Rapid Fire Cardiac Rhythm Study Quiz
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Questions and Answers

What is the normal range for PRI (P-R interval)?

  • 0.12-0.20 sec (correct)
  • 0.30-0.40 sec
  • 0.06-0.10 sec
  • 0.20-0.30 sec

    • Which rhythm is characterized by irregular P-P intervals that gradually lengthen and shorten with the respiratory rate?

  • Sinus Pause
  • Sinus Tachycardia
  • Sinus Bradycardia
  • Sinus Arrhythmia (correct)

    • What is the distinguishing feature of Premature Atrial Contraction/Complex (PAC's) in terms of the P wave?

  • P wave for each QRS
  • P wave of PAC may have different shape from sinus beat (correct)
  • No P wavesfibrillatory (f)
  • P wave may be buried in preceding T wave

    • What is the defining characteristic of Atrial Fibrillation?

    <p>No P wavesfibrillatory (f)</p> Signup and view all the answers

    What is the normal range for QRS duration?

    <p>0.06-0.10 sec</p> Signup and view all the answers

    Which rhythm is characterized by a regular rate of 60-100 bpm and one P wave for every QRS?

    <p>Sinus Bradycardia</p> Signup and view all the answers

    What is the distinguishing feature of Premature Atrial Contraction/Complex (PAC's) in terms of the P wave?

    <p>P wave of PAC may have different shape from sinus beat</p> Signup and view all the answers

    Which rhythm is characterized by an irregular rhythm and no discernible P waves?

    <p>Atrial Fibrillation</p> Signup and view all the answers

    What is the normal range for PRI (P-R interval)?

    <p>0.12-0.20 sec</p> Signup and view all the answers

    What is the primary nursing intervention to manage a patient experiencing pain related to ischemia?

    <p>Administer oxygen and dysrhythmia medication as ordered</p> Signup and view all the answers

    Which therapeutic measure is most effective in reducing cardiac workload?

    <p>Placing the patient on limited activities or complete bed rest</p> Signup and view all the answers

    What should a nurse do first when a patient verbalizes fear related to their disease process?

    <p>Allow patients to verbalize their fears and emotions</p> Signup and view all the answers

    How should the head of the bed (HOB) be positioned to assist with patient comfort and cardiac function?

    <p>Elevated at 30-45 degrees</p> Signup and view all the answers

    What action should be taken if a patient reports chest pain during monitoring?

    <p>Notify the physician of the chest pain immediately</p> Signup and view all the answers

    What is a common cause of sinus tachycardia?

    <p>Caffeine consumption</p> Signup and view all the answers

    Which group is considered vulnerable to the symptoms of sinus tachycardia?

    <p>Those with ischemic heart disease</p> Signup and view all the answers

    In the measurement of QT interval, what is the normal value proportional to?

    <p>Half of the R to R interval</p> Signup and view all the answers

    What describes a dysrhythmia?

    <p>Any cardiac rhythm deviating from normal sinus rhythm</p> Signup and view all the answers

    Which of the following is NOT typically a symptom of dysrhythmias?

    <p>Elevated blood glucose levels</p> Signup and view all the answers

    What is a primary strategy in the medical management of tachycardia?

    <p>Addressing the primary cause of the tachycardia</p> Signup and view all the answers

    What role does the sympathetic nervous system play in sinus tachycardia?

    <p>It stimulates an increase in heart rate</p> Signup and view all the answers

    Which of the following best describes the heart rate during sinus tachycardia?

    <p>100 to 150 bpm or more</p> Signup and view all the answers

    What is the primary rate range characteristic of ventricular tachycardia (V-Tach)?

    <p>110 – 250 bpm</p> Signup and view all the answers

    Which of the following is a potential cause of ventricular tachycardia?

    <p>Acute myocardial infarction</p> Signup and view all the answers

    What is the main symptom that indicates low cardiac output during a ventricular tachycardia episode?

