MS CH 25 Nursing Care of Patients With Cardiac Dysrhythmias
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Questions and Answers

Which organ system is responsible for initiating an impulse to stimulate the mechanical cells of the heart to contract?

  • Respiratory system
  • Endocrine system
  • Cardiovascular system (correct)
  • Nervous system
  • What is the term for the process of returning the heart to normal sinus rhythm using a therapeutic dose of electrical energy?

  • Cardioversion (correct)
  • Fluoroscopy
  • Ablation
  • Defibrillation
  • Which node is responsible for delaying the electrical impulse before it is allowed to pass into the ventricles?

  • Atrioventricular node (correct)
  • Ventricular septal node
  • Sinoatrial node
  • Bundle of His
  • What term is used to describe an abnormally slow heart rate, usually below 60 beats per minute?

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

    Which medical condition is characterized by an abnormally high level of potassium in the blood?

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

    What term is used to describe the period when the ventricles are at rest and filling with blood?

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

    Which term describes a dysrhythmia in which every other beat is a premature ventricular contraction?

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

    What is the term for the period when the ventricles are contracting and pushing blood out of the heart?

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

    What is the name for a device implanted under the skin that continuously monitors the heart rhythm and delivers an electrical shock to restore a normal heartbeat if necessary?

    <p>Cardioverter-defibrillator (ICD)</p> Signup and view all the answers

    Which term refers to a condition where more than one site in the atria or ventricles generates electrical impulses, causing a dysrhythmia with different QRS complexes?

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

    What does the electrocardiogram (ECG) directly indicate?

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

    If the SA node fails, what protective mechanism can initiate impulses to maintain heart function?

    <p>Escape mechanism</p> Signup and view all the answers

    Which node is the primary pacemaker of the heart?

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

    What does the P wave represent in the cardiac cycle?

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

    What does the 12-lead ECG provide views of?

    <p>Heart's electrical activity</p> Signup and view all the answers

    During which phase does blood get pushed into the ventricles?

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

    What is the time from the beginning of one heartbeat to the beginning of the next called?

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

    What initiates impulses to stimulate both ventricles to contract?

    <p>&quot;Bundle of His&quot;</p> Signup and view all the answers

    Which area can initiate impulses as a protective mechanism if necessary?

    <p>&quot;Other areas of the heart&quot;</p> Signup and view all the answers

    What interval measures the time from the start of the Q wave to the end of the S wave and typically lasts 0.06 to 0.10 seconds?

    <p>QRS interval</p> Signup and view all the answers

    Which wave represents ventricular repolarization and ends when the wave returns to the isoelectric line?

    <p>T wave</p> Signup and view all the answers

    What is the name for a small wave occurring shortly after the T wave, most prominent in patients with hypokalemia?

    <p>U wave</p> Signup and view all the answers

    What interval reflects the time from completion of myocardial contraction to recovery for the next impulse, starting at the end of the QRS and ending at the beginning of the T wave?

    <p>ST segment</p> Signup and view all the answers

    What does the PR interval measure?

    <p>Time from SA node to AV node</p> Signup and view all the answers

    Which interval measures the time from start of Q wave to end of T wave, representing ventricular depolarization and repolarization?

    <p>QT interval</p> Signup and view all the answers

    What represents the time from SA node to AV node and can range from 0.12 to 0.20 seconds?

    <p>PR interval</p> Signup and view all the answers

    Which complex is composed of Q, R, and S waves and is larger than the P wave due to ventricles' greater muscle mass?

    <p>QRS complex</p> Signup and view all the answers

    Which interval represents ventricular depolarization and repolarization and can cause dysrhythmias when prolonged or shortened?

    <p>QT interval</p> Signup and view all the answers

    What does the T wave represent on an ECG?

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

    What method can be used to calculate heart rate by counting R waves in a 6-second strip and multiplying by 10?

    <p>Six-second method</p> Signup and view all the answers

    What term is used to describe a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

    <p>Regularly irregular rhythm</p> Signup and view all the answers

    What should be examined for the presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance?

    <p>P waves</p> Signup and view all the answers

    Which interval is measured to report abnormalities to the healthcare provider?

    <p>QT interval</p> Signup and view all the answers

    What does an abnormal P wave indicate in ECG interpretation?

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

    Which method for calculating heart rate involves counting small squares between two R waves and dividing by 1500?

    <p>One-minute method</p> Signup and view all the answers

    What term refers to an irregular rhythm with varying R-to-R spacing on an ECG?

    <p>Irregular rhythm</p> Signup and view all the answers

    What is the normal range for the PR interval in seconds during ECG interpretation?

