Monday, February 2, 2015

Practice EKG Strips 400

Identify the following rhythms.

1.







a. Asystole
b. Ventricular standstill
c. Agonal rhythm
d. Atrial fibrillation

2.











a. Sinus arrhythmia
b. Sinus bradycardia with bigeminal PACs
c. Complete heart block
d. Idioventricular rhythm

3.










a. Atrial fibrillation with RVR
b. Sinus tachycardia
c. Supraventricular tachycardia
d. Ventricular tachycardia

4.











a. Demand atrial paced
b. Demand ventricular paced
c. Demand AV pacing
d. Demand biventricular pacing

5.










a. NSR with multifocal PVCs
b. NSR with bigeminal PVCs
c. NSR with trigeminal PVCs
d. NSR with quadrigeminal PVCs



Answers
1. c. Agonal rhythm. The rate is very slow, about 16 bpm. There are no P waves. The QRS complexes are wide .24 sec. Answer A is not correct since there is some ventricular activity. B. Is not correct because with ventricular standstill you do not see ventricular activity but you do have atrial activity, P waves only. D. Is not correct because there is not any fibrillation between the QRS complexes.

2. B. Sinus bradycardia with bigeminal PACs. The recurring pattern of PACs every other beat point towards bigeminy rather than a sinus arrhythmia. There are upright P waves before each QRS complexes. The P waves are paired up with a QRS complex so this rules out answer C. The presence of the P waves rules out answer D.

3. a. Atrial fibrillation with RVR.   The rhythm is irregular with a rate of 130 bpm.  No P waves are seeen.  The QRS complexes are narrow.  No ectopic beats are seen.  PR: ---, QRS: .08 sec, QT: .36 sec

4.  B. Pacer spikes are seen before the QRS complexes of beats 1, 2, 4, 5, 6, and 8. The remainder are the patient's inherent rhythm.

5. C. NSR with trigeminal PVCs. Uniform PVCs are seen every third beat. A long compensatory pause follows each QRS complex.

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