Wednesday, March 11, 2015

Practice EKG Strips 427

Identify the following rhythms.

1.












a. Sinus bradycardia
b. Junctional rhythm
c. Sinus arrest
d. Atrial fibrillation with slow ventricular response


2.











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


3.











a. Normal sinus rhythm
b. First degree block
c. Atrial flutter
d. 2nd degree heart block type II

4.













a. Torsades pointes
b. Ventricular tachycardia
c. Accelerated idioventricular rhythm
d. Atrial fibrillation

5.














a. Accelerated junctional rhythm
b. Accelerated idioventricular rhythm
c. Normal sinus rhythm
d. Atrial fibrillation


Answers
1. b. Junctional rhythm. The rhythm looks regular. The rate is 38 bpm. It looks like there are some retrograde P waves seen after the QRS complexes. There is a negative deflection right before the upstroke of the T wave. These may be retrograde P waves. If this is the case, the ventricles are depolarizing and contracting before the atria. The QRS complexes are narrow. No ectopic beats are seen.

2. c. Atrial fibrillation. The rhythm is irregular. The rate is 50 bpm. No P waves are seen. There is fibrillation between the QRS complexes. The QRS complexes are narrow. No ectopic or premature beats are seen. PR: --, QRS: .08 sec, QT: 56 sec.

3. b. First degree block. Maybe some U waves present or some odd variation in the T waves. I doubt that they are dropped PACs since they are seen so regularly. The 3rd and 5th beats look PVC. They look wider than the sinus beats and do not have a P wave.

4. a. Torsades pointes, This is a form of polymorphic VT in which the QRS complexes appear to be grouped with a net electrical axis in one direction then pause and change to the opposite electrical axis with the next group of beats. It give the appearance of being twisted around the central isoelectric axis.

5. a. Accelerated junctional rhythm. Inverted P waves. Regular rhythm. Rate of 80 bpm. QRS complexes are narrow. No ectopic beats. PR: ---, QRS: .08 sec, QT: .40 sec.

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