Telemetry Exam 62 Questions with Verified Answers
ECG rhythm analysis - CORRECT ANSWER -determine if you have P waves
-do the QRS complexes march out?
-determine HR
-interpret rhythm
Normal sinus rhythm (NSR) -
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Telemetry Exam 62 Questions with Verified Answers
ECG rhythm analysis - CORRECT ANSWER -determine if you have P waves
-do the QRS complexes march out?
-determine HR
-interpret rhythm
Normal sinus rhythm (NSR) - CORRECT ANSWER 60-100
Sinus Bradycardia potential causes - CORRECT ANSWER athletes, sleeping, medications, MIs, increased ICP, hypothermia
Sinus Bradycardia symptoms - CORRECT ANSWER fatigue, dizziness, faint, chest pain, SOB, decreased cardiac output, pale, change in LOC, HR < 60
Medications that may cause sinus bradycardia - CORRECT ANSWER -anesthesia
-beta blockers
-digoxen
Sinus bradycardia treatment - CORRECT ANSWER **Atropine (IV)
-find cause of the bradycardia
-O2 therapy
-telemetry
-notify provider
-possibly dopamine or epinephrine drip
What if Atropine doesn't work for sinus bradycardia? - CORRECT ANSWER pacer
Sinus tachycardia potential causes - CORRECT ANSWER agitation, anxiety, fear, stress, exercise, pain, fever, caffeine, anemia, compensation for bradycardia
Sinus tachycardia symptoms - CORRECT ANSWER palpitations, chest pain, SOB, dizzy
Sinus tachycardia treatment - CORRECT ANSWER **depends on the cause
-unknown cause: beta blocker
-unstable (poor CO): cardioversion
Cardioversion - CORRECT ANSWER -waits until it knows the heart rhythm
-starts SA node
-lower amount of energy required
Premature Atrial Contraction (PAC) - CORRECT ANSWER -early beat
-originates somewhere in the atria
-may have different P wave
PAC potential causes - CORRECT ANSWER caffeine (redbull, etc.), nicotine, hypoxia, stress, alcohol intoxication, electrolyte imbalance (K and Mg), COPD: rt hypoxia
PAC symptoms - CORRECT ANSWER heart "skips a beat"
PAC treatment - CORRECT ANSWER -**remove the cause
-possible beta blockers if persistent
Atrial Fibrillation - CORRECT ANSWER -originate from multiple ectopic foci in atria
-P waves are difficult to find
-QRS don't march out
How common is atrial fibrilation? - CORRECT ANSWER fairly common-- many people live with a fib
A fib potential causes - CORRECT ANSWER previous MI, heart disease, chronic alcoholic, electrolyte imbalances
A fib treatment - CORRECT ANSWER -control HR (<100)
-diltiazem (IV)
-metrolpolol, digoxen
-cardiovert them
A fib and anticoagulants - CORRECT ANSWER if lasts more than 38 hours check for clot-- give anticoagulants first
Atrial flutter - CORRECT ANSWER -ectopic focus: in atria
-atrial impulses = 250 to 350 bpm
-NO P wave
Appearance of atrial flutter - CORRECT ANSWER "saw toothed" or "picket fence" appearance
-only some impulses get through
Atrial flutter potential causes - CORRECT ANSWER sick heart
Atrial flutter treatment - CORRECT ANSWER -*treat underlying issue
-ablation
-cariovert
Supraventricular tachycardia (SVT) potential causes - CORRECT ANSWER overexertion, stress, chronic disease, stimulants, born prone to it
SVT symptoms - CORRECT ANSWER rapid HB, palpitations
SVT treatment - CORRECT ANSWER *slam Adenosine 6 mg in fast
-causes heart to go into asystole
-need crash cart
-return to normal rhythm
-if it doesn't work, do another dose (12 mg)
Heart blocks - CORRECT ANSWER -First degree
-Second degree (Type I and II)
-Third degree block
First degree AV block - CORRECT ANSWER wide p-QRS interval
-slow conduction
First degree potential causes - CORRECT ANSWER sick heart, MI, CAD, electrolyte imbalance, meds
First degree symptoms - CORRECT ANSWER usually asymptomatic
First degree treatment - CORRECT ANSWER may be no treatment if no cause
First degree AV block analogy - CORRECT ANSWER P wave = wife
QRS = husband
every night the husband comes home; but sometimes he's late
Second degree AV block - CORRECT ANSWER wide and irregular p-QRS interval
Second degree potential causes - CORRECT ANSWER sick heart, infection, clots, poor valves, drugs (beta blockers, digoxen)
Second degree treatment - CORRECT ANSWER need a pacemaker
Second degree Type I analogy - CORRECT ANSWER husband comes home at 6 one night, then 7, then 8, then he doesn't come home
Second degree Type II analogy - CORRECT ANSWER husband comes home at 5 one night, spends 2 nights away, comes back for a night, leaves for 2 nights again
Third degree block - CORRECT ANSWER complete heart block
-the "atria and ventricles are functioning totally independently or dissociated from each other"
Third degree symptoms - CORRECT ANSWER syncope
Third degree treatment - CORRECT ANSWER pacemaker
Third degree analogy - CORRECT ANSWER there is no association between the husband and wife; couple needs to start talking more for the sake of the kids
Ventricular rhythms - CORRECT ANSWER Ventricle: primary pacemaker
Dangerous!
Ventricular rhythms rate - CORRECT ANSWER 20-40 bpm
Ventricular rhythms QRS complex - CORRECT ANSWER 0.12 or greater (really wide)
Ventricular rhythms T wave - CORRECT ANSWER opposite of QRS
Premature Ventricular Complex (PVC) potential causes - CORRECT ANSWER alcohol use, stimulants, stress, hypoxia, electrolyte imbalance
PVC symptoms - CORRECT ANSWER depends on the number of PVCs: "skips a beat", may not notice, bad cardiac output, chest pain
PVC treatment - CORRECT ANSWER treat underlying cause
-hypoxia: oxgen
-stimulant: decrease amount
-antidysrhythmic
Ventricular fibrillation potential causes - CORRECT ANSWER electrolyte issues, sick heart, electrical shock
Ventricular fibrillation symptoms - CORRECT ANSWER DEAD
Ventricular fibrillation treatment - CORRECT ANSWER CPR, bagging, code cart, defibrillate, IV push epinephrine
**all within first 2 minutes
Two types of ventricular fibrillation - CORRECT ANSWER corse or fine
Pulseless electrical activity (PEA) symptoms - CORRECT ANSWER VERY DEAD
PEA treatment - CORRECT ANSWER -fix H's and T's
-CPR
-can't shock
-epinephrine
PEA - CORRECT ANSWER electrical and conduction goes through but no beat
5 T's - CORRECT ANSWER -drug toxicity
-cardiac tamponade
-thrombosis (PE or big MI)
-tension pneumothorax
-trauma
5 H's - CORRECT ANSWER -hypoxia
-hyper/hypokalemia
-hydrogen ion (acidosis)
-hypothermia
-hypovolemia
Asystole "flat line" sypmtoms - CORRECT ANSWER VERY DEAD
Asystole treatment - CORRECT ANSWER *outcomes bad
-CPR, epinephrine
-fix H's and T's
Why should you never shock someone in asystole? - CORRECT ANSWER there is no electrical activity
What happens if someone is in asystole for several minutes? - CORRECT ANSWER low chance of getting them back
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