Advent Health EKG Questions and Answers Rated A

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Advent Health EKG Questions and Answers Rated A Afib The impulse originates in the Atria • The Atrial rate is > 300 and unable to measure [N/A] • No discernable P waves - PRI & Atrial rhythm ... cannot be measured [N/A] • The Ventricular rhythm is irregular • QRS within normal limits • If the Ventricular rate is <100 the rhythm is controlled A-fib; if the Ventricular rate is > 100 the rhythm is uncontrolled A-fib • This is a chronic rhythm for some patients Treatment: controlled patients: anticoagulants and antiarrythmics; uncontrolled but stable patients: Beta blockers, calcium channel blockers, or digoxin; Unstable patients: cardioversion Junctional Rhythm Impulse starts in the AV junction • P waves are absent, short, inverted or retrograde • Ventricular Rhythm: Regular • Ventricular Rate: 40-60 bpm • QRS is usually within normal limits Accelerated Junctional Rhythm Accelerated Junctional Same criteria as Junctional Rhythm, except the Ventricular rate is 60-100 For stable patients: IV access, vagal maneuvers, adenosine, O2, Beta blockers, calcium channel blockers Idioventricular Rhythm (IVR) Impulse originates in the ventricles ▪ Rhythm: Ventricular is usually regular ▪ Rate: Ventricular between 20-40 ▪ QRS: ≥ 0.12 ▪ Atrial rate, rhythm, and PRI: N/A - Treatment: assess pt, check for DNR in chart, transcutaneous pacing, atropine. NEVER GIVE ANTI-ARRYTHMICS MEDICATIONS Accelerated Idioventricular Rhythm Follows the same criteria as IVR, except Ventricular rate is 40-100. • If no intervention happens, the patient will deteriorate. - Treatment: assess pt, atropine, transcutaneous pacing. NEVER GIVE ANTI-ARRHYTHMIC MEDICATIONS Ventricular Pacing • The pacemaker lead is placed in to right ventricle. • The pacemaker generator fires an impulse Initiating ventricular activity. • The right ventricle will contract first followed by the left ventricle. This results in a wide QRS • Atrial activity is typically absent. Therefore, Atrial rhythm, rate, and PRI are non- measurable • Rhythm: Ventricular regular • Rate: Ventricular within set pacer limits. Measured from pacer spike to pacer spike • QRS: Wide; Pacer spike seen before each QRS. Measured from pacer spike to end of QRS Atrial-ventricular Pacing One pacemaker lead is placed into the right atria and another is placed into the right ventricle. • The pacemaker generator fires an impulse to the atria and then to the ventricle sequentially causing atrial then ventricular contraction. • Rhythm: Atrial and Ventricular regular • Rate: Atrial and Ventricular same & within set limits • P waves: Pacer spike seen at beginning of atrial activity P waves may or may not be seen (lead type dependent) • PRI: WNL - Measured from atrial spike to ventricular spike • QRS: Wide - Measured from ventricular spike to end of QRS [Show More]

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