EKG Interpretation and Heart Function
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Questions and Answers

What is the first action to take when an ECG alarm goes off?

  • Administer epinephrine immediately.
  • Call for help and begin CPR.
  • Check the defibrillator settings.
  • Assess the patient. (correct)

What is defined as the total volume of blood pumped by the ventricle per minute?

  • Cardiac Output (correct)
  • Afterload
  • Systolic pressure
  • Ejection Fraction

During which phase does the peak pressure in the arteries occur?

  • Ejection Fraction
  • Resting phase
  • Diastole
  • Systole (correct)

Which action is appropriate if an electrical impulse returns in a patient undergoing asystole treatment?

<p>Defibrillate using 360 joules. (B)</p> Signup and view all the answers

What does preload refer to in the cardiac cycle?

<p>The pressure exerted on the ventricle walls at end diastole. (A)</p> Signup and view all the answers

What is the normal pacing rate of the SA node?

<p>60-100 bpm (B)</p> Signup and view all the answers

What does the PR interval represent in EKG interpretation?

<p>Time between atrial and ventricular depolarization (D)</p> Signup and view all the answers

What would be the appropriate treatment for symptomatic sinus bradycardia?

<p>Administration of atropine (A), Placement of a temporary pacemaker (B)</p> Signup and view all the answers

Which of the following describes a characteristic of Sinus Tachycardia?

<p>It may be a normal response to stress (C)</p> Signup and view all the answers

What is the correct duration for a QRS complex in a normal EKG?

<p>0.06s - 0.10s (B)</p> Signup and view all the answers

What is the role of the Bundle of His in the heart's conduction system?

<p>Connects the atria and ventricles (B)</p> Signup and view all the answers

During EKG analysis, how is the heart rate calculated?

<p>Count the QRS complexes and multiply by 10 (D)</p> Signup and view all the answers

What is indicated by the QT interval in an EKG?

<p>Time for ventricles to repolarize (B)</p> Signup and view all the answers

What is the significance of PVCs when they fall on the T wave of the preceding beat?

<p>They may lead to ventricular tachycardia or fibrillation. (D)</p> Signup and view all the answers

Which of the following is a common cause of premature ventricular contractions (PVCs)?

<p>Electrolyte imbalance (C)</p> Signup and view all the answers

In the treatment of ventricular tachycardia (VT) with a pulse, what is the first step?

<p>Perform synchronized cardioversion. (D)</p> Signup and view all the answers

What is the primary intervention for ventricular fibrillation (VF)?

<p>Start CPR and defibrillate. (A)</p> Signup and view all the answers

Which medication is commonly used for treating arrhythmias including ventricular tachycardia?

<p>Amiodarone (B)</p> Signup and view all the answers

What characteristic defines ventricular fibrillation (VF)?

<p>Continuous firing from multiple foci. (D)</p> Signup and view all the answers

What is a possible preventative treatment for patients at risk of life-threatening arrhythmias?

<p>Automatic Implantable Cardiac Defibrillator (AICD) (C)</p> Signup and view all the answers

Which abnormal heart rhythm is associated with severe decrease in cardiac output and potential loss of atrial contraction?

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

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

<p>Fever (D)</p> Signup and view all the answers

Which treatment option is specifically used to reduce heart rate in cases of sinus tachycardia?

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

What is the characteristic feature of atrial fibrillation?

<p>No organized atrial depolarization (C)</p> Signup and view all the answers

Which of the following treatments is NOT typically used for atrial dysrhythmias?

<p>Beta-agonists (C)</p> Signup and view all the answers

In cases of atrial flutter, what is observed in the heart rhythm?

<p>Absence of P waves and sawtooth pattern (A)</p> Signup and view all the answers

What is a potential consequence of untreated atrial fibrillation lasting more than 48 hours?

<p>Increased risk for thrombus formation (A)</p> Signup and view all the answers

What is the purpose of synchronized cardioversion in atrial fibrillation/flutter?

<p>To convert the rhythm to a normal sinus rhythm (C)</p> Signup and view all the answers

Which of the following medications is an antiarrhythmic used for atrial dysrhythmias?

