Thursday, June 26, 2014

Practice Rhythm Strips 305

Identify the following rhythms.

1.







a. Junctional rhythm
b. Sinus bradycardia
c. Complete heart block
d. Idioventricular rhythm


2.







What is the rhythm?
 a. Ventricular tachycardia
 b. Multifocal atrial tachycardia
 c. Sinus tachycardia
 d. Supraventricular tachycardia


3.






a. Complete heart block
b. Junctional rhythm
c. Idioventricular rhythm
d. Ventricular paced


4.






a. 2nd degree AV block type II
b. Atrial flutter
c. Sinus tachycardia
d. 2nd degree AV block type I


5.






a. NSR with sinus arrest
b. Complete heart block
c. Junctional rhythm
d. Sinus bradycardia


Answers
1. b. Sinus bradycardia. The rhythm is regular and the rate is 50/min. The P waves are paired with QRS complexes. The QRS complexes are narrow. No ectopic beats are seen. PR: .16 sec, QRS: .08 sec, QT: .44 sec. Interpretation: Sinus bradycardia
2. d. Supraventricular tachycardia. The rhythm is regular with a rate of 214mn. No P waves are seen. The QRS complexes are narrow so we know the rhythm comes from above the ventricles. No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .28 sec. Interpretation: Supraventricular tachycardia
3. d. Ventricular paced. The rhythm is regular with a rate of about 70/min. The P waves are paired with a QRS complex and are upright. The are pacer spikes before each QRS complex. No ecoptic beats are seen. PR: .12 sec, QRS: .16 sec, QT: .56 sec. Interpretation: Ventricular paced
4. b. Atrial flutter. The familiar "saw tooth" appearance identifies this rhythm as atrial flutter. The rhythm is regular with a ventricular rate of 70 and an atrial rate of 300/min. The flutter waves are seen in a 3:1 ratio to the QRS complexes. The QRS complexes are narrow and there is a tall T seen. Could be hyperkalemic. It would be a good reason to check a serum K level. PR: ---, QRS: .08 sec, QT: .36 sec. Interpretation: Atrial flutter.
5. c. Junctional rhythm.  This rhythm looks regular. The heart rate is 50/min. No P waves are seen. The QRS complexes are narrow. These are characteristics of a junctional rhythm. PR: ---, QRS: .o8 sec, QT: .44 sec. Interpretation: Junctional rhythm.



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