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Glossary of EKG

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Created by bfnurse

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
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.
When have a Pacemaker, what will the EKG show?
"pacer spike" @ either before the p-wave (atrial spike) or before the QRS (ventricular spike)
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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