NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
Module 5 – Rhythms
Measurements of Rhythms
PR Interval
represents the delay from the AV node to allow for ventricular filling
normal PR interval size is 0.12-0.20 seconds or
3.5-5 small squares (should fit in one big box)
QRS Complex
• depolarization of the ventricles, triggers main pumping action
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
• normal= 0.08 and 0.10 seconds (should fit in half of one big box)
• greater than 0.12 seconds is considered abnormal
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
(think ventricular tachycardia)
ST Segment
• represents the interval between ventricular depolarization and repolarization
• measures from the end of the QRS complex to the start of the T wave
• normal measurements are 0.005 to 0.150 seconds and SHOULD BE FLAT on the isoelectric line
• most common reason for elevated ST segment is a myocardial infarction
• most common reason for a depressed ST segment is ischemia
QTc (QT interval)
• represents the time of ventricular activity including both depolarization and repolarization
• the normal QT interval is 0.36 to 0.44 seconds (should fit in 2-2 ½ big boxes)
• it is measured from the beginning of the QRS complex to the end of the T wave
• the QT interval will vary with patient gender, age, and heart rate
• another guideline is that a normal QT interval is less than half of the R-
R interval for heart rates below 100bpm
T Wave
• represents ventricular repolarization (recovery)
• can be upright, inverted, notched, large or small
• many different reasons for T wave changes – some are medical, others are not
• important to verify patient’s history and medication use when validating T wave abnormality
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
Identification and Treatments for Atrial Arrhythmias
• Always consider nursing interventions: monitor patient, establish IV, give oxygen (if hypoxic)
Supraventricular Tachycardia
• rapid stimulation of the atrial tissue that occurs >160 bpm
• P wave embedded in T wave
Treatment:
-least invasive: vasovagal maneuver (bear down)
-next least invasive: Adenosine
-last: electricity – synchronized cardioversion
Atrial Fibrillation
• No discernible P waves
• Irregularly spaced out R waves
• Symptoms: heart palpitations, chest pain
(angina), shortness of breath, dizziness, syncope
• SA node dysfunction
• atria “quivering”
Treatment:
-CCB, BB, Digoxin, Coumadin/Heparin
-Unstable: synchronized cardioversion
-Surgery: ablation
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
UPDATE 2022
Module 5 – Rhythms
Measurements of Rhythms
PR Interval
represents the delay from the AV node to allow for ventricular filling
normal PR interval size is 0.12-0.20 seconds or
3.5-5 small squares (should fit in one big box)
QRS Complex
• depolarization of the ventricles, triggers main pumping action
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
• normal= 0.08 and 0.10 seconds (should fit in half of one big box)
• greater than 0.12 seconds is considered abnormal
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
(think ventricular tachycardia)
ST Segment
• represents the interval between ventricular depolarization and repolarization
• measures from the end of the QRS complex to the start of the T wave
• normal measurements are 0.005 to 0.150 seconds and SHOULD BE FLAT on the isoelectric line
• most common reason for elevated ST segment is a myocardial infarction
• most common reason for a depressed ST segment is ischemia
QTc (QT interval)
• represents the time of ventricular activity including both depolarization and repolarization
• the normal QT interval is 0.36 to 0.44 seconds (should fit in 2-2 ½ big boxes)
• it is measured from the beginning of the QRS complex to the end of the T wave
• the QT interval will vary with patient gender, age, and heart rate
• another guideline is that a normal QT interval is less than half of the R-
R interval for heart rates below 100bpm
T Wave
• represents ventricular repolarization (recovery)
• can be upright, inverted, notched, large or small
• many different reasons for T wave changes – some are medical, others are not
• important to verify patient’s history and medication use when validating T wave abnormality
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
,NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
Identification and Treatments for Atrial Arrhythmias
• Always consider nursing interventions: monitor patient, establish IV, give oxygen (if hypoxic)
Supraventricular Tachycardia
• rapid stimulation of the atrial tissue that occurs >160 bpm
• P wave embedded in T wave
Treatment:
-least invasive: vasovagal maneuver (bear down)
-next least invasive: Adenosine
-last: electricity – synchronized cardioversion
Atrial Fibrillation
• No discernible P waves
• Irregularly spaced out R waves
• Symptoms: heart palpitations, chest pain
(angina), shortness of breath, dizziness, syncope
• SA node dysfunction
• atria “quivering”
Treatment:
-CCB, BB, Digoxin, Coumadin/Heparin
-Unstable: synchronized cardioversion
-Surgery: ablation
NUR 2795 CONCEPT REVIEW FOR TEST3 LATEST
UPDATE 2022
