Float Nurse

A 60 year old patient with a history of glaucoma, hypertension, and CHF.  The home meds were Betoptic (dorzolamide) BID, Timoptic (timinol) BID,  Cozaar (losartan)  qd, ASA qd, and Lasix (furosemide) BID.   The patient was admitted to the hospital with bradycardia, dizziness, and presyncopal episodes.  The cardiac enzymes were WNL.  An echo showed that the CHF was stable with a normal EF.  The cardiologist suggested that the bradycardia might be a side effect of the Timoptic (Timinol) eye drops.   The monitor shows some extreme bradycardia with AV dissociation. After 48 hours after cessation of the Timoptic the rhythm remained unchanged and a diagnosis of sick sinus syndrome was made On the 4th day, the patient received an implanted pacemaker

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Sinus rhythm with run of VT

This strips shows an AV paced rhythm.   After the 4th complex there is failure to capture.  The fifth complex show failure to sense.  The AV interval on the sixth complex is shorter than the previous paced beats.  Between the 7th and 8th complex there is failure to capture.  The 8th complex is a fusion complex.

Serum potassium > 7.0  mEq/L is associated with conduction abnormalities and bradycardia: Prolonged QRS interval with bizarre QRS morphology High-grade AV block with slow junctional and ventricular escape rhythms Any kind of conduction block (bundle branch blocks, fascicular blocks) Sinus bradycardia or slow AF Development of a sine wave appearance (a pre-terminal rhythm) From Life in the Fast Lane https://lifeinthefastlane.com/ecg-library/basics/hyperkalaemia/

01. Identify the following rhythm. a. Atrial fibrillation b. Normal sinus rhythm c. Artifact d. Ventricular fibrillation 02. Identify the following rhythm. a. Atrial flutter b. Normal sinus rhythm c. Sinus arrhythmia d. Complete heart block 03. Identify the following rhythm. a. Sinus bradycardia with an exit block b. Junctional rhythm c. Third degree heart block d. Sinus rhythm with a dropped PAC 04. Identify the following rhythm. a. Normal sinus rhythm b. Junctional rhythm c. Atrial fibrillation d. Torsades de pointes 05. Identify the following rhythm. a. Wenckebach b. First degree block c. Sinus rhythm with a pause d. Atrial flutter 06. Identify the following rhythm. a. Third degree heart block b. Ventricular tachycardia c. Sinus bradycardia with bigeminal PVCs d. Sinus rhythm with multifocal PVCs 07. Identify the following rhythm. a. Sinus bradycardia b. Sinus arrhythmia c. Si