    <p>Light-headedness</p> Signup and view all the answers

    What is the initial medical management for a patient in ventricular fibrillation?

    <p>Immediate defibrillation</p> Signup and view all the answers

    Which intervals or waveforms are observed in ventricular fibrillation?

    <p>Chaotic and non-discernible rhythm</p> Signup and view all the answers

    Which of the following is considered a potential trigger for ventricular fibrillation?

    <p>Valvular heart disease</p> Signup and view all the answers

    What type of medical intervention is used for patients with a pulse but hemodynamically unstable during a V-Tach episode?

    <p>Cardioversion</p> Signup and view all the answers

    Which symptom is most associated with ventricular tachycardia?

    <p>Chest discomfort</p> Signup and view all the answers

    Which pharmacological agent is often used in the event of acute myocardial ischemia suspected as a cause of V-Tach?

    <p>Lidocaine</p> Signup and view all the answers

    Which diagnostic test is crucial for recognizing dysrhythmias such as V-Tach and V-Fib?

    <p>Holter monitoring</p> Signup and view all the answers

    What is the role of the sinoatrial (SA) node in the conduction system of the heart?

    <p>It initiates electrical impulses throughout the myocardium.</p> Signup and view all the answers

    Which structure directly receives signals from the sinoatrial (SA) node?

    <p>Atrioventricular (AV) node</p> Signup and view all the answers

    How does the electrical signal from the SA node spread to the left atrial myocardium?

    <p>Through interatrial conducting fibers.</p> Signup and view all the answers

    What is the significance of the bundle of His in the conduction system?

    <p>It conducts signals from the AV node to the ventricles.</p> Signup and view all the answers

    Which structures branch out from the bundle of His to supply the ventricles with electrical signals?

    <p>Right and left bundle branches</p> Signup and view all the answers

    What physiological event is represented by the P wave on an ECG?

    <p>Atrial walls depolarization</p> Signup and view all the answers

    What does the QRS complex indicate in the cardiac cycle?

    <p>Ventricular depolarization and atrial repolarization</p> Signup and view all the answers

    When does the T wave appear on an ECG?

    <p>As the ventricular walls repolarize</p> Signup and view all the answers

    Which sequence correctly describes the events occurring in the cardiac cycle?

    <p>Atrial depolarization, ventricular depolarization, ventricular repolarization</p> Signup and view all the answers

    What occurs in the heart's electrical activity just before the QRS complex?

    <p>Atrial depolarization</p> Signup and view all the answers

    What characterizes sinus tachycardia in terms of heart rate?

    <p>Rate between 100 to 150 bpm</p> Signup and view all the answers

    Which of the following conditions can lead to sinus tachycardia?

    <p>Fever</p> Signup and view all the answers

    What is the primary concern regarding bradycardia?

    <p>It can be life-threatening if undetermined.</p> Signup and view all the answers

    What is a common clinical manifestation of sinus tachycardia?

    <p>Occasional palpitations</p> Signup and view all the answers

    Which statement is true about the management of bradycardia?

    <p>A pacemaker may be necessary in some cases.</p> Signup and view all the answers

    Which alteration does a dysrhythmia involve?

    <p>Abnormal impulse formation through the SA node</p> Signup and view all the answers

    What is NOT typical of the QRS complex on an ECG?

    <p>Indicates atrial repolarization</p> Signup and view all the answers

    How does sinus bradycardia differ from normal sinus rhythm?

    <p>It has a lower heart rate than 60 bpm.</p> Signup and view all the answers

    What is a significant advantage of Pradaxa and Xarelto compared to warfarin?

    <p>They do not require continuing dosage modification.</p> Signup and view all the answers

    Which type of heart block indicates a complete failure of electrical impulses from the atria to the ventricles?

    <p>Third-degree block</p> Signup and view all the answers

    What are the common causes of premature ventricular contractions (PVCs)?

