Practice EKG Strips 422

Identify the following rhythms.

1. Lidocaine is a secondary antiarrhythmic that is used in the treatment of pulseless VF/VT. What is the recommended initial dose of Lidocaine that can be used to treat this rhythm?

a. 1.0 - 1.5 mg/kg IV/IO
b. 300 mg IV push
c. 1 mg every 3 - 5 minutes
d. 2 - 10 mcg/kg/min

2.

a. NSR with trigeminal PACs
b. NSR with trigeminal PVCs
c. NSR with trigeminal PJCs
d. NSR with a triplet of PVCs

3. What is the initial joule setting when defibrillating a patient with this rhythm using a monophasic defibrillator?

a. 100 J
b. 200 J
c. 300 J
d. 360 J

4.

a. Sinus rhythm with unifocal PVCs
b. Atrial fibrillation with trigeminal PVCs
c. Atrial flutter with multifocal PVCs
d. First degree block with bigeminal PVCs

5.

a. Sinus bradycardia with sinus arrhythmia
b. Sinus bradycardia with sinus arrest
c. Complete heart block
d. Sinus rhythm with PACs

Answers
1. a. 1.0 - 1.5 mg/kg IV/IO. A second dose can be given at 0.5 - .75 mg/kg. A maximum cumulative dose is 3 mg/kg in 24 hours. If the rhythm converts with Lidocaine, then 1 - 4 mg/min.

2. b. NSR with trigeminal PVCs. The rhythm is irregular due to the PVCs. The P waves are upright and are paired with a QRS complex. The QRS complexes are a little wide. Unifocal PVCs can be seen every third beat, trigeminy. PR: .16 sec. QRS: .10 sec. QT: .40 sec

3. d. 360 J monophasic

4. a. Sinus rhythm with unifocal PVCs

5. a. Sinus bradycardia with sinus arrhythmia. The rhythm is irregular. The rate is around 50 bpm. The P waves have a positive axis and are paired with a QRS complex. The QRS complexes are narrow. A very tall T wave is present. Maybe hyperkalemia or hyperacute T waves. PR: .20 sec, QRS: .08 sec, QT: .40 sec.