Friday, June 20, 2014

Practice Rhythm Strips 301

Identify the following rhythms.


1.







a. First degree block with a dropped PAC
b. Sinus arrhythmia with a pause
c. Second degree AV block type II
d. NSR with sinus arrest

2.







a.  Sinus bradycardia with sinus pauses
b.  Normal sinus rhythm with bigeminal PACs
c.  Sinus arrhythmia with dropped PACs
d. 2nd degree AV block type II


3.








a.  First degree block
b.  Second degree block type I
c.  Second degree block type II
d.  Third degree block

4.







a.  First degree block
b.  Second degree block type I
c.  Second degree block type II
d.  Third degree block

5.








a. Accelerated idioventricular rhythm
b. Accelerated junctional rhythm
c. Idioventricular rhythm
d. Junctional rhythm


Answers
1. c. Second degree AV block type II. The rhythm is irregular with a heart rate of 50/min. The P waves are positive but not all of them are paired with a QRS complex. The PR interval is the same on the conducted beats. A nonconducted P wave follows the 2nd complex. The P-P interval is consistent so this is a nonconducted sinus P wave and not a nonconducted PAC. The QRS complexes are wide. No ectopic beats are seen. PR: .16 sec, QRS: .12 sec, QT: .36 sec. Interpretation: 2nd degree block type II
2. a.  Sinus bradycardia with sinus pauses.   P waves kinda look the same. Maybe some pauses, maybe not. The rhythm is irregular with a rate of 70/min. The P waves are uniform-looking, upright and associated with a QRS complex. The PR interval is consistent from beat to beat. The QRS complexes are narrow. No ectopic beats are seen. There are .08 sec pauses that follow the 2nd, 4th, and 6th complexes. PR: .16 sec, QRS: .08 sec, QT: .32 sec. Interpretation: NSR with pauses.
3. d.  Third degree block.  No association between the P waves and the QRS complexes.
4. b.  Second degree block type I.  The rhythm is irregular with a rate of 70/min. The P waves are uniform and upright. Some nonconducted P waves are seen after the 2nd, 4th, and 6th complexes. These nonconducted P waves are fused with the T waves of the preceding complexes. There is progressive elongation of the PR interval. The QRS complexes are narrow. No ectopic beats are seen. PR: .16/.24 sec, QRS: .08 sec, QT: .36 sec. Interpretation 2nd degree block type I
5. b. Accelerated junctional rhythm.  The rhythm is slightly irregular with a rate of 70/min. The P waves are negative and precede the QRS complexes. The QRS complexes are narrow. No ectopic beats are seen. PR: .16 sec, QRS: .08 sec, QT: .36 sec. Interpretation: Accelerated junctional rhythm


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