Float Nurse

Complete heart block.  The rhythm is irregular.  The QRS complexes are narrow too.  This suggests that the block is higher in the ventricle.  The rate is faster too.   

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Complete heart block The rhythm is regular with a ventricular rate of 38/min.   There are small upright P waves present but they are not associated with a QRS complex.   The QRS complexes are wide suggesting a ventricular origin.   No ectopic beats are seen.   PR:  ---,  QRS:  .16 sec,  QT:  .40 sec. Interpretation:  Complete heart block 2. Normal sinus rhythm The rhythm is regular.   The rate is 75/min.   There are upright P waves before each QRS complex. Lead II shows 3mm ST segment depression with an inverted T wave.   No ectopic beats are seen. PR:  .16 sec,  QRS:  .08 sec,  QT:  .36 sec.  Interpretation:  Normal sinus rhythm 3. Normal sinus rhythm with a multifocal couplet This strip shows an arterial blood pressure waveform in the 2nd lead. ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 3rd degree heart block The rhythm is regular with a ventricular rate of 38/min.  There are small upright P waves present but they are not paired with a QRS complex.  The atrial rate is 65/min.   No ectopic beats are noted.   PR:  ---,  QRS:  .16 sec,  QT:  .44 sec.   Interpretation:  3rd degree heart block 2. Junctional rhythm The rhythm is regular with a rate of 38/min.   The P waves are absent.   The QRS complex is narrow.   No ectopic beats are seen.   PR:  ---,  QRS:  .08 sec,  QT:  .48 sec.   Interpretation: Junctional rhythm. 3. 1st degree AV block The rhythm is regular with a heart rate of 68/min.   The P waves are uniform, upright, and associated with a QRS complex.   The PR interval is prolonged.  No ectopic beats are...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial flutter with variable ventricular response The rhythm is irregular with a rate of 60/minute.   Multiple P waves or flutter waves are present in a 3:1 and 4:1 ratio.   No ectopic beats are seen.  PR:---,  QRS: .08 sec,  QT: .24 sec. Interpretation: Atrial flutter with variable ventricular response 2. Complete heart block The rhythm is regular with a rate of 38/min.   There are some small upright P waves seen but they are associated with the QRS complexes.   The atrial rate is 60/min.   No ectopic beats are seen.  PR:  ---,  QRS:  .16 sec,  QT:  .44 sec.   Interpretation:  Complete heart block 3. Normal sinus rhythm The rhythm is regular with a heart rate of 100/min.   The P waves are uniform, upri...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Compete heart block The rhythm is regular with a ventricular rate of 36/min and an atrial rate of 83/min.   There is complete AV dissociation so the P waves do not have a corresponding QRS complex.   The P waves are uniform and upright suggesting a sinus origin.   The QRS complex is wide suggesting a ventricular escape mechanism that is stimulating the ventricles.   PR:  ---,  QRS:  .12 sec,  QT:  .52 sec. 2. Supraventricular tachycardia The rhythm is regular with a heart rate of 150/min.   The P waves are not readily seen.  The QRS complex is narrow which is indicative of a supraventricular rhythm.  The rhythm has a saw tooth appearance which resembles atrial flutter but until the rate is slowed down we can not be sure. Vagal maneuvers may provide some clues No ectopic beats are seen....

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st degree block with a PVC The rhythm is irregular due to the PVC.   The rate is 60/min.    The P waves are upright and precede the QRS complexes.   The PR interval is prolonged.   There is a single PVC present.  PR:  .36 sec,  QRS:  .08 sec,  QT:  .40 sec. 2. Agonal rhythm The rhythm may be regular or irregular.   The rate is 20/min.    No P waves are present.   The QRS complexes are wide suggesting a ventricular origin to the rhythm.   PR:  ---,  QRS:  .20 sec,  QT:  .52 sec. 3. Atrial fibrillation  The rhythm is irregular with a heart rate of 100/min.   The P waves are absent.   There are flutter waves seen between the QRS complex,  seen more clearly in the V1 lead.  No ectopic beats are noted.  PR:  ---,  QRS:  ...