Wednesday, February 11, 2015

Practice EKG Strips 407

Identify the following rhythms.

1.











a. Agonal rhythm
b. Junctional rhythm
c. Complete heart block
d. Atrial fibrillation with slow ventricular response

2.











a. Atrial flutter
b. Atrial fibrillation
c. Atrial tachycardia
d. Atrial paced

3.












a. Junctional rhythm
b. Complete heart block
c. Agonal rhythm
d. Idioventricular rhythm

4.














a. NSR with PACs
b. Sinus arrhythmia
c. 2nd degree heart block type II
d. Sinus rhythm with pauses

5.













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

Answers
1. a. Agonal rhythm. The rhythm is irregular with a rate of 20 bpm. No P waves are seen. The QRS complexes are very wide and bizarre looking. A 5 second pause is seen between the 2nd and 3rd complexes.

2.  a. Atrial flutter. The rhythm is irregular due to the variable conduction through the AV node. The rate is 110 bpm. There are flutter waves present. The QRS complexes are narrow. A PVC is seen at the end of the strip.

3. a. Junctional rhythm. The rhythm is regular. No P waves are seen. The QRS is wide with a rSR complex seen in lead V1, RBBB. No ectopic beats are seen. With the wide QRS complex I would normally call this an accelerated idioventricular rhythm. However, this is an example of a junctional rhythm with a wide QRS complex. You would have to know the history of the patient and be able to compare the current EKG strip to previous ones.

4. a. NSR with PACs. The rhythm is irregular due to the frequent PACs. The rate is 90 bpm. The P waves are upright and are associated with a QRS complex. The QRS complexes are narrow. There are PACs every other beat, atrial bigeminy. The P waves of the ectopic beats are seen best in the V1 lead. PR: .16 sec, QRS: .08 sec, QT: .44 sec.

5. a. Sinus tachycardia. The rhythm is regular. The rate is 125 bpm. The P waves are upright and are followed by a QRS complex. The QRS complexes are narrow, normal conduction. No ectopic beats are seen. PR: .16 sec, QRS: . 08 sec, QT: .28 sec.


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