Tuesday, June 24, 2014

Practice Rhythm Strips 303

Identify the following rhythms.

1.







a. Atrial paced
b. Biventricular paced
c. Dual paced
d. Ventricular paced


2.






a. Normal sinus rhythm with couplets
b. Normal sinus rhythm with multifocal PVCs
c. Normal sinus rhythm with multiform PVCs
d. Normal sinus rhythm with bigeminal PVCs


3.







a. Idioventricular rhythm
b. Sinus bradycardia
c. Junctional rhythm
d. Agonal rhythm


4.







a. Sinus bradycardia with 1st degree block
b. Junctional rhythm with 1st degree block
c. Idioventricular rhythm with 1st degree block
d. 2nd degree AV block type I


5.








a. 1st degree AV block
b. 2nd degree AV block type I
c. 2nd degree AV block type II
d. 3rd degree block


Answers
1. c. Dual paced. The rhythm is regular. The rate is 70/min. There are atrial pacer spikes seen before the P waves and Biventricular pacer spikes seen before each QRS complex. No ectopic beats are noted. PR: .20 sec, QRS: .16 sec, QT: .48 sec. Interpretation: Dual paced.
2. d. Normal sinus rhythm with bigeminal PVCs. The rhythm is irregular with a rate of 80/min. There are upright P waves associated with a QRS complex. The QRS complexes are wider than normal. There are unifocal PVCs seen every other beat. PR: .16 sec, QRS: .12 sec, QT: .36 sec. Interpretation: NSR with bigeminal PVCs
3. c. Junctional rhythm. The rhythm is regular with a rate of 60/min. No P waves are seen. The QRS complexes are narrow. No ectopic beats are noted. PR: ---, QRS: .08 sec, QT: .40 sec. Interpretation: Junctional rhythm
4. a. Sinus bradycardia with 1st degree block.  The rhythm is regular. The rate is 47/min. The P waves are upright and paired with a QRS complex. The PR interval is prolonged. The QRS complexes are narrow. No ectopic beats are seen. PR: .24 sec, QT: .08 sec, QT: .40 sec. Interpretation: Sinus bradycardia with 1st degree block
5. c. 2nd degree AV block type II.   Look at your PR interval. If it is consistent then it is either a 1st degree or a type II. If it is consistent and there are dropped beats then it is 2nd degree type II. Easy peasy!

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