    <p>Electrolyte imbalances, stress, and myocardial ischemia</p> Signup and view all the answers

    What is the primary medical management approach for symptomatic PVCs?

    <p>Intravenous beta-adrenergic blockers or antiarrhythmics</p> Signup and view all the answers

    What often accompanies a third-degree heart block?

    <p>Hypotension, angina, and bradycardia</p> Signup and view all the answers

    Which of the following describes ventricular tachycardia (VT)?

    <p>It is characterized by three or more successive PVCs.</p> Signup and view all the answers

    Which clinical manifestation is associated with ventricular fibrillation?

    <p>Loss of consciousness and lack of pulse</p> Signup and view all the answers

    What is the result of catheter ablation in patients with atrial fibrillation?

    <p>It destroys areas that trigger abnormal electrical signals.</p> Signup and view all the answers

    What is one main characteristic of first-degree heart block?

    <p>Prolonged PR interval with no symptoms</p> Signup and view all the answers

    During which rhythm do patients often experience a heart rate between 140 and 240 bpm?

    <p>Ventricular tachycardia (VT)</p> Signup and view all the answers

    What condition is typically indicated by a marked drop in cardiac output?

    <p>Ventricular fibrillation</p> Signup and view all the answers

    Which drugs are often used for ongoing suppression of ventricular tachycardia?

    <p>Beta-adrenergic blockers and calcium channel blockers</p> Signup and view all the answers

    What does the medical management of ventricular tachycardia focus on?

    <p>Evaluating and treating associated heart conditions</p> Signup and view all the answers

    What is a potential consequence of prolonged episodes of ventricular tachycardia?

    <p>Ventricular fibrillation or death</p> Signup and view all the answers

    Which of the following is NOT a common cause of sinus bradycardia?

    <p>Hyperthyroidism</p> Signup and view all the answers

    What is the primary focus of medical management in sinus bradycardia?

    <p>Treating underlying conditions</p> Signup and view all the answers

    In which condition might bradycardia be considered beneficial?

    <p>Myocardial infarction (MI)</p> Signup and view all the answers

    What are common symptoms of bradycardia when the heart rate drops below 60 bpm?

    <p>Fatigue and lightheadedness</p> Signup and view all the answers

    What is a common pharmacological treatment for atrial fibrillation to prevent thrombi formation?

    <p>Anticoagulants</p> Signup and view all the answers

    What is one of the primary risks associated with atrial fibrillation?

    <p>Increased risk of stroke</p> Signup and view all the answers

    Which of the following factors is most likely to trigger supraventricular tachycardia (SVT)?

    <p>Excess caffeine intake</p> Signup and view all the answers

    What is the typical pulse rate associated with supraventricular tachycardia (SVT)?

    <p>150-250 bpm</p> Signup and view all the answers

    Which medication may be used in the management of atrial fibrillation to slow the ventricular response?

    <p>Beta-adrenergic blockers</p> Signup and view all the answers

    When might a transesophageal echocardiography (TEE) be utilized in atrial fibrillation management?

    <p>To detect a thrombus before electrical cardioversion</p> Signup and view all the answers

    What is the common ventricular response rate in untreated atrial fibrillation?

    <p>100-180 bpm</p> Signup and view all the answers

    Which symptom is often associated with atrial fibrillation due to decreased cardiac output?

    <p>Fatigue</p> Signup and view all the answers

    What non-pharmacological treatment option may be used for persistent SVT caused by an accessory pathway?

    <p>Radiofrequency catheter ablation</p> Signup and view all the answers

    What is a common clinical manifestation of ventricular response in atrial fibrillation?

    <p>Irregular pulse deficit</p> Signup and view all the answers

    Study Notes

    Cardiac Rhythms and Dysrhythmias

    • Normal PR interval ranges from 0.06 to 0.10 seconds.
    • T waves should be assessed for deflection (positive or negative), position relative to the isoelectric line, and peakedness.
    • QT interval is typically half of the R-R interval.

