Cardiac - Rhythm Strips Questions and
Answers
Normal Sinus Rhythm
•Predisposing Factors:
-NORMAL
-Regular impulses at a normal rate.
•ECG Appearance:
-P wave, QRS wave, T wave
-60-100 bpm
-Equal distances bwt each beat
-PRI: 0.12-0.20 sec.
-QRS: < 0.12 sec
•Hemodynamic Effects & Nursing Implications:
-Normal
•Treatment:
-Normal
Normal Sinus Rhythm EKG
Sinus Arrhythmia
•Predisposing Factors:
-Normal
-Varies with breathing
•ECG Appearance:
-NSR but irregular
•Hemodynamic Effects & Nursing Implications:
-Normal
•Treatment:
-Normal
Sinus Arrhythmia EKG
Sinus Bradycardia
•*Sinus= arrhythmia originates in SA (sinus) node*
•Predisposing Factors:
-Meds: Beta blocker, Digoxin, Narcotics
-Athletes that have low base HR
-Sleep
-Valsava Maneuver-straining with BM
, -Carotid Massage
-Hypothyroid
-Hypothermia
•ECG Appearance:
-Same as NSR except 40-60 bpm
•Hemodynamic Effects & Nursing Implications:
-Sinus Brady is ok it pt. is asymptomatic
•Symptomatic Sinus Brady can cause:
-Hypotension
-Diaphoresis
-Chest Pain
-SOB
-Change in mental status
•Treatment:
1. Why brady? May be normal for pt. If not, assess pt. treat underlying cause first.
- Ex. If cold=warm pt., constipated=stool softener,
decr. thyroid=synthroid.
2. O2
3. Pacer
4. Epi or dopamine gtts
5. Atropine- help inc. HR
Sinus Bradycardia EKG
Sinus Tachycardia
•*Sinus= arrhythmia originates in SA (sinus) node*
•Predisposing Factors:
-Running, exercise, hypovolemia (dehydration), pain, anxiety, fever, infection
-CHF (heart thinks its not getting enough O2 out, ↑ HR), hyperthyroid
•ECG Appearance:
-Same as NSR except >100 bpm
•Hemodynamic Effects & Nursing Implications:
-Depends on pts. tolerance of Inc. HR.
-May experience dizziness, hypotension, or increased need for O2
•Treatment:
1. Why Tachy? If normal for pt. then no treatment. What is underlying cause- assess
and treat.
-Ex. Limit Stimulants, Give O2, HF-Give Lasix, If r/t fever-treat fever, Dr. can do carotid
massage. Vagal manuevers.
2. Meds to Dec. HR: Ca channel and Beta blockers
Sinus Tachycardia EKG
Answers
Normal Sinus Rhythm
•Predisposing Factors:
-NORMAL
-Regular impulses at a normal rate.
•ECG Appearance:
-P wave, QRS wave, T wave
-60-100 bpm
-Equal distances bwt each beat
-PRI: 0.12-0.20 sec.
-QRS: < 0.12 sec
•Hemodynamic Effects & Nursing Implications:
-Normal
•Treatment:
-Normal
Normal Sinus Rhythm EKG
Sinus Arrhythmia
•Predisposing Factors:
-Normal
-Varies with breathing
•ECG Appearance:
-NSR but irregular
•Hemodynamic Effects & Nursing Implications:
-Normal
•Treatment:
-Normal
Sinus Arrhythmia EKG
Sinus Bradycardia
•*Sinus= arrhythmia originates in SA (sinus) node*
•Predisposing Factors:
-Meds: Beta blocker, Digoxin, Narcotics
-Athletes that have low base HR
-Sleep
-Valsava Maneuver-straining with BM
, -Carotid Massage
-Hypothyroid
-Hypothermia
•ECG Appearance:
-Same as NSR except 40-60 bpm
•Hemodynamic Effects & Nursing Implications:
-Sinus Brady is ok it pt. is asymptomatic
•Symptomatic Sinus Brady can cause:
-Hypotension
-Diaphoresis
-Chest Pain
-SOB
-Change in mental status
•Treatment:
1. Why brady? May be normal for pt. If not, assess pt. treat underlying cause first.
- Ex. If cold=warm pt., constipated=stool softener,
decr. thyroid=synthroid.
2. O2
3. Pacer
4. Epi or dopamine gtts
5. Atropine- help inc. HR
Sinus Bradycardia EKG
Sinus Tachycardia
•*Sinus= arrhythmia originates in SA (sinus) node*
•Predisposing Factors:
-Running, exercise, hypovolemia (dehydration), pain, anxiety, fever, infection
-CHF (heart thinks its not getting enough O2 out, ↑ HR), hyperthyroid
•ECG Appearance:
-Same as NSR except >100 bpm
•Hemodynamic Effects & Nursing Implications:
-Depends on pts. tolerance of Inc. HR.
-May experience dizziness, hypotension, or increased need for O2
•Treatment:
1. Why Tachy? If normal for pt. then no treatment. What is underlying cause- assess
and treat.
-Ex. Limit Stimulants, Give O2, HF-Give Lasix, If r/t fever-treat fever, Dr. can do carotid
massage. Vagal manuevers.
2. Meds to Dec. HR: Ca channel and Beta blockers
Sinus Tachycardia EKG
