Friday, February 27, 2015

Practice EKG Strips 219

Identify the following rhythms.

1.













a. Sinus arrhythmia
b. Sinus rhythm with PACs
c. Second degree heart block type I
d. NSR with PVCs

2.














a. Junctional tachycardia
b. Atrial tachycardia
c. Sinus tachycardia
d. Supraventricular tachycardia

3.













a. Sinus tachycardia with PVCs
b. Supraventricular tachycardia with PVCs
c. Wandering atrial pacemaker with PVCs
d. Multifocal atrial tachycardia with PVCs

4. A 45 year old female comes to the ER with complaints of shortness of breath with exertion, palpitations, and dizziness. VS: 98.4-188-20. BP: 105/73. Sats: 93% on room air. She is taken to an ER room and a # 20 IV is started in her left AC and blood work drawn. She is placed on the monitor and the following rhythm is seen. Vagal maneuvers are attempted but without a change in the rhythm. The MD orders Adenosine to be given. Which of the following statements is true regarding Adenosine:












a. It is an antiarrhythmic used to treat SVT
b. The initial dose is 6 mg given over 1 minute
c. It may cause a brief period of sinus arrest
d. It can be repeated at 1.5 x the initial dose

5.














a. Atrial fibrillation
b. Sinus arrest
c. Sinus arrhythmia
d. Wandering atrial pacemaker



Answers
1. c. Second degree heart block type I. The rhythm is irregular. The rate is 70/min. You can see that the PR interval tends to get longer from beat to beat. A dropped P wave follows the 1st, 3rd, 5th, and 7th complexes. The P - P interval is constant

2. a. Junctional tachycardia. The rhythm is regular. The rate is around 115 bpm. No P waves are seen. The QRS complexes are narrow. No ectopic beats are seen- how boring. PR:---, QRS: .08 sec, QT: 28 sec.

3. a. Sinus tachycardia with PVCs. The rhythm is irregular due to the PVCs. The rate is around 115/min. The P waves are pointing upward and are associated with a QRS complex. There is a deep Q wave seen in lead II, possibly an old MI. There are some unifocal PVCs. PR: ..16 sec, QRS: .12 sec, QT: .32 sec.

4. c. It may cause a brief period of sinus arrest. I did not pull the wool over your eyes on this one. Answer B is incorrect because you give Adenosine very fast, over 2-3 seconds. Even though Adenosine is used to treat a arrhythmia, it is technically called a nucleoside. D is incorrect because you double the dose on the second dose.

5. a. Atrial fibrillation. The rhythm looks irregular. The rate is around 60 per minute. No P waves are seen just some fibrillation between the QRS complexes. The QRS complexes are wide. No ectopic beats are seen. PR: --, QRS: .12 sec, QT: .48 sec.

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