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Kaiser Tele Rhythms Exam | Actual Questions and Answers Latest Updated
2024/2025 (Graded A+)
Sinus Arrhythmia - ✔✔Sinus Arrhythmia Looks almost normal Action: none, continue to monitor First Drug: none Possible cause: respiratory deviation, peds, aging heart Sinus Bradycardia - ✔✔Action: oxygen, notify MD - if symptomatic, follow AHA guidelines. First Drug: Atropine if symptomatic - low BP Possible cause: vagal-stimulation, athlete, sleep, ischemia to SA node, Meds, ↑ ICP Sinus Tachycardia - ✔✔Action: Determine & Treat the cause - this is key First Drug: None, watch for drugs that may be the cause Possible causes: pain, fever, anxiety, exercise, hypoxia, caffeine, sympathetic stimulation. Premature Atrial Contraction - PAC's - ✔✔Action: no action needed; if new or frequent notify MD First Drug: None Possible causes: caffeine, fatigue, tobacco, alcohol, stress, atrial enlargement Atrial Flutter - ✔✔Action: If new, notify MD, O2 if dyspneic First Drug: Digoxin, beta blockers, amiodarone, Cardizem Possible causes: Atrial enlargement - CHF, HTN, edema post heart surgery, valve disease, hyperthyroidism Atrial Fibrillation - ✔✔Action: If new, notify MD; O2 if dyspneic First Drug: Digoxin, beta blockers, amiodarone, Cardizem
Possible causes: Atrial enlargement - CHF, HTN, edema post heart surgery, valve disease, hyperthyroidism Premature Junctional Contraction - PJC's - ✔✔Action: If frequent or new notify MD First Drug: None Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, meds Junctional Rhythm - ✔✔Actions: If new notify MD, O2 if dyspneic,meds (if extreme Brady, Call RRT) FirstDrug: Atropine(0.5mg)ifsymptomatic-BP Possible causes: ischemia - SA node, SA node function due to meds - Digoxin tox. Accelerated Junctional - ✔✔Actions: If new notify MD, O2 if dyspneic, meds First Drug: none Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, med toxicity - esp. Dig Toxicity (check potassium) Junctional Tachycardia - ✔✔Actions: If new notify MD, O2 if dyspneic, meds First Drug: none Possible causes: AV Node Irritability - caffeine, fatigue, tobacco, alcohol, stress, med toxicity - esp. Dig Toxicity (check potassium) SVT-Supraventricular Tachycardia - ✔✔Action: Vagal Maneuvers, O2, notify MD - Call RRT if symptomatic First Drug: Adenosine (6mg, 12mg, 12mg - Rapid IV push) Possible causes: stimulants, CHF, thyroid, med toxicity (Could be Sinus Tach; Atrial Tach; Atrial Flutter; or Junctional Tach - cannot determine!) 1st Degree AV Block - ✔✔Action: observe for further PR prolongation; meds; if new notify MD First Drug: None Possible causes: heart disease or meds
Ventricular Fibrillation- VF - ✔✔Action: Call a code, defibrillate - start CPR and follow ACLS pulseless arrest algorithm First Drug: After 2 shocks then drugs of choice: Epinephrine 1 mg* IV/IO, Amiodarone 300 mg* IV/IO, then any additional doses are 150 mg* IV/IO. Possible causes: K or Mg, hypoxia, ischemia, MI, med toxicity Idioventricular - ✔✔Action: Notify MD Stat (ICU/PACU Only) - With pulse M/S/Tele units call RRT, O2, set- up pacerNo Pulse- Call code and start CPR First Drug: None Pace the patient. Possible causes: MI, extreme drug toxicity Asystole - ✔✔Action: Call Code Blue; CPR; O2; set-up for pacing - verify in two leads First Drug: Epinephrine Possible causes: acute MI, conduction disturbance due to dying heart, extreme med toxicity Pacemaker - Failure to Capture - ✔✔Pacing Spikes occurring without QRS complex Action: O2; set-up for TCP pacing; notify MD, or call RRT for M/S/T unit. If new Pacer: Turn patient to Left side; notify MD If Temporary Pacer-Check battery; check connections; increase MA First Drug: usually none Possible causes: Electrolyte, metabolic abnormalities; medication toxicity; inadequate voltage (MA); battery failure; loose connections; lead fracture or dislodgement, Tissue inflammation or necrosis Pacemaker - Failure to Sense - ✔✔Pacing Spikes occurring near patient's intrinsic beat Action: O2; Notify MD for reprogramming If Temporary Pacer-Check battery; check connections; adjust sensitivity First Drug: usually none Possible causes: Incorrect sensing threshold; loose connections; lead fracture or dislodgement I have an IDEA on how to treat bradycardia - ✔✔I: Isoproteranol
D: Dopamine E: Epinephrine A: Atropine
- ✔✔25 mm = 1 s 5 mm = 0.2 s 1 mm = 0.04 s Duration of P wave - ✔✔Less that 0.12 seconds when the PR interval is lengthened beyond the normal interval, it is called - ✔✔first degree AV block Duration of PR interval - ✔✔0.12-0.2 seconds When the PR interval is shorter than 0.12 s - ✔✔Wolf Parkinson's White Syndrome Wolf-Parkinson-White Syndrome has a _____ wave - ✔✔Delta wave 🔼 Duration of QRS complex - ✔✔0.10 seconds or below Complete bundle branch block - ✔✔in adults, a QRS measuring 0.12 s or more
