When the sympathetic nerve fibers are stimulated, the heart rate is __.
elevated
Electrode location sites should be rotated ___ or when the pt is sweaty or has had a bath.
q24h
What method is used to calculate atrial and ventricular rate for irregular rhythms?
6 second rule
T or F: The qrs complex in MCL1 can be negative and still be normal.
T
A wave form is a movement __ the isoelectric line in either a positive or negative direction.
away from
Lead II is helpful in detecting….
sinus node and atrial arrhythmias
What affects preload: volume in the veins, pressure in the arteries or ventricles, or volume of blood in the ventricles?
volume in the veins
Along with Lead II, lead III is most helpful in monitoring changes in what part of the heart?
Inferior wall MI
What are the best areas to place electrodes?
on soft tissue
The ekg produces an upright pattern on the paper in response to electrical activity in the heart flowing towards a
positive electrode
The QT interval represents
total ventricular activity
What are the AV valves?
mitral and tricuspid
What part of the EKG reflects the refractory period?
The QRS to the peak of the T wave
5 large EKG strip boxes totals how much time?
1 second
The PRI is considered abnormal or prolonged if it is
0.20 secs
What is the most common cause for an alarm sounding?
a loose lead wire
Which lead is the most useful for routine monitoring and monitoring the sinus node?
Lead II
Which lead is helpful in monitoring atrial rhythms and hemiblocks?
Lead I
What is the normal measurement of a QRS complex?
0.04-0.10
What are EKG artifacts?
false cardiac waveforms
What is the first step in preparing a pt for an EKG?
reassuring the pt and maintaining privacy
What are the factors that impact afterload?
arterial contractility, pressure, and resistance
What is released when the parasympathetic nerve fibers are stimulated?
acetylcholine
Which lead is helpful in assessing bundle branch defects and confirming pacemaker wire placement?
MCL1
Normal Sinus rhythm has a HR of
60-100
Afib, Aflutter, and __ are examples of SVT
junctional tachycardia
What rhythm shows a normal rate, normal QRS and PRI durations, and an absent beat or beats?
sinus pause
What wave might not be visible if the pt presents w/ sinus tachycardia?
t wave
In sinus arrhythmia, which interval remains regular
PRI
What is the most common type of rhythm in SVT?
paroxysmal SVT
You would not see a normal ___ interval on an EKG strip with SVT.
PR
When you have a regular atrial and ventricular rhythm and a normal QRS and PRI and the atrial and ventricular rate is between 100-150 bpm, this rhythm would be ID’d as
sinus tachycardia
What is the appropriate tx for a stable pt with afib and a controlled ventricular response?
admin anticoagulants and antiarrhythmics
What is the heart’s electrical activity dominated by?
the sa node
In sinus bradycardia, the atrial and ventricular rate is
40-60 bpm
A pt is ID’d as having an uncontrolled ventricular rate when aflutter is accompanied by a ventricular rate ____
100
What rhythm is initiated by the SA node and transmitted through the atria, AV junction, bundle branches, and purkinje fibers?
Sinus
Sinus tachycardia is defined as sinus rhythm at a rate of
100-150 bpm
When atropine is ineffective for sinus bradycardia, what would be your next intervention?
transcutaneous pacing
What is one of the primary concerns for a pt presenting w/ afib?
Controlling the ventricular rate
To be ID’d as accelerated junctional rhythm, the ventricular rate must reach ____
60-100 bpm
The criteria for ID’ing a rhythm as SVT includes
a very rapid ventricular rate
a QRS complex within normal limits
What is the one EKG characteristic where normal sinus rhythm differs from sinus arrhythmia?
The distance between the Ps and the Rs
What is the key identifier for a PAC?
an early P wave
From what pacemaker site do junctional rhythms originate?
the AV node
The sudden onset or cessation of an arrhythmia is called
paroxysmal
What are the possible tx options for a stable symptomatic patient with junctional tachycardia?
Admin adenosine, O2, ensure IV access
A PJC would not display which EKG characteristic?
a wide QRS > 0.10 secs
T or F: Any ectopy should be cause for concern in healthy people
F
A way to determine if you are looking at a junctional or atrial rhythm is to look at the __ wave
P
T or F: PACs need to be counted in the underlying rhythm.
F
What is the name of the rhythm with an atrial rate of 250 bpm , a non measurable PRI, and a ventricular rate of 120 bpm?
Aflutter with uncontrolled ventricular rate
What arrhythmia are you more likely to see in infants, children, the elderly, and patients on mechanical ventilation?
sinus arrhythmia
What med is the first line tx for symptomatic SVT?
adenosine
What would a premature beat that starts in the atria and follows an abnormal pathway through the ventricles be called?
an aberrantly conducted PAC