Basic Telemetry Exam 42 Questions with Verified Answers,100% CORRECT

Basic Telemetry Exam 42 Questions with Verified Answers EKG - CORRECT ANSWER - records electrical activity of the heart - can provide clinician with imformation about the heart's function Myocytes - CORRECT ANSWER ...

Basic Telemetry Exam 42 Questions with Verified Answers EKG - CORRECT ANSWER - records electrical activity of the heart - can provide clinician with imformation about the heart's function Myocytes - CORRECT ANSWER - heart muscle cells - negatively charged - when they depolarize by electrical impulse, they become positive and contract - a wave of positive depolarization of myocytes flowing toward a positve electrode will result in a postive or upward deflection on EKG tracing Cardiac myocytes demonstrate: - CORRECT ANSWER - automaticity - rhythmicity - conductivity NO mitotic activity! Sinoatrial (SA) Node - CORRECT ANSWER - the heart's natural pacemaker - dominant center of automaticity - paces at 60-100 bpm Atrioventricular (AV) Node - CORRECT ANSWER - the bridge between the atria and ventricles - electrical signals pass from the atria down to the ventricles through AV node His-Purkinje System - CORRECT ANSWER - carries electrical signals throughout the ventricles to make them contract Includes: - His Bundle - R and L bundle branch - Purkinje fibers P-wave - CORRECT ANSWER - atrial depolarization QRS Complex - CORRECT ANSWER - ventricular deplorization ST Segment - CORRECT ANSWER - ventricular repolarization T-wave - CORRECT ANSWER - ventricular repolarization Estimate HR using QRS Complex Measurement - CORRECT ANSWER Count number of large boxes between QRS complexes on a 6 sec strip. 300/# of large boxes = HR Method to Assess 6 Sec EKG Strip - CORRECT ANSWER 1) evaluate P-wave 2) evaluate P-R interval 3) evaluate QRS complex 4) evaluate QRS interval 5) evaluate T wave 6) evaluate R-R interval 7) evaluate HR 8) is EKG consistent with clinical observation? Evaluating a P-wave: - CORRECT ANSWER - is it normal & upright? - is there a P-wave for every QRS - do all P-waves look alike - if not present, is other atrial activity present Normal P-R interval lasts ____ seconds. - CORRECT ANSWER 0.12-0.20 seconds Normal duration of QRS complex is ___ seconds. - CORRECT ANSWER 0.06-0.10 seconds Evaluation of T-wave - CORRECT ANSWER - is it upright & normal - rounded - symmetric Evaluation of R-R interval - CORRECT ANSWER - is it regular - if irregular, is there a pattern of the irregularity? Normal Sinus Rhythm - CORRECT ANSWER - Rhythm: regular - Rate: 60-99 bpm - QRS Duration: normal - P-wave: visible before each QRS - P-R Interval: normal (<5 small squares) Sinus Bradycardia - CORRECT ANSWER - Rhythm: regular - Rate: <60 bpm - QRS Duration: normal - P-wave: visible before each QRS - P-R Interval: normal Causes of Sinus Bradycardia - CORRECT ANSWER - healthy athletes - drug abuse - hypoglucaemia - brain injury w/ increased intracranial pressure - one on beta-blockers Sinus Tachycardia - CORRECT ANSWER - Rhythm: regular - Rate: >100 bpm (originates at SA node) - QRS Duration: normal - P-wave: visible before each QRS - P-R Interval: normal Causes of Sinus Tachycardia - CORRECT ANSWER - stress - fright - illness - exercise Premature Atrial Complexes (PACs) - CORRECT ANSWER - P-wave originating from ectopic focus - P-wave on early beat is different than regular beats; may be buried in T-wave - R-R interval = irregular; p-waves are early - may have pause after PACs Causes of PACs - CORRECT ANSWER - Stress - Nicotine - Caffiene - Alcohol - Infection - Hypoxemia - Myocardial ischemia - Rheumatic disease Supraventricular Tachycardia (SVT) - CORRECT ANSWER - originating at or above AV node - Rhythm: regular - Rate: 140-220 bpm - QRS Duration: usually normal - P-wave: often buried in preceding T-wave - P-R Interval: depends on site of supraventricular pacemaker impulses Atrial Fibrillation - CORRECT ANSWER - Rhythm: irregularly irregular - Rate: 100-160 bpm - QRS Duration: normal - P-wave: not distinguishable as the atria are firing off all over - P-R Interval: not measurable "p-wave all over the place" multiple ectopic foci in atria Atrial Flutter - CORRECT ANSWER - "sawtooth" - Rhythm: regular - Rate: ~110 bpm - QRS Duration: usually normal - P-wave: repalced with multiple F (flutter) waves 2:1 or 3:1 (F:QRS) - P-wave rate: 300 bpm - P-R Interval: not measurable Premature Ventricular Complexes (PVCs) - CORRECT ANSWER - Rhythm: regular irregular - Rate: normal - QRS Duration: normal - P-wave: 1:1 - P-wave Rate: normal - P-R Interval: normal Bigeminy - CORRECT ANSWER - PVC every other beat Trigeminy - CORRECT ANSWER - PVC every third beat Quadrigeminy - CORRECT ANSWER - PVC every fourth beat 1st Degree AV Block - CORRECT ANSWER - P-R Interval is abnormal/greater than 0.20 seconds - HR: normal - electrical signmal initiated by the SA node is blocked on it's way to the AV node - some psych drugs can cause this 2nd Degree AV Block - Type I (Wenckebach's Phenomenon) - CORRECT ANSWER - there are P-waves that stand alone, without a QRS complex - P-R Interval is abnormal: >0.20 seconds; the interval progressively lengthens until the QRS complex is dropped - caused by a block in the AV junction that blocks the conduction of some impulses 2nd Degree AV Block - Type II - CORRECT ANSWER - Life-threatening - multiple P-waves without a QRS complex - HR ~ 50 bpm - P-wave:QRS Complex = up to 4:1 - occurs because there is not conduction of impulses to the ventricles - block is usually below the Bundle of His and could be a B bundle branch block - can be caused by a myocardial infarction, ischemia or infarction of AV node - may require a placemaker implantation - can progress to 3rd degree heart block 3rd Degree AV Block - CORRECT ANSWER - No true relationship between Ps & Qs - Life-threatening & requires pacemaker implantation = medical emergency - complete heart block - all impulses conducted to above the ventricles are not sent to the ventricles - caused by: acute myocardial infarction, degeneration of conduction system - symptoms: dizziness, dyspnea, chest pain Ventricular Tachycardia (VTach) - CORRECT ANSWER = fast rhythm >100 or 120, with 3 or more irregular beat (PVCs) in a row arising from ventricles - Rhythm: regular - Rate: 180-190 bpm - QRS duration: prolonged - P-wave: not seen - results from abnormal tissues in the ventricles generating a rapid and irregular heart rhythm - poor CO is associated wtih this rhythm - SHOCK this rhythm if patient is unconscious and w/out pulse Ventricular Fibrillation - CORRECT ANSWER - Rhythm: irregular - Rate: 300+, disorganized - QRS Duration: not recognizable - P-wave: not seen - Defibrillate this patient QUICKLY. Asystole - CORRECT ANSWER - a state of no cardiac electrical activity, as such no contractions of the myocardium and no CO or blood flow are present - Rhythm: flate - Rate: 0 bpm - QRS Duration: None - P-wave: none - Carryout CPR!! Atrial Pacemaker - CORRECT ANSWER - one spike producing an abnormal P-wave (atrial capture) followed by a normal QRS - vertical pacer spike before a QRS complex Ventricular Pacemaker - CORRECT ANSWER - one spike producing a wide QRS (ventricular capture) - spike at QRS AV Sequential Pacemaker - CORRECT ANSWER - one spike followed by and abnormal P-wave (atrial capture) followed by a second spike producting a wide QRS (ventircular capture) ST Segment Elevation - CORRECT ANSWER - Rhythm: regular - Rate: 80 bpm - QRS Duration: normal - P-wave: normal - ST Element does not go isoelectric which could indicate infarction