ECG Normal Sinus Rhythm
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Questions and Answers

What is the normal heart rate in beats per minute?

  • 100-120
  • 120-140
  • 40-60
  • 60-100 (correct)
  • What is the duration of a normal PR interval?

  • 0.20-0.25 second
  • 0.05-0.10 second
  • 0.12-0.20 second (correct)
  • 0.10-0.15 second
  • What is the term used to describe an abnormal heart rhythm?

  • Tachycardia
  • Dysrhythmia
  • Cardiac arrest
  • Arrhythmia (correct)
  • What is the primary cause of sinus block?

    <p>Ischemia of the SA node</p> Signup and view all the answers

    Which of the following is a cause of arrhythmias?

    <p>Myocardial ischemia</p> Signup and view all the answers

    What should be treated in a patient with an arrhythmia?

    <p>The patient and their symptoms</p> Signup and view all the answers

    What is the characteristic of the P waves in a sinus block?

    <p>Upright and normal in morphology</p> Signup and view all the answers

    What is the treatment for an asymptomatic patient with sinus block?

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

    What is the term for the absence of cardiac electrical activity?

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

    What is the difference between sinus pause and sinus arrest?

    <p>Sinus pause is a single missed beat, while sinus arrest is multiple missed beats</p> Signup and view all the answers

    What is the clinical significance of frequent or prolonged episodes of sinus block?

    <p>It can compromise cardiac output, resulting in syncope</p> Signup and view all the answers

    What is sick sinus syndrome characterized by?

    <p>Wild swings in the heart rate</p> Signup and view all the answers

    What is the pacemaker site in sick sinus syndrome?

    <p>SA node</p> Signup and view all the answers

    What is the normal PR interval in sick sinus syndrome?

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

    What is the treatment for sinus pause or sinus block if atropine fails?

    <p>Transcutaneous pacing or a catecholamine infusion</p> Signup and view all the answers

    What is the danger of complete cessation of SA node activity?

    <p>Cardiac standstill</p> Signup and view all the answers

    What is the primary concern when the SA node activity ceases completely?

    <p>Cardiac standstill</p> Signup and view all the answers

    What is the primary focus when treating a patient with cardiac arrhythmias?

    <p>The patient</p> Signup and view all the answers

    What is the treatment for a patient with signs of poor perfusion due to SA node dysfunction?

    <p>Transcutaneous pacing or catecholamine infusion</p> Signup and view all the answers

    What is the normal direction of depolarization impulse transmission through the conductive system and myocardium?

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

    What is the characteristic of a wandering atrial pacemaker in terms of pacemaker site?

    <p>Varies among the SA node, atrial tissue, and the AV junction</p> Signup and view all the answers

    What is the result of enhanced automaticity in the heart?

    <p>Ectopic beats</p> Signup and view all the answers

    What is the term for a heart cell that is not a pacemaker cell?

    <p>Ectopic focus</p> Signup and view all the answers

    What is the significance of a wandering atrial pacemaker?

    <p>It usually has no detrimental effects</p> Signup and view all the answers

    What type of arrhythmia is characterized by a rapid heart rate?

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

    What is the definition of multifocal atrial tachycardia (MAT)?

    <p>A wandering pacemaker rhythm with a rate more than 100</p> Signup and view all the answers

    What is the common underlying condition in patients with multifocal atrial tachycardia?

    <p>Pulmonary disease</p> Signup and view all the answers

    What is the term for the classification of arrhythmias based on the site of origin?

    <p>Site of origin</p> Signup and view all the answers

    What is the characteristic of premature atrial contractions (PACs) in terms of P wave morphology?

    <p>Different P wave morphology for each beat</p> Signup and view all the answers

    What is the term for a slowing of the SA node?

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

    What is the cause of a noncompensatory pause in the underlying rhythm in PACs?

    <p>Depolarization of the atrial syncytium</p> Signup and view all the answers

    What is the normal heart rate range for sinus bradycardia?

