Monday, February 16, 2015

Practice EKG Strips 410

Identify the following rhythms.

1.











a. Second degree heart block type II
b. Second degree heart block type I
c. Third degree heart block
d. First degree heart block

2.











a. Atrial pacing
b. AV pacing with biventricular pacing
c. Biventricular pacing
d. Ventricular pacing


3.A 35 year old with a 2 day history of her "heart racing" comes to the ER with shortness of breath and dizziness. She is alert and oriented. VS: 98.2-167-23. BP 107/67. Sats 94% on room air. After placing her on the monitor the following rhythm is seen. An IV is started in her left AV and oxygen at 2 L/min via nasal cannula is started. What is the next appropriate intervention?












a. Give Cardizem 0.35 mg/kg IV
b. Attempt vagal maneuvers
c. Give Adenosine 6 mg IV
d. Cardioversion at 50 J

4.











a. Atrial fibrillation
b. Junctional rhythm
c. Idioventricular rhythm
d. Sinus bradycardia

5.











a. Sinus rhythm with unifocal PVCs
b. Sinus rhythm with trigeminy
c. Sinus rhythm with a triplet of PVCs
d. Sinus rhythm with multiform PVCs


Answers
1. a. Second degree heart block type II.  The PR interval on the conducted beats is the same.  There are dropped or nonconducted P waves seen after each QRS complex.  The P-P interval is consistent. No ectopic beats are noted.

2. b. AV pacing with biventricular pacing.  An atrial spike is seen before each P wave and two pacerspikes are seen before each QRS complex.  No ectopic beats are seen.

3. B. Attempt vagal maneuvers. The patient is only symptomatic st this time.  Let's get ready for the adenosine.

4.b. Junctional rhythm.  The rhythm is regular with a rate of 40 bpm. The QRS complexes are narrow.  No ectopic beats are seen.  PR:--, QRS: .08 sec, QT: .40 sec.

5. a. Sinus rhythm with unifocal PVCs.  t. The underlying rhythm is sinus.  Upright P waves precede a QRS complex.  The QRS complexes are narrow.  Unfocal PVCs are seen every fourth beat. A compensatory pause follows each PVC. PR: .20 sec, QRS: .08 sec, QT: ,36 sec,


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