<p>Dofetilide (D)</p> Signup and view all the answers

Flashcards

SA Node

The sinoatrial node, the primary pacemaker of the heart, initiating electrical impulses at a rate of 60-100 bpm

AV Node

The atrioventricular node, a backup pacemaker (40-60 bpm) that delays the electrical impulse to allow the atria to contract and fill the ventricles

EKG/ECG Paper Units

Horizontal: 0.04 seconds/small box, 0.20 seconds/large box; Vertical: 0.5 mV/large box

Sinus Bradycardia

A heart rhythm where the SA node fires too slowly.

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Sinus Tachycardia

A heart rhythm where the SA node fires too quickly. Can be a normal response to stress.

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PR interval

The time between the start of the P wave and the start of the QRS complex (0.12-0.20 seconds)

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QRS duration

Duration of the QRS complex (0.06-0.10 seconds)

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Rhythm Analysis Steps

Checking for P wave before QRS, regularity of rhythm, rate, PR interval (0.12-0.20s), and QRS duration (0.06-0.10s).

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Premature Ventricular Contractions (PVCs)

Ventricular cells firing occasionally, causing wide, bizarre QRS complexes, often more than one beat.

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Ventricular Tachycardia

Ventricular cells continuously firing due to a looping circuit, resulting in a sustained rapid heartbeat.

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Ventricular Fibrillation

Continuous firing from multiple ventricular foci, leading to a very irregular, ineffective heartbeat.

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PVC Significance

Decreased cardiac output, potential for angina/CHF, common after procedures like PCI or clot lysis

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Ventricular Tachycardia (VT) Significance

Severe drop in Cardiac Output (CO) due to poor ventricular filling and lack of atrial contraction; VT without a pulse evolves to VF

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Ventricular Tachycardia (VT) Treatment with Pulse

Synchronized cardioversion is necessary to restore a normal heart rhythm.

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Ventricular Tachycardia (VT) Treatment without Pulse

CPR and defibrillation with epinephrine and amiodarone are required.

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Ventricular Fibrillation (VF) Treatment

Immediate CPR, defibrillation, epinephrine, and amiodarone administration are critical life-saving measures.

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Sinus Tachycardia Causes

Sinus tachycardia is caused by anxiety, stress, pain, hypovolemia, stimulants (like caffeine), anemia, heart failure, hypotension, and hyperthyroidism.

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Sinus Tachycardia Treatment

Treatment for sinus tachycardia involves addressing the underlying cause and using beta-blockers (like metoprolol or atenolol) to slow the heart rate and reduce oxygen consumption.

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Atrial Fibrillation Rhythm

Atrial fibrillation is identified by a lack of organized atrial depolarization, resulting in no normal P waves

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Atrial Flutter Rhythm

Atrial flutter is characterized by continuous atrial activity forming 'flutter waves', which appear as a sawtooth pattern in an ECG; at a rate ranging from 250-350 bpm.

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Atrial Dysrhythmia Treatment

Treatment for atrial dysrhythmias (fibrillation/flutter) focuses on decreasing heart output(CO), avoiding blood clots/anticoagulation (if ongoing for more than 48 hrs), slowing the ventricular rate, using antiarrhythmics, cardioversion, or catheter ablation.

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Synchronized Cardioversion

A treatment method for atrial fibrillation or flutter where an electrical shock is delivered during the QRS complex to restore a normal sinus rhythm.

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Atrial Cell Problems

Atrial problems can cause continuous firing from multiple foci (multiple points) or from continuous micro re-entrant 'wavelets'.

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Atrial Dysrhythmia Effects

Atrial dysrhythmias (fibrillation/flutter) reduce the atrial kick (vital for blood movement) and increase the risk of blood clots, potentially requiring anticoagulation treatment if lasting longer than 48 hours.

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Asystole

A heart rhythm with no electrical activity and no pulse. It's a life-threatening condition requiring immediate CPR and medication.

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Epinephrine in Asystole

Epinephrine is administered during asystole to stimulate the heart and potentially trigger a heartbeat.

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Cardiac Output

The volume of blood pumped by the heart per minute. It's a crucial measure of heart function.

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Preload

The pressure inside the ventricle at the end of diastole (relaxation). It's the 'stretch' before contraction.

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Afterload

The pressure the heart must overcome to eject blood into the arteries. It's like the resistance the heart faces.

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Study Notes

EKG Interpretation

  • EKG interpretation involves analyzing electrical signals from the heart.
  • Heart's electrical activity is visualized in the form of a tracing on EKG paper.
  • Understanding the waves and intervals on an EKG is crucial for detecting heart abnormalities.

