Advanced Telemetry Exam 18 Questions with Verified Answers Normal sinus rhythm (NSR) - CORRECT ANSWER Regular 60-100 BPM P Wave Normal PR Interval 0.12-0.20 QRS Complex 0.04-0.10 ST Segment no ... rmal T Waive Normal Sinus Bradycardia - CORRECT ANSWER <60 BPM If new onset but stable Cardio Consult If unstable: ERS Atropine max 3mg (Dopamine, Epinephrine, Isoproterenolol) Pacing Sinus Tachycardia - CORRECT ANSWER Rate 100-220 minus pt age P Wave - normal or merged into T waive If asymptomatic and stable monitor and observe If symptomatic or unstable MD or ERS Establish IV Vagal Manouvers Oxygen Cardioversion if highly unstable Sinus Arrhythmia - CORRECT ANSWER Irregular and messy P waive normal Sinus Pause - CORRECT ANSWER Irregular If pause lasts more than 2 seconds it's a sinus arrest QRS normal rhythm but can happen with unusually wide beats related to junctionalnor ventrucular escape rhythms. MD or ERS if new onset, symptomatic or unstable. Oxygen Atropine Pacing Premature Atrial Contraction (PAC) - CORRECT ANSWER Irregular P Waves appear different from normal waives PRI varies RR short + RR Prolonged If more than 6 cardio consult Tylenol, Sedative, Sleeping Med Wandering Atrial Pacemaker (WAP) - CORRECT ANSWER Slightly irregular At least 3 different P waives With rate >100 it's called Multifocal Atrial Tachycardia MD consult or ERS if new onset and unstable Supraventricular Tachycardia (SVT) - CORRECT ANSWER Regular >150 P waive Normal or disappeared into T waive ERS If stable: Ventilate, o2, meds Unstable: Cardioversion 100J, SoB, Chest Pain, Slurred SP, Diaphoresis Vagal Manouvers Modified Trandenburg Adenosine FAST PUSH No pulse CODE Atrial Flutter - CORRECT ANSWER Regular F waives saw tooth Monimorphic If unstable ERS. If new onset md consult CA channel blocker Beta blocker or digoxin Anticoagulants atrial fibrillation - CORRECT ANSWER Irregular irregular 100-150 F waives, messy QRS normal/narrow >150 ERS Anticoagulants Calcium Channel Blocker Amniodarone If HR < 60 hold the med. Ventilate + Oxygen Treatment is ablation Premature Junctional Contraction (PJC) - CORRECT ANSWER Regular with short intervals P inverted or hidden or after QRS PRI <0.12 for the PJC QRS narrow Caused by hypoxia or MI If asymptomatic observe If symptomatic consult Juctional (escape) Rhythm - CORRECT ANSWER Regular 40-60 If 61-100 it's Accelerated Junctional Rhythm If 100+ Junctional Tachyxardia P Waive inverted, hidden or retrograde PRI <0.12 if present Narrow QRS Notify MD if symptomatic & stable Oxygen Atropine Ventilation Fluids Dopamine Pacing Unstable <50 ERS Wolff-Parkinson-White Syndrome (WPW) - CORRECT ANSWER Regular PR <0.12 QRS wide with delta waive NEVER give Calcium Channel Blocker First degree AV block - CORRECT ANSWER Regular PRI wide Observe until consult Second Degree Type 1 AV Block - CORRECT ANSWER Irregular as grouping patterns P waive normal but sometimes not followed by QRS Progressively Prolonged Observe until consult Second Degree Type 2 AV Block - CORRECT ANSWER Regular P waive normal, 2 or more per QRS complex PRI normal or prolonged but CONSTANT O2, MD ASAP, pacing Third Degree AV Block - CORRECT ANSWER Regular 20-40 (ventricular escape) or 40-60 (junctional escape) P waive normal QRS wide 3 different P waives and 3 different T waives Left Bundle Branch Block - CORRECT ANSWER Normal Notched R Long R and T waive in opposite direction Md Consult ASAP might be MI [Show More]
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