Relias Dysrhythmia Basic A Exam Guide set

Normal sinus rhythm Regular Rate: 60-100 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Sinus Bradycardia Regular Rate: <60 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Sinus Tachycardia Regular Rate: 100-150 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Premature Atrial ContracIon IRREGULAR Rate: depends on underlying rhythm P wave: Present or hidden in T wave PR Interval: 0.12-0.20 sec QRS: <0.12 sec

Atrial FibrillaIon IRREGULAR Atrial rate: UNMEASURABLE Ventricular rate: variable P wave: unable to see PR Interval: N/A QRS: <0.12 sec

A fib RVR IRREGULAR Ventricular rate: 100-175 P wave: unable to see PR Interval: N/A QRS <0.12 sec

Atrial FluVer Usually REGULAR can be irregular Atrial rate: 250-350 Ventricular rate: variable BUT < atrial rate P Wave: FluVer PR Interval: N/A QRS: <0.12 sec

Supraventricular Tachycardia Regular Rate: 150-350 P wave: Hidden in QRS or T wave PR: unable to determine QRS: <0.12 sec

JuncIonal Rhythm Regular Rate: 40-60 P Wave: ABSENT or INVERTED PR Interval: None or <0.12 QRS: <0.12 sec

Accelerated JuncIonal Rhythm Regular Rate: 60-100 P Wave: NONE or INVERTED PR Interval: None or <0.12 QRS: <0.12 sec

JuncIonal Tachycardia Regular Rate: >100 P Wave: NONE or INVERTED PR Interval: None or <0.12 QRS: <0.12 sec

Premature Ventricular ContracIon IRREGULAR Rate: refer to underlying rhythm P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE , >0.12 sec

Ventricular Tachycardia Regular Rate: >100 P Wave: NONE PR Interval: N/A QRS: WIDE and BIZARRE, >0.12 sec

Ventricular FibrillaIon ChaoIc Coarse: big waves Fine: small waves Rate: unmeasurable P Wave: NONE PR Interval: N/A QRS: N/A

Idioventricular Regular Rate: 20-50 P wave: NONE PR Interval: N/A QRS: WIDE, >0.12 sec

Accelerated Idoventricular Rhythm Regular Rate: 50-100 P wave: NONE PR Interval: N/A QRS: WIDE, >0.12 sec

1st Degree AV Block Regular Rate: 60-100 P Wave: Present, upright PR interval: >0.20 sec CONSISTENTLY LONG QRS: <0.12 sec Husband stays late Ill 9 consistently

2nd Degree AV Block Type I Mobitz, Wenckebach IRREGULAR Rate: 60-100 P wave: Present, upright PR Interval: Progressively longer unIl drop (PR interval longer and longer unIl drop) QRS: <0.12 sec Husband stays late Ill 9, then 11, then 1, then doesn't come home at all

2nd Degree AV Block Type II Irregular or regular Rate: <60 P wave: Present, upright PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop QRS: <0.12 sec Husband stays late Ill 9 consistently, then wife goes out and doesn't come home

3rd Degree AV Block Atrials and ventricles don't communicate Rate: regular atrial P wave: Present, upright No relaIonship between P waves and QRS PR Interval: VARIABLE QRS: variable P-P ad R-R consistent but NO correlaIon Husband and wife live separate lives and don't communicate

SA Node 1st 60-100 AV Node 2nd 40-60 Bundle of His 3rd 40-45 Right and Leg Bundle Branches 4th 40-45 Purkinje Fibers 5th 20-50 1 Small Box

0.04 sec 1 Big Box 0.20 sec JuncIonal Rhythms SA Node DID NOT FIRE AV Node fired NO P WAVE bc SA node didn't fire Narrow QRS P Wave Amplitude 0.5-2.5 mm Will be shorter than T wave Shows firing of SA node QRS 0.06-0.10 sec SHOULD BE <0.12 sec Wide QRS: delay in ventricular contracIon, delay of conducIon through bundle branches or purkinje fibers BUNDLE BRANCH BLOCK or BLOCK IN PURKINJE FIBERS (idioventricular) Calculate Regular Rate 1500/ # boxes R-R Calculate Irregular Rate # of Rs in 6 sec strip X 10 Unifocal PVCs Only 1 shape PVC

Bigeminy PVC occurs every OTHER beat Trigeminy PVC occurs every THIRD beat Couplet 2 PVCs together

Triplet 3 PVCs together MulIfocal MulIple shapes Monomorphic V Tach Same Shapes V Tach

Polymorphic V Tach Different Shapes V tach

Coarse V Fib Chopy but not as high as polymorphic V tach

Fine V Fib Fine and fibrillatory

Idioventricular Rhythms

Only purkinje fibers firing WIDE QRS always Atrially Paced Spike comes before P Ventricularly Paced Spike comes before QRS and QRS will be wide AV Paced Spike before P and before QR Failure to Capture Spikes with no QRS

Failure to Sense Spikes happen regardless of QRS on their own

How to determine the rhythm Regular or irregular?

Rate?

P before every QRS? QRS for every P? QRS wide or narrow?

QT Interval 0.34-0.43 P Wave 0.06-0.12 sec PR Interval 0.12-0.20 sec

SA Node Firing Rhythms Fires normally @ 60-100 -SR 60-100 -SB <60 -ST 100-150 -SVT 150-350 AV Node Firing, SA Node Failed Rhythms Fires normally @ 40-60 -JuncIonal rhythm 40-60 -Accelerated juncIonal rhythm 60-100 -JuncIonal tachycardia 100-150 Only Purkinje Fibers Firing Rhythms (Everything else has failed) Fires normally @ 20-50 -Idioventricular 20-50 -Accelerated idioventricular 50-100

Dysrhythmia – Basic A

A - Vtach