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

    What should be noted if there is a variation in the PR interval during ECG interpretation?

    <p>Pattern of variation</p> Signup and view all the answers

    Which interval in ECG interpretation should have all complexes look alike and be normal and constant?

    <p>QRS interval</p> Signup and view all the answers

    During which phase does the impulse travel down the bundle of His and stimulates both ventricles to contract?

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

    What represents atrial depolarization and is the first wave of the cardiac cycle, appearing as a small hill?

    <p>P wave</p> Signup and view all the answers

    What term is used to describe the time from the beginning of one heartbeat to the beginning of the next, which includes the P wave, QRS complex, and T wave?

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

    Which interval measures the time from the start of the Q wave to the end of the S wave and typically lasts 0.06 to 0.10 seconds?

    <p>QRS interval</p> Signup and view all the answers

    What does the 12-lead ECG provide views of?

    <p>Heart's electrical activity</p> Signup and view all the answers

    What represents the time from SA node to AV node and can range from 0.12 to 0.20 seconds?

    <p>PR interval</p> Signup and view all the answers

    Which wave represents ventricular repolarization and ends when the wave returns to the isoelectric line?

    <p>T wave</p> Signup and view all the answers

    What should be examined for the presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance?

    <p>Electrical activity in the heart</p> Signup and view all the answers

    What is used to describe a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

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

    What is the term for the period when the ventricles are at rest and filling with blood?

    <p>ST segment</p> Signup and view all the answers

    If the SA node fails, what protective mechanism can initiate impulses to maintain heart function?

    <p>Purkinje fibers</p> Signup and view all the answers

    Which interval in ECG interpretation should have all complexes look alike and be normal and constant?

    <p>PR interval</p> Signup and view all the answers

    What does the electrocardiogram (ECG) directly indicate?

    <p>Heart rate</p> Signup and view all the answers

    What represents the time from SA node to AV node and can range from 0.12 to 0.20 seconds?

    <p>PR interval</p> Signup and view all the answers

    Which node is responsible for delaying the electrical impulse before it is allowed to pass into the ventricles?

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

    What does an abnormal P wave indicate in ECG interpretation?

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

    What initiates impulses to stimulate both ventricles to contract?

    <p>Purkinje fibers</p> Signup and view all the answers

    What does the regularity of an ECG rhythm refer to?

    <p>The varying R-to-R spacing</p> Signup and view all the answers

    How is heart rate calculated using the one-minute method?

    <p>Count the small squares between two R waves and divide by 1500</p> Signup and view all the answers

    What is examined to determine the presence of dysrhythmia in ECG interpretation?

    <p>PR interval variation</p> Signup and view all the answers

    Which interval in ECG interpretation should have a normal and constant appearance?

    <p>QRS interval</p> Signup and view all the answers

    What is the normal range for the PR interval in seconds during ECG interpretation?

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

    What does the T wave represent on an ECG?

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

    Which term describes a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

    <p>Regularly irregular</p> Signup and view all the answers

    What represents the time from SA node to AV node and can range from $0.12$ to $0.20$ seconds?

    <p>$PR$ interval</p> Signup and view all the answers

    If the SA node fails, what protective mechanism can initiate impulses to maintain heart function?

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

    What process involves returning the heart to normal sinus rhythm using a therapeutic dose of electrical energy?

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

    What does the wave representing ventricular repolarization and ending when the wave returns to the isoelectric line on an ECG indicate?

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

    Which node is the primary pacemaker of the heart?

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

    What term is used to describe an abnormally slow heart rate, usually below 60 beats per minute?

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

    Which wave represents ventricular repolarization and ends when the wave returns to the isoelectric line on an ECG?

    <p>T wave</p> Signup and view all the answers

    What method can be used to calculate heart rate by counting R waves in a 6-second strip and multiplying by 10?

    <p>Standard method</p> Signup and view all the answers

    What interval measures the time from start of Q wave to end of T wave, representing ventricular depolarization and repolarization?

    <p>QT interval</p> Signup and view all the answers

    Which organ system is responsible for initiating an impulse to stimulate the mechanical cells of the heart to contract?

    <p>Nervous system</p> Signup and view all the answers

    What does an abnormal P wave indicate in ECG interpretation?

    <p>Dysfunction in atrial conduction pathways</p> Signup and view all the answers

    During which phase does blood get pushed into the ventricles?

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

    What term refers to a condition where more than one site in the atria or ventricles generates electrical impulses, causing a dysrhythmia with different QRS complexes?

