Monday, March 2, 2015

Practice EKG Strips 420

Identify the following rhythms:

1.













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

2.













a. Atrial tachycardia
b. Multifocal atrial tachycardia
c. Wandering atrial pacemaker
d. Sinus rhythm with PACs

3.













a. Normal sinus rhythm
b. Junctional rhythm
c. Sinus bradycardia
d. Sinus arrhythmia

4.












a. Atrial fibrillation with runs of AIVR
b. Atrial fibrillation with runs of VT
c. Atrial fibrillation with runs of PSVT
d. Atrial fibrillation with runs of RVR

5.













a. Normal sinus rhythm
b. First degree block
c. Sinus bradycardia
d. Sinus arrhythmia


Answers
1. C. Second degree heart block type II. The PR interval is consistent from beat to beat. The rate is very slow, 30 bpm. The P waves are upright and are paired with a QRS complex. Though there are some nonconducted P waves present. The PR interval is really stretched out. For such a slow rate, the QRS complexes are surprisingly narrow. PR: .36 sec. QRS: .08 sec. QT: .52 sec.

2. c. Wandering atrial pacemaker. There are PACs a-plenty. The distinguishing factor between NSR with PACs and WAP is that there are at least three competing ectopic sites within the atrium. This produces PACs of differing morphology.

3. b. Junctional rhythm. The rhythm is regular with a rate of 50 bpm. Negative P waves are seen before each QRS complex. The QRS complexes are narrow. No ectopic beats are seen. PR: .12 sec, QRS: .08 sec, QT: .28 sec.

4.  a. Atrial fibrillation with runs of AIVR. The rhythm is irregular. The rate is around 100 bpm. There are no P waves. There are two four beat run of AIVRs. The wide morphology of the QRS complexes indicate that the ectopic rhythm arises from the ventricles. The rate is of these two ectopic rhythms is around 100/min. This is within the upper limits of an AIVR rhythm. Seems slow for VT.
a. Normal sinus rhythm. The rate looks regular. The rate is about 65 bpm. Broad upright P waves are seen before each QRS complex. Could be left atrial enlargement. The QRS complexes are well wide. The RSR complexes suggest a RBBB. No ectopic complexes are seen. PR: .20 sec. QRS: .16 sec. QT: .44 sec.
5.

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