    Dysrhythmias

    • Defined as any cardiac rhythm deviating from normal sinus rhythm.
    • Causes include alteration in impulse formation/transmission from the SA node and myocardial cell irritability.
    • Symptoms can range from minor to life-threatening, varying by type and severity.

    Sinus Tachycardia

    • Characterized by a rapid, regular rhythm with a heart rate of 100 to 150 bpm.
    • Originates in the SA node and is influenced by sympathetic nervous system stimulation.
    • Common causes: exercise, anxiety, fever, shock, medications, heart failure, and caffeine.
    • Clinical manifestations may include palpitations or be asymptomatic, particularly in populations with ischemic heart disease.

    Medical Management of Sinus Tachycardia

    • Focuses on treating the underlying cause of increased heart rate.
    • Normal sinus tachycardia typically not due to a primary cardiac issue.

    Ventricular Tachycardia (V-Tach)

    • Defined as three or more successive premature ventricular contractions (PVCs).
    • Life-threatening condition with a heart rate between 110 and 250 bpm.
    • Regular rhythm unless interrupted by capture beats; no PR interval, with QRS complex > 0.12 seconds.
    • Etiology includes acute myocardial infarction (MI), hypoxemia, electrolyte disturbances, and some drug toxicities.

    Clinical Manifestations of V-Tach

    • Presence of a pulse and blood pressure may occur, but low cardiac output can lead to symptoms.

    Medical Management of V-Tach

    • Initial treatment includes IV procainamide or amiodarone; lidocaine is used if acute ischemia is considered.
    • Cardioversion is indicated for patients with a pulse who are hemodynamically unstable.
    • Advanced cardiac life support (ACLS) protocols are employed for patients without a pulse.

    Ventricular Fibrillation (V-Fib)

    • Characterized by ventricular quivering, leading to a state of clinical death with no cardiac output.
    • Heart rate and rhythm are indiscernible; baseline appears chaotic with no identifiable waveforms.
    • Etiology is often ischemia from MI, electrolyte imbalances, or QT prolongation from certain medications.

    Medical Management of V-Fib

    • Immediate emergency treatment with CPR and defibrillation is critical, ideally within 15-20 seconds to prevent brain damage.
    • Epinephrine is administered every 3-5 minutes, alongside continued CPR and possible use of amiodarone.

    Assessment of Dysrhythmias

    • Subjective symptoms may include palpitations, skipped beats, nausea, light-headedness, dyspnea, fatigue, and chest discomfort.
    • Objective findings may include EKG monitoring, irregular pulse, tachycardia, and syncope.

    Diagnostic Tests

    • Assess presentation relative to patient norms; e.g., athletes may present with bradycardia.
    • Employ EKG monitoring, telemetry, Holter monitoring, and cardiac catheterization as needed.

    Conduction System of the Heart

    • Specialized cardiac muscle cells are responsible for generating and conducting electrical impulses throughout the myocardium, ensuring synchronized heart contractions.
    • The sinoatrial (SA) node functions as the heart's natural pacemaker, initiating the electrical signal that regulates heart rhythm.
    • The electrical signal first spreads directly to the right atrial myocardium, facilitating contraction.
    • Interatrial conducting fibers relay the signal to the left atrial myocardium, ensuring coordinated atrial contraction.
    • The signal reaches the atrioventricular (AV) node via three internodal bundles, which pause the signal briefly to allow for complete atrial contraction before sending it to the ventricles.
    • The AV node transmits the signal through the bundle of His, which divides into right and left bundle branches, leading to the ventricles.
    • Smaller branches known as Purkinje fibers extend from the bundle branches and surround the ventricles, ensuring rapid and synchronized ventricular contraction.

    Cardiac Electrical Activity

    • The P wave represents atrial depolarization and occurs when the atrioventricular (AV) node and atrial walls activate.
    • Following the P wave, the QRS complex indicates the repolarization of the atria while simultaneously depicting the depolarization of the ventricular walls.
    • The T wave appears on the electrocardiogram (ECG) when the ventricular walls undergo repolarization.

