Telemetry Exam 54 Questions with Verified Answers
Isoelectric - CORRECT ANSWER What is the depolarized status of the ventricles called?
5 mm - CORRECT ANSWER What is the measurement between two dark lines on a ECG
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Telemetry Exam 54 Questions with Verified Answers
Isoelectric - CORRECT ANSWER What is the depolarized status of the ventricles called?
5 mm - CORRECT ANSWER What is the measurement between two dark lines on a ECG strip?
1 second of time - CORRECT ANSWER How much time is 5 LARGE boxes on an ECG strip?
0.20 seconds - CORRECT ANSWER How much time is 1 LARGE box on an ECG strip?
0.04 seconds (= 1 mm) - CORRECT ANSWER How much time is 1 small box on an ECG strip?
P waves - CORRECT ANSWER To determine atrial rate, you would measure WHAT between two adjacent complexes using a caliper?
QRS complexes - CORRECT ANSWER To determine ventricular rate, you would measure WHAT between two adjacent complexes using a caliper?
pacemaker spikes - CORRECT ANSWER To determine pacemaker rate, you would measure WHAT between two adjacent complexes using a caliper?
6 seconds, using a 6 second strip - CORRECT ANSWER What length of time is needed when analyzing the heart rate of an irregular rhythm?
15 large boxes or 3 seconds - CORRECT ANSWER On most commonly produced ECG paper, what is the measurement and time between large marks printed above the graph strip?
Using the 6 second strip method, count the number of complexes in 6 seconds and multiply by 10 to get BPM. - CORRECT ANSWER What is the easiest way to determine heart rate of a dysrhythmic ECG?
< 0.11 seconds (not quite 3 small boxes) - CORRECT ANSWER What is the normal length of a P wave?
0.12 - 0.20 seconds (3 - 5 small boxes) - CORRECT ANSWER What is the normal length of a PR interval?
< 0.10 seconds (<2.5 small boxes) - CORRECT ANSWER What is the normal length of a QRS interval (from baseline to baseline)?
Definitely a concern, could be an indication of ischemic heart disease, pericarditis, or other conditions. - CORRECT ANSWER Is a shift up or down from the baseline in the QT segment normal or a concern?
Use the pre-calculated chart or the specific formula for .determining the corrected QTC - CORRECT ANSWER How do you determine the corrected QT interval to determine if a given strip is normal or abnormal?
Term for number of small boxes (0.04 seconds) between two complexes. - CORRECT ANSWER In a corrected QT chart, what is the "Cycle Time"
A.) What is the atrial rhythm? (Look for P waves)
B.) What is the ventricular rhythm? (Look at the QRS complexes.
C.) Is AV conduction normal? (What is the relationship between the P waves and the QRS complexes?)
D.) Are there any unsual complexes? (Are there early complexes, late complexes, or complexes of unusual contour?
E.) Is the rhythm dangerous? - CORRECT ANSWER What is are the 5 major questions to ask when determining diagnosis of an ECG?
They are occurring at the same time as a QRS complex or T wave, and being much smaller are hidden. - CORRECT ANSWER Why are P waves sometimes not seen on a ECG strip?
Yes, using a caliper, march the P waves across the strip, and notice any deformations of the QRS complex or T wave which indicates the "hidden" P wave. - CORRECT ANSWER Can you ever find the hidden P waves?
Lead II, or aVF and V1 - CORRECT ANSWER Which lead is the best angle to use when identifying P waves on an ECG?
Normal Sinus Rhythm w/ rate of 60 - 100 BPM - CORRECT ANSWER Regular and upright P waves indicate what?
sinus tachycardia - CORRECT ANSWER A heart rate of over 100 BPM is what (with normal P waves)?
sinus bradycardia - CORRECT ANSWER A heart rate of under 60 BPM is what (with normal P waves)?
physiological response to exercise, fever, pain, fear, or other stresses; or could indicate occult congestive heart failure or other cardiac decompensation. - CORRECT ANSWER What can cause sinus tachycardia?
increased vagal or parasympathetic tone; or could indicate an acute stage of myocardial infarction (especially diaphragmatic infarction). - CORRECT ANSWER What can cause sinus bradycardia?
sinus arrhythmia - CORRECT ANSWER If the longest PP or RR interval exceeds the shortest such interval by 0.16 (4 small boxes) then what is the diagnosis (given that all P waves are identical and normal)?
