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.