    <p>Less than 60 beats per minute</p> Signup and view all the answers

    What is the treatment for patients with multifocal atrial tachycardia?

    <p>Underlying medical disease treatment</p> Signup and view all the answers

    What is the primary treatment for sinus bradycardia?

    <p>No treatment unless signs of poor perfusion are present</p> Signup and view all the answers

    What is the significance of multifocal atrial tachycardia?

    <p>It is a sign of a serious underlying medical illness</p> Signup and view all the answers

    What is the purpose of administering atropine sulfate in sinus bradycardia?

    <p>To increase the heart rate</p> Signup and view all the answers

    What is the primary cause of sinus tachycardia?

    <p>Increased rate of SA node discharge</p> Signup and view all the answers

    Which of the following is a compensatory mechanism for decreased stroke volume?

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

    What is the usual rate of sinus arrhythmia?

    <p>60-100</p> Signup and view all the answers

    What is the cause of sinus arrest?

    <p>Ischemia of the SA node</p> Signup and view all the answers

    What is the characteristic of the RR interval following a sinus arrest?

    <p>It varies</p> Signup and view all the answers

    What is the treatment for asymptomatic sinus arrest?

    <p>Only observation</p> Signup and view all the answers

    What is the characteristic of the pause in sinus block?

    <p>It is a multiple of the previous RR interval</p> Signup and view all the answers

    Which of the following is a normal variant, particularly in young and elderly people?

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

    What is the result of very rapid heart rates in diseased hearts?

    <p>Increased myocardial oxygen demand</p> Signup and view all the answers

    Which of the following is a clinical significance of sinus tachycardia?

    <p>It is a compensatory mechanism for decreased stroke volume</p> Signup and view all the answers

    What is the next step if the patient does not convert after 1 to 2 minutes of administering adenosine?

    <p>Administer a second bolus of 12 mg over 1 to 3 seconds</p> Signup and view all the answers

    Why is it important to determine whether the arrhythmia is narrow-complex or wide-complex tachycardia?

    <p>Because the treatments are considerably different for the two arrhythmias</p> Signup and view all the answers

    What is the purpose of looking at lead II or VI in ECG?

    <p>To determine whether the arrhythmia is narrow-complex or wide-complex tachycardia</p> Signup and view all the answers

    What is the contraindication for DC countershock?

    <p>If you suspect digitalis toxicity as the cause of the PSVT</p> Signup and view all the answers

    What is the energy level of the initial synchronized direct current countershock?

    <p>50 to 100 joules</p> Signup and view all the answers

    What is the recommended action if the patient becomes unstable with a heart rate of more than 150 beats per minute?

    <p>Proceed with synchronized cardioversion</p> Signup and view all the answers

    What is the characteristic of the P wave in a PAC?

    <p>It occurs earlier than the next expected P wave</p> Signup and view all the answers

    What is the effect of paroxysmal supraventricular tachycardia on cardiac output?

    <p>It decreases cardiac output due to inadequate ventricular filling time</p> Signup and view all the answers

    What is the PR interval of an ectopic focus near the AV node?

    <p>Less than 0.12 second</p> Signup and view all the answers

    What is the significance of frequent PACs?

    <p>They can indicate organic heart disease</p> Signup and view all the answers

    What is the characteristic of the QRS complex in a PAC?

    <p>It can be more than 0.12 second if the PAC is abnormally conducted</p> Signup and view all the answers

    What is the effect of vagal maneuvers on PSVT?

    <p>They slow the heart rate</p> Signup and view all the answers

    What is the rate of paroxysmal supraventricular tachycardia?

    <p>150-250 beats per minute</p> Signup and view all the answers

    What is the characteristic of the P wave in PSVT?

    <p>It is buried in the preceding T wave</p> Signup and view all the answers

    What is the treatment for asymptomatic PACs?

    <p>Only observation is required</p> Signup and view all the answers

    What is the significance of PSVT in young patients with good cardiac reserves?

    <p>They can tolerate PSVT well for short periods</p> Signup and view all the answers

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