EKG Rhythm Strips 05
Identify the rhythms
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1.
2nd Degree Heart Block Type II (Mobitz II). The rhythm is irregular. There are more P waves than QRS complexes due to nonconducted impulses from the atrium. On the conducted beats there is one P wave for each QRS complex and the PR interval is uniform. If the patient is symptomatic with this rhythm, then Atropine 0.5mg may be tried. However, if the patient is unstable catecolamine infusions or transcutaneous pacing may be indicated.
2.
Atrial fibrillations with a rapid ventricular rate. The rhythm is irregular and there are really no identifiable P waves. What is the risk of cardioverting this rhythm if it has persisted over 48 hours?
3.
NSR with multifocal PVCs. The rhythm is regular except for the ectopic beats. The ectopic beats are ventricular in orgin because of their wide, bizzare morphology (shape). Because there are different sites of ectopy, the morphology of the PVCs is different and they are identified as multifocal PVCs.
4.
NSR with PJCs. The rhythm is regular and there an upright P wave for each QRS complex except on the ectopic beats. The ecotopic beats are narrow so this indicates that they arise somewhere above the ventricles. There are not upright P waves associtated with the ectopic beats so this indicates that they are not atrial in origin. Thus they are identified as a premature junctional beats. With a PJC the P wave may be absent, inverted or follow the QRS complex.
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Ventricular standstill or P wave asystole. There are no QRS complexes following the P waves. There is complete loss of ventricular electrical activity so there is no cardiac output. Is transcutaneous pacing indicated for this rhythm?
Reviewed 2/28/16
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Answers:
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| 2nd Degree Heart Block Type II (Mobitz II) |
2.
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| Atrial fibrillations with a rapid ventricular rate |
3.
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| NSR with multifocal PVCs |
4.
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| NSR with PJCs |
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| Ventricular standstill or P wave asystole |
Reviewed 2/28/16
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