Float Nurse

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Normal sinus rhythm with unifocal PVCs The rhythm is irregular due to the PVCs.   The rate is 90/min.  P waves precede QRS complexes and are uniform and upright.   Two unifocal ectopic beats are present.   There is a P wave before each of them and the QRS complex is wide.   These complexes may represent some kind of fusion beats.  PR:  .12 sec,  QRS:  .08 sec,  QT:  .36 sec. 2. Bigeminal PVCs The rhythm is irregular due to the PVCs.  The rate is 40/min. (this strip is longer than 6 seconds so be careful about how you count the R waves).  The P waves are upright and precede a QRS complex.  The PR interval is shortened.  There are unifocal PVCs every other beat,  bigeminy pattern.  The PVC look like they fall on what would be the T wave.  R-on-T?   PR: ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Atrial fibrillation with unifocal PVCs The rhythm is irregular with a rate of 60/min.   P waves are absent but some fibrillatory activity is seen between the QRS complexes.  3 unifocal PVCs are seen, one single and two are paired together.   PR:  ---,  QRS:  .12 sec,  QT:  .36 sec. 2. Demand ventricular pacing The rhythm is irregular due to the ectopic beats.   The rate is 90/min.   The P waves are positive and correspond to a QRS complex.   A single PVC is present.  The 2nd and 6th complexes are the patient's own beats.  The patient has an underlying 1st degree block with a PR interval of 26 sec.  The remainder are ventricular paced beats.  The intervals for the paced beats:  PR:  .12 sec,  QRS:  .16 sec,  QT:  .48 sec. 3. Normal sinus ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Complete heart block The rhythm is regular.  The atrial rate is 65/min and the ventricular rate is 35/min.   There are upright P waves present but they are not associated with the QRS complexes.  No ectopic beats are noted.   PR:  ---,  QRS:  .16 sec,  QT:  .52 sec. 2. Demand ventricular pacing The rhythm is irregular because of the transition between demand pacing and the patient's own rhythm.   The rate is 80/min.   There are small upright P waves present and the PR interval is prolonged. No ectopic beats are noted.  PR:  .28 sec,  QRS .08 sec,  QT:  .32 sec. 3. Supraventricular tachycardia The rhythm is regular with a rate of 150/min.   No P waves are present.   No ectopic beats are seen.  PR:  ---  QRS:  .06 sec, ...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. Bigeminy The rhythm is irregular due to the unifocal PVCs.   The rate is 90.  There are small upright P waves present.  There are PVCs occurring every 2nd beat.   PR:  .14 sec,  QRS:  .16 sec, QT:  .40 sec. 2. Biventricular paced with a multifocal couplet The rhythm is irregular due to the couplet.   The rate is 80/min.  The are flutter waves between the QRS complexes.  A multifocal couplet is present.  There are biventricular pacer spikes before the QRS complexes.  PR: ---,  QRS:  .12 sec,  QT:  .32 sec 3. Trigeminy The rhythm is irregular due to the unifocal PVCs.   The rate is 80/min.   The are small upright P waves present.  The PR interval is progressively lengthening.  Unifocal PVCs are present every 3r...

Identify the following rhythms. 1. 2. 3. 4. 5. Answers 1. 1st degree block changing to a type I AV block The rhythm is irregular.   The rate is 70/min.  The P wave are upright and precede the QRS complexes.   The PR interval is prolonged.   Beginning at the 5th complex the rhythm transitions into a type I block with progressive lengthening of the PR interval and ending with a dropped beat after the 8th complex.  The ST segment is down slopping.  No ecoptic beats are seen.  PR:  .24 sec then progressively lengthening,  QRS:  .08 sec,  QT:  .44 sec. 2. Atrial fibrillation This rhythm is irregular and the rate is 110/min.   No P waves are present but there are some fibrillatory/flutter waves present.  Uncommonly it is called "flutteration."   No ectopy is present.  PR:  ---,  QRS:  .08 sec,   QT:  .24 sec. 3. ...