normal sinus rhythm (NSR)
rhythm
P wave, PR interval, QRS, QT, bpm - CORRECT ANSWER p wave: uniform and before QRS
PR int: .12-.2
QRS: .06-.1
QT: .36-.44
60-100 bpm
Sinus Tachycardia
bpm, rhythm, P waves, PR int, QRS - CORRECT ANSWER 100-150 bpm
p waves: uniform and before QRS, can be hidden
PR int: .12-.2
QRS: .06-.1
Sinus tachycardia causes and intervention - CORRECT ANSWER causes: pain, fever, caffeine, exercise, anxiety
intervention: assess patient, notify MD
sinus bradycardia
bpm, rhythm, P waves, PT int, QRS - CORRECT ANSWER 40-60 bpm
regular rhythm
P waves: upright, before QRS
PR int: .12-.2
QRS: .06-.1
sinus bradycardia causes and intervention - CORRECT ANSWER causes: sleep, hyperkalemia, hypothermia, hypoxia, normal in athletes
intervention: assess pt, call RRT if symptomatic, notify MD
sinus arrhythmia
rate, rhythm, PR int, QRS, p waves - CORRECT ANSWER rate varies
irregular rhythm
PR int: .12-.2
P waves are normal
QRS: normal, .06-.1
sinus arrhythmia causes and intervention - CORRECT ANSWER causes: changes in vagal tone during diff phases of respiration
intervention: assess pt, identify and document rhythm
premature atrial contraction (PAC)
rhythm, PR int, QRS, P wave - CORRECT ANSWER irregular rhythm, occurs before regular beat
PR interval: .12-.2
QRS: normal
P wave: upright, but abnormal shape
Supraventricular Tachycardia (SVT)
rhythm, QRS, p waves, PR interval, bpm - CORRECT ANSWER 150-250 bpm
regular rhythm
QRS is normal
P waves are usually not visible
PR interval may not be seen
Atrial flutter
PR interval, ventricular rhythm, QRS, P waves, general shape - CORRECT ANSWER no P waves
PR interval is not measurable
ventricular rhythm: 60-150
QRS is normal
sawtooth shaped
atria beat regularly
atrial fibrillation (A fib)
Ventricular rate, P waves, PR int, rhythm, QRS, shape - CORRECT ANSWER ventricular rate 60-100 bpm
no P waves
PR interval is not measurable
QRS is normal
atria beat irregularly
jagged, zigzag
premature junction contraction (PJC)
rate, rhythm, p waves, PR int, QRS - CORRECT ANSWER rate= basic rate + # of PJC's
reg rhythm except PJCs
P waves are inverted or absent
QRS is normal
PR interval less than .12
Junctional Rhythm
bpm, rhythm, PR interval, QRS, P waves - CORRECT ANSWER 40-60 bpm
regular rhythm
PR is less than .12
QRS is normal
P waves are inverted or not visible
like PJC but consistent and regular
junctional rhythm bpm
accelerated junctional tachycardia bpm
junctional tachycardia bpm - CORRECT ANSWER junc rhythm: 40-60 bpm
accelerated junc tachy: 60-100
junc tachy: 100-220
PAC vs PJC vs PVC - CORRECT ANSWER PAC p waves: upright and before QRS, just occur before supposed to
PJC: p wave is inverted or absent, or after QRS
PVC: no p wave, wide V/QRS, abnormal QRS shape
asystole - CORRECT ANSWER 0 bpm
may see P waves
no QRS
no PR interval
no ventricular activity
Idioventricular Rhythm - CORRECT ANSWER rate 20-40 bpm
looks like vtach but is slow
no P waves
regular rhythm
no PR interval
wide QRS interval (>.12)
ventricular fibrillation
rate, rhythm, shape, p waves, pr interval - CORRECT ANSWER not able to determine rate
irregular rhythm
no p waves
no PR interval
coarse/fine waves
ventricular tachycardia (polymorphic)
torsades de pointes
rhythm, bpm, p waves, pr interval, QRS - CORRECT ANSWER irregular rhythm
100-250 bpm
no p waves, no pr interval
QRS >.12, with alternating shape (neg and pos deflection)
ventricular tachycardia (monomorphic)
rhythm, bpm, p waves, pr interval, QRS - CORRECT ANSWER regular rhythm
100-250 bpm
no p waves, no pr interval
QRS >.12, relatively same shape
premature ventricular contraction (PVC)
rate, rhythm, pr interval, p wave, QRS - CORRECT ANSWER early ventricular contraction
QRS is wide and abnormal shape
rate determined by basic rate + PVC's
no p wave, no pr interval
1st degree AV block
rate, rhythm, p waves, QRS, PR interval, characteristic - CORRECT ANSWER normal rate
regular rhythm
normal P waves
PR interval is PROLONGED but consistent
QRS is normal
2nd degree AV block type 1
rhythm, QRS, p waves, pr interval, characteristic - CORRECT ANSWER irregular rhythm
QRS is normal
P waves have normal shape but more than QRS
PR interval becomes increasingly longer until QRS is dropped
2nd degree AV block type 2
rhythm, rate, PR interval, P waves, QRS - CORRECT ANSWER ventricular rate is slow
irregular d/t missed QRS, otherwise regular
PR interval is normal and constant
P waves are regular, but not all conduct QRS
QRS are usually normal, but can be wide
3rd degree AV block (complete heart block)
rate (vent and atrial), rhythm, QRS, p waves, pr interval - CORRECT ANSWER vent rate: 30-40
atrial rate: 60-100
regular rhythm
QRS: normal or wide
more P waves than QRS
PR interval: no relationship between P waves and QRS, highly variable
2:1 AV block - CORRECT ANSWER regular
2 P waves to every QRS
form of second degree
bundle branch block (BBB)
qrs, s wave - CORRECT ANSWER QRS >.12
prominent, wide S wave
or abnormal QRS
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