NUR 4227 - Exam 2 UPDATED ACTUAL Questions and
CORRECT Answers
conduction system of the heart SA node → AV node → bundle HIS → bundle branches → purkinje fibers
SA node: 60-100 bpm
AV node/Bundle of HIS: 40-60 bpm
BB/Purkinje fibers: 20-40 bpm
ECG basics: counting boxes sm box: 0.04 sec
lg box: 0.20 sec
ECG: lead placements
ECG: calculating HR count the # of squares from R to R
1 box = 300 bpm
2 = 150
3 = 100
4 = 75
5 = 60
6 = 50
NI: halter monitors 24 hour heart monitor
-no strenuous activity, showering, caffeine/smoking
-push button if feel something funny
-keep pt calm - explain what it's for
five steps to analyzing a strip 1. HR 60-100?
2. rhythm regular?
3. P wave? present? one/QRS? upright? similar?
4. PR interval 3-5 boxes (0.12 - 0.20)
5. QRS complex 1.5-3 boxes (0.06 - 0.12)
, how to measure PR and QRS interval
how to measure atrial rate and ventricular rate atrial rate: count P waves in 6 seconds x 10 (or count P-P wave)
ventricular rate: count QRS complexes in 6 seconds x 10 (or count R-R)
initial interventions for dysrhythmias -if unresponsive CAB
-if responsive ABC
-O2 NC/NRB
-VS
-12 lead ECG, identify dysrhythmia
-IV access
-labs
artifact abnormalities of electrical activity NOT resulting from cardiac muscle (hair
interference, lead falls off/misplaced, shakiness)
atropine ↑ HR. tx: sympto brady, sinus arrest/pause
adenosine ↓ HR. tx: tachy, SVT
dopamine ↑ HR, ↑ contractility, ↑ BP
epi/norepi vasoconstrictors ↑ HR/BP
digoxin ↓ HR, ↑ contractility
CCB/BB ↓ HR; CCB relax muscle contraction ↓ BP
amiodarone antiarrhythmic, ↓ HR, ↓ excitability of heart tissue
procainamide antiarrhythmic, ↓ HR
sinus rhythms impulse originates in the SA node
ex. normal sinus, brady, tachy, arrhythmia, sinus arrest
-all have P waves uniform and before QRS (if QRS present)
-PR interval 0.12 - 0.20 (3-5 boxes) NORMAL
-QRS normal if present (0.06 - 0.12, 1.5-3 boxes)
normal PR and QRS interval measurements PR: 0.12 - 0.20 (3-5 boxes)
QRS: 0.06 - 0.12 (1.5-3 boxes)
CORRECT Answers
conduction system of the heart SA node → AV node → bundle HIS → bundle branches → purkinje fibers
SA node: 60-100 bpm
AV node/Bundle of HIS: 40-60 bpm
BB/Purkinje fibers: 20-40 bpm
ECG basics: counting boxes sm box: 0.04 sec
lg box: 0.20 sec
ECG: lead placements
ECG: calculating HR count the # of squares from R to R
1 box = 300 bpm
2 = 150
3 = 100
4 = 75
5 = 60
6 = 50
NI: halter monitors 24 hour heart monitor
-no strenuous activity, showering, caffeine/smoking
-push button if feel something funny
-keep pt calm - explain what it's for
five steps to analyzing a strip 1. HR 60-100?
2. rhythm regular?
3. P wave? present? one/QRS? upright? similar?
4. PR interval 3-5 boxes (0.12 - 0.20)
5. QRS complex 1.5-3 boxes (0.06 - 0.12)
, how to measure PR and QRS interval
how to measure atrial rate and ventricular rate atrial rate: count P waves in 6 seconds x 10 (or count P-P wave)
ventricular rate: count QRS complexes in 6 seconds x 10 (or count R-R)
initial interventions for dysrhythmias -if unresponsive CAB
-if responsive ABC
-O2 NC/NRB
-VS
-12 lead ECG, identify dysrhythmia
-IV access
-labs
artifact abnormalities of electrical activity NOT resulting from cardiac muscle (hair
interference, lead falls off/misplaced, shakiness)
atropine ↑ HR. tx: sympto brady, sinus arrest/pause
adenosine ↓ HR. tx: tachy, SVT
dopamine ↑ HR, ↑ contractility, ↑ BP
epi/norepi vasoconstrictors ↑ HR/BP
digoxin ↓ HR, ↑ contractility
CCB/BB ↓ HR; CCB relax muscle contraction ↓ BP
amiodarone antiarrhythmic, ↓ HR, ↓ excitability of heart tissue
procainamide antiarrhythmic, ↓ HR
sinus rhythms impulse originates in the SA node
ex. normal sinus, brady, tachy, arrhythmia, sinus arrest
-all have P waves uniform and before QRS (if QRS present)
-PR interval 0.12 - 0.20 (3-5 boxes) NORMAL
-QRS normal if present (0.06 - 0.12, 1.5-3 boxes)
normal PR and QRS interval measurements PR: 0.12 - 0.20 (3-5 boxes)
QRS: 0.06 - 0.12 (1.5-3 boxes)
