Monday, March 16, 2015

Practice EKG Strips 430

Identify the following rhythms.

1.











a. NSR with a pause
b. First degree block with a pause
c. Wenckebach
d. Sinus arrhythmia

2.  During a Code Blue CPR is initiated and the patient is placed on the monitor. The following rhythm is observed. The patient is pulseless and apneic. Two person CPR is in progress. What is the rate of compressions when performing two person CPR?











a. 80/min
b. 90/min
c. 100/min
d. 120/min

3.










a. Atrial fibrillation
b. Atrial flutter
c. Sinus arrhythmia
d. 2nd degree AV block type II

4.










a. Atrial paced
b. Atrial flutter
c. Ventricular paced
d. Accelerated idioventricular rhythm


5.











a. Sinus arrhythmia
b. Wenckebach
c. NSR with bigeminal PACs
d. Sinus arrest

Answers
1. b. First degree block with a pause. The rhythm is irregular. The rate is 70 bpm. A 1.2 second pause follows the 1st complex. There are some biphasic P waves present, p pulmonale. The PR interval is prolonged. The QRS is wide. An rSR complex is seen in the V1 lead- RBBB.  I question whether the small negative deflection after the T wave of the 1st complex might be a dropped P wave. That would account for the pause. PR: .24 sec, QRS: .16 sec, QT: .44 sec.

2. c. 100/min. Push hard and fast. Allow full chest recoil. Compress the chest about 2 inches. Minimize interruptions. Avoid over ventilating the patient. Switch positions every 5 cycles or 2 minutes.

3. a. Atrial flutter. The rhythm is irregular. There are some flutter waves They look organized and regularly occurring. The ventricular response is irregular.

4. c. Ventricular paced.  The rhythm is regular.  Upright P waves are present but they are slightly fused in the T waves of the preceding complexes.

5. c. NSR with bigeminal PACs. The rhythm is irregular. The rate is 90/min. Upright P waves are seen and they are paired with a QRS complex. The P waves are not uniform though. A PAC is seen every other beat- bigeminy. The QRS complexes are narrow. PR: .12 sec, QRS: .08 sec, QT: .40 sec.

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