Pacemakers of the Heart

  • Sinoatrial (SA) node initiates the heartbeat (60-100 bpm).
  • Atrioventricular (AV) node delays the signal allowing atrial contraction to complete before ventricular contraction (40-60 bpm).
  • Bundle of His facilitates the transmission of signal to ventricles via Purkinje fibers (20-40 bpm).

Impulse Conduction and EKG

  • SA node initiates the electrical impulse.
  • P-wave represents atrial depolarization.
  • QRS complex represents ventricular depolarization.
  • T-wave represents ventricular repolarization.
  • AV node delays the signal before ventricular contraction.
  • His-Purkinje system distributes the electrical signal to the ventricles.

EKG/ECG Paper Basics

  • Horizontal axis represents time (small box = 0.04 seconds; large box = 0.2 seconds).
  • Vertical axis represents voltage (large box = 0.5 mV).
  • Every 3 seconds (15 big boxes), there's a vertical line.

Rhythm Analysis Steps

  • Assess for a P wave before each QRS complex.
  • Determine if the rhythm is regular.
  • Calculate the heart rate by counting QRS complexes in 6 seconds and multiplying by 10.
  • Measure PR interval (0.12-0.20 seconds).
  • Evaluate QRS duration (0.06-0.10 seconds).

Other Steps in Interpretation

  • Analyze QT interval, determine its significance.
  • Identify the location of the ST segment.
  • Evaluate the shape and morphology of the T wave.

SA Node Problems

  • Sinus Bradycardia - SA node fires too slowly.
  • Sinus Tachycardia - SA node fires too quickly.

Ventricular Cell Problems

  • Premature Ventricular Contractions (PVCs): Ventricular cells fire early.
  • Ventricular Tachycardia: Continuous rapid ventricular contractions.
  • Ventricular fibrillation: Disorganized, rapid electrical activity in ventricles, life-threatening.

Ventricular Conduction

  • Normal conduction: signal moves rapidly through ventricles.
  • Abnormal conduction: signal moves slowly, affecting ventricular function.

Atrial Cell Problems

  • Atrial fibrillation: uncoordinated atrial depolarization.
  • Atrial flutter: rapid, regular atrial depolarization (sawtooth pattern).

Atrial Dysrhythmias Treatment

  • Anticoagulation, addressing thrombus formation.
  • Slowing ventricular response.
  • Antiarrhythmic drug treatment.

Synchronized Cardioversion

  • Therapy for atrial fibrillation/flutter.
  • Defibrillator delivers a shock during the QRS complex.
  • Prior TEE to look for any thrombi in the heart

PVCs- Significance and Treatment

  • PVCs' location on a preceding T wave is of significance.
  • Causes include electrolyte imbalance and other underlying conditions.
  • Treatment aims to manage hemodynamic status and consider drugs.

VT Causes, Significance, and Treatment

  • VT has causes like PVCs and conditions.
  • VT without a pulse is dangerous.
  • Treatment depends on whether a pulse is present.
  • Preventative strategies focus on underlying factors and devices.

VF Treatment

  • VF requires immediate intervention.
  • CPR and ACLS steps are critical.
  • Defibrillation and drug administration (epinephrine, amiodarone) are crucial.

Asystole Treatment

  • Asystole means no electrical activity and no pulse.
  • Immediate CPR and epi administration are vital.

ECG Alarm Response

  • Patient assessment is the first step when an EKG alarm goes off.

Pacemakers

  • Pacemakers are devices for assisting or initiating the heartbeat.

Dual Lead Pacer

  • Dual-chamber pacing involves stimulating both atria and ventricles.

Defibrillators

  • Implantable devices that can deliver shocks to correct potentially life-threatening arrhythmias.

Cardiac Cycle Mechanics

  • Systole is peak arterial pressure during ventricular contraction.
  • Diastole is minimum arterial pressure during ventricular relaxation.
  • Ejection fraction measures the efficiency of blood pumped.
  • Cardiac output is the volume of blood pumped per minute.
  • Preload and afterload are factors influencing ventricular function.

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EKG Interpretation PDF

Description

This quiz covers the fundamentals of EKG interpretation, focusing on the analysis of the heart's electrical signals. It includes critical concepts like the roles of the SA node, AV node, and the impulse conduction system, as well as how to read EKG paper fundamentals. Understanding these elements is crucial for identifying heart abnormalities.

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