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

    What does the QRS complex represent in an ECG?

    <p>Time for electrical impulse to travel from AV node to ventricles</p> Signup and view all the answers

    What is the normal range for the QT interval during ECG interpretation?

    <p>$0.34$ to $0.43$ seconds</p> Signup and view all the answers

    What does an inverted T wave on an ECG indicate?

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

    What is the U wave on an ECG most prominent in patients with?

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

    Which segment reflects the time from completion of myocardial contraction to recovery for the next impulse in an ECG?

    <p>ST segment</p> Signup and view all the answers

    What is the primary pacemaker of the heart?

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

    Which wave represents atrial depolarization and is the first wave of the cardiac cycle?

    <p>P wave</p> Signup and view all the answers

    What does the PR interval measure in ECG interpretation?

    <p>Time from SA node to AV node</p> Signup and view all the answers

    During which phase does blood get pushed into the ventricles?

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

    During which phase does blood get pushed into the ventricles?

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

    What interval measures the time from the start of the Q wave to the end of the S wave and typically lasts 0.06 to 0.10 seconds?

    <p>QRS complex</p> Signup and view all the answers

    What is the term for the period when the ventricles are at rest and filling with blood?

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

    What does an abnormal P wave indicate in ECG interpretation?

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

    What represents atrial depolarization and is the first wave of the cardiac cycle, appearing as a small hill?

    <p>P wave</p> Signup and view all the answers

    Which node is responsible for delaying the electrical impulse before it is allowed to pass into the ventricles?

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

    What term refers to a condition where more than one site in the atria or ventricles generates electrical impulses, causing a dysrhythmia with different QRS complexes?

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

    What does the T wave represent on an ECG?

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

    Which medical condition is characterized by an abnormally high level of potassium in the blood?

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

    Which method can be used to calculate heart rate by counting R waves in a 6-second strip and multiplying by 10?

    <p>One-minute method</p> Signup and view all the answers

    What is the term for the period when the ventricles are contracting and pushing blood out of the heart?

    <p>Systole phase</p> Signup and view all the answers

    What represents the time from SA node to AV node and can range from 0.12 to 0.20 seconds?

    <p>PR interval</p> Signup and view all the answers

    What does an abnormal P wave indicate in ECG interpretation?

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

    What term is used to describe a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

    <p>Regularly irregular</p> Signup and view all the answers

    Which wave represents ventricular repolarization and ends when the wave returns to the isoelectric line?

    <p>T wave</p> Signup and view all the answers

    During which phase does the impulse travel down the bundle of His and stimulates both ventricles to contract?

    <p>Ventricular systole phase</p> Signup and view all the answers

    What should be examined for the presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance?

    <p>$P$ wave appearance</p> Signup and view all the answers

    What is used to describe a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

    <p>Regularly irregular</p> Signup and view all the answers

    What does the electrocardiogram (ECG) directly indicate?

    <p>Electrical activity of the heart</p> Signup and view all the answers

    What is the primary pacemaker of the heart?

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

    Which wave represents ventricular repolarization on an ECG?

    <p>T wave</p> Signup and view all the answers

    What does the P wave represent in the cardiac cycle?

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

    During which phase does blood get pushed into the ventricles?

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

    What term describes a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm?

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

    What represents the time from SA node to AV node and can range from 0.12 to 0.20 seconds?

    <p>PR interval</p> Signup and view all the answers

    Which wave represents ventricular depolarization and repolarization on an ECG?

    <p>QRS complex</p> Signup and view all the answers

    Regularly irregular rhythm indicates a predictable pattern of irregularity in R-to-R spacing on an ECG rhythm.

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

    The one-minute method for calculating heart rate involves counting R waves in a 6-second strip and multiplying by 10.

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

    Abnormal P waves on an ECG indicate dysrhythmia, requiring further examination.

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

    The PR interval measures the time from the start of the P wave to the start of the QRS complex.

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

    The QRS interval should have all complexes look alike and be normal and constant.

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

    The QT interval is measured to report abnormalities to the healthcare provider.

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

    An irregularly irregular rhythm on an ECG indicates a varying R-to-R spacing with no pattern of irregularity.

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

    The six-second method for calculating heart rate involves counting small squares between two R waves and dividing by 1500.

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

    The PR interval measures the time from the start of the P wave to the start of the T wave.

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

    The importance of a systematic method for interpreting ECG rhythms is to decrease understanding and overlook items.