    Cardiac Dysrhythmias Overview

    • Cardiac dysrhythmia (arrhythmia) disturbs normal sinus rhythm originating from the SA node.
    • Normal sinus rhythm has a rate of 60 to 100 bpm, with distinct P waves before each QRS complex.
    • Dysrhythmias can arise from impulse formation issues in the SA node or irritation of myocardial cells.

    Sinus Tachycardia

    • Defined as a fast, regular rhythm from the SA node, with a heart rate of 100 to 150 bpm or more.
    • Causes include exercise, anxiety, fever, shock, heart failure, caffeine, recreational drugs, and tobacco.
    • May cause palpitations and occasionally hypotension or angina but can be asymptomatic.
    • Treatment targets the underlying cause rather than the tachycardia itself.

    Sinus Bradycardia

    • Characterized by a slow rhythm with a pulse rate less than 60 bpm.
    • Can be life-threatening and may require a pacemaker if due to SA node dysfunction.
    • Common causes include obstructive sleep apnea, medications, and vagal stimulation.
    • Symptoms can include fatigue, lightheadedness, or syncope but may not be present in all patients.
    • Atropine, pacemaker insertion, and addressing the root cause are common treatments.

    Supraventricular Tachycardia (SVT)

    • Sudden, rapid heartbeat originating in the atria, usually 150 to 250 bpm.
    • Causes involve medications, alcohol, emotional stress, and hormonal imbalances.
    • Symptoms may include palpitations, lightheadedness, dyspnea, and angina.
    • Management focuses on patient tolerance and might include carotid sinus pressure, adenosine, or ablation therapy if persistent.

    Atrial Fibrillation

    • Characterized by disorganized electrical activity in the atria, leading to a rapid atrial rate of 350-600 bpm.
    • Associated with risks like stroke, especially in older adults or those with structural heart issues.
    • Common causes include hypertension, cardiomyopathy, and certain medications.
    • Symptoms include pulse deficit, fatigue, and potential thrombus formation that could lead to strokes.
    • Treatment aims at managing irritability, controlling ventricular response, and preventing thrombi formation using anticoagulants.

    Atrioventricular Block (AV Block)

    • Occurs when conduction is impaired from the SA node to the ventricles, classified into three degrees: first, second, and third.
    • Causes include atherosclerosis, myocardial infarction, and drug toxicity.
    • Management may involve monitoring and pacing, especially in third-degree block, which can lead to complete heart block.

    Premature Ventricular Contractions (PVCs)

    • Abnormal heartbeats originating from the ventricles, classified by the frequency and pattern of occurrences.
    • Commonly caused by stress, drugs, or electrolyte imbalances.
    • Symptoms can range from asymptomatic to palpitations and decreased cardiac output.
    • Treatment options include beta-adrenergic blockers and catheter ablation if frequent and symptomatic.

    Ventricular Tachycardia (VT)

    • Defined as three or more successive PVCs with rates typically exceeding 100 bpm.
    • Causes include drug toxicity, hypoxemia, and electrolyte imbalances.
    • Can lead to ventricular fibrillation if not treated aggressively.
    • Management includes evaluating the patient's response and potential use of a pacemaker for significant blockages.

    Ventricular Fibrillation

    • Characterized by rapid, disorganized ventricular muscle contractions and is a medical emergency.
    • Commonly results from myocardial ischemia or untreated VT, leading to zero cardiac output.
    • Clinical manifestations include loss of consciousness, absence of a pulse, and potential seizures.
    • Immediate treatment focuses on CPR and advanced cardiac life support measures.

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    Description

    Test your knowledge of cardiac rhythm criteria for patient care technicians with this heart rhythm study guide quiz. Identify normal and abnormal atrial and ventricular criteria, including sinus bradycardia, sinus tachycardia, and ventricular conduction abnormalities.

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