6 questions for EKG analysis - answer-Is it regular?
-Does every P have a QRS and does every QRS have a P?
-What is the Rate?
-Is the PR interval WNL?
-Is the QRS WNL?
-Is the ST segment prolonged, short or elevated?
Normal PR interval length - answer0.12-0.20 sec
Normal QRS length - answer< 0.12 or equal to 0.12
Normal ST segment - answer0.08 to 0.12, not elevated
Normal sinus rhythm - answer-regular
-every P has a QRS
-rate 70 bpm
-PR interval is 0.20, WNL
-QRS length is 0.04 WNL
-ST segment is 0.08, WNL
Sinus Tachycardia - answer-regular
-every P has a QRS
-rate 140 bpm (high)
-PR interval is 0.12, WNL
-QRS length is 0.04 WNL
-ST segment is 0.08, WNL
TX: only if symptomatic,
treat underlying cause
Sinus Bradycardia - answer-regular
-every P has a QRS
-rate <60 bpm
-PR WNL
-QRS length WNL
-ST segment is WNL
TX: only if symptomatic
IV atropine
isoproterenol
pacemaker
, Premature Atrial Beat - answerResult of an irritable ectopic electrical impulse from with
in the atria is initiated early.
-Rhythm: irregular
-every P has a QRS - no there will be extra p waves, some may be hidden
-rate - can be WNL, <60, or >100
-PR WNL
-QRS length WNL
-ST segment is WNL
TX: Usually requires no treatment
teach reduce alcohol
caffeine intake
stress
smoking.
MD may RX beta blocker.
Paroxysmal Supraventricular Tachycardia (PSVT) - answer-Rhythm: regular
-every P has a QRS - no, P waves often not identifiable
-rate - can be 100-280bpm (most often 150-200bpm)
-PR interval - not measurable
-QRS length - 0.6-0.10 WNL
-ST segment may be difficult to distinguish
TX: treat if symptomatic,
vagal maneuvers,
O2
adenosine
beta blocker
temp. pacing
synchronized cardioversion.
Atrial Flutter - answer-Rhythm: regular (may vary depending on AV conduction)
-every P has a QRS - no, 2:1, 4:1, 6:1
-rate - Atrial: 240-360, Ventricular varies, usually <150bmp
-PR interval - not measurable
-QRS length - WNL
-ST segment and T waves are not identifiable
TX:
Synchronized cardioversion,
medication to slow ventricular response beta blockers, Ca channel blockers, followed by
a class I antidysrhythmic agent or amiodarone.
Atrial Fibrillation - answer-Rhythm: irregularly irregular
-every P has a QRS - variable
-rate - atrial 300-600 (to rapid to count), ventricular 100-180bpm in untreated clients
-PR interval - not measurable
-QRS length - WNL
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