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

    Study Notes

    • Six-step process for interpreting ECG rhythms for identifying dysrhythmias

    • Regularity of the rhythm:

      • Determined by R-to-R spacing on ECG
      • Normal rhythm: same R-to-R spacing, rarely varies
      • Irregular rhythm: varying R-to-R spacing
      • Regularly irregular: predictable pattern of irregularity
      • Irregularly irregular: no pattern of irregularity
    • Methods for calculating heart rate:

      • One-minute method: count small squares between two R waves and divide by 1500
      • Six-second method: count R waves in a 6-second strip and multiply by 10
    • P waves:

      • Examined for presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance
      • Abnormal P waves indicate dysrhythmia, requiring further examination
    • PR interval:

      • Normal interval: 0.12-0.20 seconds
      • Variation: note if there is a pattern
    • QRS interval:

      • Normal and constant
      • All QRS complexes look alike
    • QT interval:

      • Measured to report abnormalities to healthcare provider
    • Importance of systematic method for interpreting ECG rhythms to increase understanding and avoid overlooking items.

    • Six-step process for interpreting ECG rhythms for identifying dysrhythmias

    • Regularity of the rhythm:

      • Determined by R-to-R spacing on ECG
      • Normal rhythm: same R-to-R spacing, rarely varies
      • Irregular rhythm: varying R-to-R spacing
      • Regularly irregular: predictable pattern of irregularity
      • Irregularly irregular: no pattern of irregularity
    • Methods for calculating heart rate:

      • One-minute method: count small squares between two R waves and divide by 1500
      • Six-second method: count R waves in a 6-second strip and multiply by 10
    • P waves:

      • Examined for presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance
      • Abnormal P waves indicate dysrhythmia, requiring further examination
    • PR interval:

      • Normal interval: 0.12-0.20 seconds
      • Variation: note if there is a pattern
    • QRS interval:

      • Normal and constant
      • All QRS complexes look alike
    • QT interval:

      • Measured to report abnormalities to healthcare provider
    • Importance of systematic method for interpreting ECG rhythms to increase understanding and avoid overlooking items.

    • The cardiac monitor or electrocardiogram (ECG) records electrical activity in the heart, but it does not directly indicate the contraction of heart muscle cells.

    • To determine heart muscle contraction and subsequent blood pumping, assess the patient's blood pressure and apical and peripheral pulses.

    • The sinoatrial (SA) node located in the upper posterior wall of the right atrium is the primary pacemaker of the heart, which normally fires at a rate of 60 to 100 beats per minute (bpm).

    • If the SA node slows or fails, other areas of the heart can initiate impulses as a protective mechanism, known as escape.

    • The atria contract during atrial systole, resulting in blood being pushed into the ventricles during ventricular diastole.

    • The impulse travels down the bundle of His and stimulates both ventricles to contract, known as ventricular systole.

    • The cardiac cycle is the time from the beginning of one heartbeat to the beginning of the next, which includes the P wave, QRS complex, and T wave.

    • The 12-lead ECG provides 12 different views of the heart's electrical activity, while continuous monitoring may use one lead.

    • The P wave represents atrial depolarization and is the first wave of the cardiac cycle, appearing as a small hill.

    • The SA node is the primary pacemaker of the heart, but other areas can initiate impulses to maintain heart function if necessary.

    • Six-step process for interpreting ECG rhythms for identifying dysrhythmias

    • Regularity of the rhythm:

      • Determined by R-to-R spacing on ECG
      • Normal rhythm: same R-to-R spacing, rarely varies
      • Irregular rhythm: varying R-to-R spacing
      • Regularly irregular: predictable pattern of irregularity
      • Irregularly irregular: no pattern of irregularity
    • Methods for calculating heart rate:

      • One-minute method: count small squares between two R waves and divide by 1500
      • Six-second method: count R waves in a 6-second strip and multiply by 10
    • P waves:

      • Examined for presence of one P wave in front of each QRS complex, regular occurrence, and similar appearance
      • Abnormal P waves indicate dysrhythmia, requiring further examination
    • PR interval:

      • Normal interval: 0.12-0.20 seconds
      • Variation: note if there is a pattern
    • QRS interval:

      • Normal and constant
      • All QRS complexes look alike
    • QT interval:

      • Measured to report abnormalities to healthcare provider
    • Importance of systematic method for interpreting ECG rhythms to increase understanding and avoid overlooking items.

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    Description

    Learn how to measure the intervals of each component of a cardiac cycle using an electrocardiogram (ECG) graph paper, which is calibrated with small squares and heavy lined blocks. Each small square is 0.04 seconds wide, making it easier to measure the time intervals of heart rhythms.

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