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Relias Dysrhythmia Basic Questions

with 100% Correct Answers | Verified |

Updated

Normal sinus rhythm Regular Rate: 60- P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Sinus Bradycardia Regular Rate: < P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Sinus Tachycardia Regular Rate: 100- P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Premature Atrial Contraction IRREGULAR Rate: depends on underlying rhythm P wave: Present or hidden in T wave PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Atrial Fibrillation IRREGULAR Atrial rate: UNMEASURABLE Ventricular rate: variable P wave: unable to see PR Interval: N/A QRS: <0.12 sec

A fib RVR IRREGULAR Ventricular rate: 100- P wave: unable to see PR Interval: N/A QRS <0.12 sec

Atrial Flutter Usually REGULAR can be irregular Atrial rate: 250-

Ventricular rate: variable BUT < atrial rate

P Wave: Flutter PR Interval: N/A QRS: <0.12 sec

Supraventricular Tachycardia Regular Rate: 150- P wave: Hidden in QRS or T wave PR: unable to determine QRS: <0.12 sec

Junctional Rhythm Regular Rate: 40- P Wave: ABSENT or INVERTED PR Interval: None or <0. QRS: <0.12 sec

Accelerated Junctional Rhythm Regular Rate: 60- P Wave: NONE or INVERTED PR Interval: None or <0. QRS: <0.12 sec

Junctional Tachycardia Regular Rate: > P Wave: NONE or INVERTED PR Interval: None or <0. QRS: <0.12 sec

Premature Ventricular Contraction IRREGULAR Rate: refer to underlying rhythm P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE , >0.12 sec

Ventricular Tachycardia Regular Rate: > P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE, >0.12 sec

Ventricular Fibrillation Chaotic Coarse: big waves Fine: small waves Rate: unmeasurable P Wave: NONE PR Interval: N/A QRS: N/A

Idioventricular Regular Rate: 20- P wave: NONE PR Interval: N/A QRS: WIDE, >0.12 sec

Accelerated Idoventricular Rhythm Regular Rate: 50- P wave: NONE PR Interval: N/A QRS: WIDE, >0.12 sec

1st Degree AV Block Regular

Rate: 60- P Wave: Present, upright PR interval: >0.20 sec CONSISTENTLY LONG QRS: <0.12 sec

Husband stays late till 9 consistently

2nd Degree AV Block Type I Mobitz, Wenckebach IRREGULAR Rate: 60- P wave: Present, upright PR Interval: Progressively longer until drop (PR interval longer and longer until drop) QRS: <0.12 sec

Husband stays late till 9, then 11, then 1, then doesn't come home at all

2nd Degree AV Block Type II Irregular or regular Rate: < P wave: Present, upright PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop QRS: <0.12 sec

Husband stays late till 9 consistently, then wife goes out and doesn't come home

3rd Degree AV Block Atrials and ventricles don't communicate

Rate: regular atrial P wave: Present, upright No relationship between P waves and QRS PR Interval: VARIABLE QRS: variable

P-P ad R-R consistent but NO correlation

Husband and wife live separate lives and don't communicate

SA Node 1st 60-

AV Node 2nd 40-

Bundle of His 3rd 40-

Right and Left Bundle Branches 4th 40-

Purkinje Fibers 5th 20-

1 Small Box 0.04 sec

1 Big Box 0.20 sec

Junctional Rhythms SA Node DID NOT FIRE AV Node fired NO P WAVE bc SA node didn't fire Narrow QRS

P Wave Amplitude 0.5-2.5 mm Will be shorter than T wave Shows firing of SA node

QRS

0.06-0.10 sec SHOULD BE <0.12 sec

Wide QRS: delay in ventricular contraction, delay of conduction through bundle branches or purkinje fibers BUNDLE BRANCH BLOCK or BLOCK IN PURKINJE FIBERS (idioventricular)

Calculate Regular Rate 1500/ # boxes R-R

Calculate Irregular Rate

of Rs in 6 sec strip X 10

Unifocal PVCs Only 1 shape PVC

Bigeminy PVC occurs every OTHER beat

Trigeminy PVC occurs every THIRD beat

Couplet 2 PVCs together

Triplet 3 PVCs together

Multifocal Multiple shapes

Monomorphic V Tach Same Shapes V Tach

Polymorphic V Tach Different Shapes V tach

Coarse V Fib Chopy but not as high as polymorphic V tach

Fine V Fib

Fine and fibrillatory

Idioventricular Rhythms Only purkinje fibers firing WIDE QRS always

Atrially Paced Spike comes before P

Ventricularly Paced Spike comes before QRS and QRS will be wide

AV Paced Spike before P and before QR

Failure to Capture Spikes with no QRS

Failure to Sense Spikes happen regardless of QRS on their own

How to determine the rhythm

Regular or irregular? Rate? P before every QRS? QRS for every P? QRS wide or narrow?

QT Interval 0.34-0.

P Wave 0.06-0.12 sec

PR Interval 0.12-0.20 sec

SA Node Firing Rhythms Fires normally @ 60- -SR 60- -SB < -ST 100- -SVT 150-

AV Node Firing, SA Node Failed Rhythms Fires normally @ 40- -Junctional rhythm 40- -Accelerated junctional rhythm 60- -Junctional tachycardia 100-

Only Purkinje Fibers Firing Rhythms (Everything else has failed) Fires normally @ 20- -Idioventricular 20- -Accelerated idioventricular 50-