Float Nurse

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1.  Accelerated junctional rhythm.   The rhythm is regular with a rate of 94/min.   No P waves are seen.   No ectopic beats are seen. The QRS complex is wide.   PR:  ---,  QRS:  .12 sec,  QT:  .40 sec.  Interpretation:  Accelerated idioventricular rhythm.   The interpretation of accelerated idioventricular rhythm is correct based upon the characteristic of the rhythm.  However, this patient actually had an underlying wide QRS complex on previous strips so the actual interpretation for this strip would be an accelerated junctional rhythm. 2. Asystole with a functional pacemaker  There are no P waves are QRS complexes.   There are pacer spikes present but they are not capturing.   Interpretation:  Asystole with a functional pacemaker 3. Dual paced with biventricula...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Asystole with AV pacer spikes The underlying rhythm is asystole.   There are atrioventricular pacer spikes present but they are not capturing.   The heart is dead but the pacemaker is still functioning and generating impulses as it was programmed to do.  Usually an internal pacemaker is disabled by placing a magnet over it. 2. Atrial flutter  The rhythm is slightly irregular with a rate of 80/min.  There are flutter waves present between the QRS complexes.   No ectopic beats are seen.   PR:  ---,  QRS:  .12 sec,  QT:  .48 sec. 3. Biventricular paced The rhythm is regular with a rate of 75/min.   P waves are present, upright, and have a corresponding QRS complex.   There are biventricular pacer spikes before each QRS complex. ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Asystole with pacer spikes The pacemaker is still functioning in this asystolic rhythm. 2. Atrial flutter The heart rhythm is regular with a rate of 53/min.   There are flutter waves seen between the QRS complexes.   The atrial rate is around 200/min.  No ectopic beats are noted.  PR:  ---,  QRS:  .08 sec,  QT:  .44 sec. 3. Idioventricular rhythm The rhythm is regular with a rate of 35/min.  No P waves are seen.   The QRS is wide indicating a ventricular escape origin.   PR:  ---,  QRS:  .12 sec,  QT:  .36 sec. 4. Multifocal atrial tachycardia The rhythm is irregular with multiple PACs and a ventricular rate of 110/min.   The P waves are associated with a QRS complex but are not uniform.   There is also some variability in the PR interval.   PR:  . 12 s...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Asystole No ventricular or atrial activity is identified.   Check to make sure all the leads are connected.   Check to make sure all the wires are connected and that the monitor is in the correct lead.  Increase the waveform size to assess for fine ventricular fibrillation.   Begin CPR and give epinephrine 1mg or vasopressin 40 units as initial medications.  Look for reversible causes:  hypoxia,  hypovolemia, hydrogen ions (acidosis), hypothermia,  hyper/hypokalemia,  tension pneumothorax,  toxins/tablets, thrombosis coronary,  thrombosis pulmonary,  tamponade 2. Atrial flutter The rhythm is regular with a rate of 50/min.  There are flutter waves between each QRS complex.  No ectopic beats are seen.  PR:  ---,  QRS:  .12 sec,  QT:  .32 sec. ...

Oh Danny boy, the pipes, the pipes are calling From glen to glen, and down the mountain side The summer's gone, and all the flowers are dying 'Tis you, 'tis you must go and I must bide. Danny Boy A 94 year old admitted with chest pain. 0206:  Called to room because patient was feeling nauseated.  Patient found to be diaphoretic,  nauseated, and anxious.   Holding chest.   Became unresponsive and pulseless.   Code Blue called. 0210:  CPR initiated.   Placed on monitor.   Normal saline started. 0211:  Defibrillated at 200 joules.   Post-shock rhythm ventricular tachycardia.   CPR resumed 0213:   Epinephrine 1mg IV given.   CPR in progress.   Positive pressure ventilations adequate. 0215:  Defribrillated 300 joules.    CPR resumed.    Ventilations becoming more difficult.  Abdomen distended.  Attempted NG insertion ...