Practice EKG Strips 404

Identify the following rhythms.

1.

a. Supraventricular tachycardia
b. Sinus tachycardia
c. Multifocal atrial tachycardia
d. Ventricular tachycardia

2.

a. Sinus rhythm with bigeminal PACs
b. Sinus rhythm with bigeminal PJCs
c. Sinus rhythm with bigeminal PVCs
d. sinus rhythm with bigeminal fusion beats

3.

a. Sinus rhythm with multifocal PVCs
b. Sinus rhythm with uniform PACs
c. Sinus rhythm with unifocal PVCs
d. Sinus rhythm with frequent PJCs

4.
After delivering a shock to cardiovert a 45 year old with supraventricular you look at the monitor and see the following rhythm. What should your next intervention be?

a. Place the defibrillator in the synch mode and deliver a shock at a higher joule setting
b. Deliver an unsynchronized 2nd shock at a higher joule setting
c. Have the patient perform vagal maneuvers and deliver another shock
d. Administer a dose of adenosine 6 mg IV rapidly

Answers
1. a. Supraventricular tachycardia. The rhythm is regular with a rate of 167 bpm. No P waves are seen. The QRS complexes are narrow. No ectopic beats are seen. PR: ---, QRS: .08 sec. QT: .28 sec.

2.  a. Sinus rhythm with bigeminal PACs. The rhythm is irregular. The rate is around 70 bpm. Up right P waves are present and are paired with a QRS complex. The QRS complexes are narrow. PACs are seen every other beat. The ectopic P waves can be seen on the later portion of the T wave

3. c. Sinus rhythm with unifocal PVCs. The rhythm is irregular due to the PVCs.  The underlying rate is 88 bpm.  There are P waves with a positive axis that are paired with a QRS complex. Unifocal PVCs are seen every fourth beat, quadrigeminy. PR: .16 sec, QRS: .10 sec, QT: .36 sec.

4. a. Place the defibrillator in the synch mode and deliver a shock at a higher joule setting.