Practice EKG Strips 414

Identify the following rhythms.

1.

a. Idioventricular rhythm
b. Accelerated idioventricular rhythm
c. Ventricular paced rhythm
d. Complete heart block

2.

a. Sinus bradycardia
b. Atrial fibrillation
c. Junctional rhythm
d. Complete heart block

3. After experiencing several episodes of this rhythm, the MD orders an Amiodarone drip beginning with a bolus dose. What is the usual loading dose for an Amiodarone infusion?

a. 150 mg IV over 10 minutes
b. 200 mg IV over 10 minutes
c. 250 mg IV over 10 minutes
d. 300 mg IV over 10 minutes

4. A 75 year old arrives to the ER in cardiac arrest. CPR is in progress. He has received two shocks at 200 J and 300 J as well as two doses of epinephrine 1 mg in route. As he is transferred to the stretcher and placed on the monitor, the following rhythm is observed. What medication is indicated in the treatment of this arrhythmia?

a. Vasopressin 40 units IV
b. Procainamide 20 mg/min
c. Magnesium 1 -2 gm IV
d. Amiodarone 150 mg IV

5.

a. Idioventricular rhythm
b. Demand ventricular rhythm
c. Junctional rhythm
d. Atrial paced

Answers
1. c. Ventricular paced rhythm. The rhythm is regular. The rate is 60 bpm. No P waves are seen. There are pacer spikes seen before each QRS complex.

2. b. Atrial fibrillation..  The rhythm is irregular.  The rate is 40 bpm.  No P waves are seen, just some fibrillation between the QRS complexes.  The QRS complexes are narrow.  No ectopic beats are seen. PR: ---, QRS: .08 sec, QT: .44 sec.

3. A. 150 mg IV over 10 minutes. Then 1 mg/min for 6 hours then 0.5 mg/hr for 18 hr

4. c. Magnesium 1 - 2 gm IV.

5. b. Demand ventricular rhythm..  The first complex is ventricular paced.  This is followed by three intrinsic beats.  The rhythm concludes with ventricular paced beats. The native beats show ST-T wave depression.