS: Wide QRS - "Twisting of the Points"
Conduction: Ventricular only
Rhythm: Slightly irregular

Ventricular fibrillation (V-fib)

abnormal heart rhythm which results in quivering of ventricles

Idioventricular Rhythm

<40
looks like vtach but slow
- no P waves (from vent foci)
- Wide QRS
(serious, death like rhythm)
- called "dying heart" rhythm...occasional ventric beat b4 death (asystole)

Accelerated Idioventricular Rhythm

Rate: 50 - 100 usually (usually slow)
P wave: Obscured by ventricular waves (occur during ventricular contraction) - SA node slower than faster ventricular pacing than should be
QRS: Wide QRS
Conduction: Ventricular only
Rhythm: Regular

- benign rhythm that is sometimes seen during acute MI or early after reperfusion. - Rarely sustained, does not progress to vfib, rarely requires treatment

asystole

absence of contractions of the heart

Failure to capture (pacemaker)

failure to sense (pacemaker)

Atrial paced rhythm

spike before P wave

Ventricular paced rhythm

ventricular contractions which occur in cases of complete heart block.