NURS 3730 EXAM 3 ACTUAL QUESTIONS AND VERIFIED
COMPLETE ANSWERS GRADED A++
Normal K+ level
3.5-5.0
Effects of hyperkalemia on an EKG
- P-waves are widened & of low amplitude due to slowing of conduction
- QRS complex (widens, fusion of QRS-T, loss of ST segment)
- Tall tented T waves
Hyperkalemia EKG
Effects of hypokalemia on an EKG
- ST depression & flattening of the T wave
- Negative T waves
- A U-wave may be visible
Hypokalemia EKG
Normal calcium level
8.4-10.5
Effects of hypercalcemia on an EKG
- Shortened QRS
- Low R wave
- Disappearance of P waves
- Tall, peaking T waves
Effects of hypocalcemia on an EKG
,- Prolongation of the QT-interval
- T wave flattening & inversion
- Prolonged ST & ST-depression
Premature Atrial Complex
- NOT sinus rhythm because this rhythm is not initiated by the SA node
- Another cell generates an electrical impulse & it traveled a similar pathway because
the QRS complexes look the same, so the rhythm happened normally when it got to the
AV node
- Patient will complain of irregular heart beat
Causes of premature atrial complex
- Caffeine
- Stress
- Fatigue
Treatment for premature atrial complex
- Reduce modifiable risk factors & follow-up
Atrial flutter
- Sawtooth appearance
- 3 P-waves to 1 QRS
- The atria depolarizes (contracts) 3 times for every 1 time the ventricles depolarize
(contract)
Causes of atrial flutter
- Coronary artery disease
- HF
,- Problem with conduction from the SA node to the AV node (AV node says they are
going to respond regularly bc if the AV node response to every SA impulse, the HR
would be insane; so the AV node says "I'm only responding to every 3 impulses")
- Valvular disorder
- Some type of damage or irritation to the atria
Risks assoc. with atrial flutter
- A-fibb because the atria are working too hard
Do we need to report atrial flutter?
DUH
Treatment for atrial flutter
- Beta-blockers/calcium-channel blockers
- Meds may not fix this, so if they don't, the reason is ectopic focus
- With ectopic focus, they ablate the cells to prevent them from continuing to mess up
the rhythm
- Cardioversion (electricity vs. chemical-meds)
- Defribillation
Defribillation is only used when...
there is NO T-wave
Why is defribillation only used when there is no T-wave?
It shocks the patient as soon as you hit the button, unlike an AED where it monitors the
rhythm, then shocks in accordance to the T-wave
Atrial Fibrillation
, - JIGGILATION
- P-jiggle (NO P-WAVE)
- Blood collects in the atria
- The AV node doesn't even know what to do, so the ventricular response is irregular
because it's saying, "what are you doing up there SA node?"
- Worse than atrial flutter
What a HUGE risk of atrial fibrillation?
- If the blood in the atria are not moving down to the ventricles, it collects in the atria,
then it can clot
What are some causes of atrial fibrillation?
- HF
- HTN
- Coronary artery disease
- Valvular disease
Treatment for atrial fibrillation
- Fix the underlying cause, but patient can go home on this because the blood still goes
to the ventricles, so we do still have CO
- They will be on anticoagulants ALL THE TIME
Management of acute atrial dysrhythmias
- Medications like Cardizem (Diltiazem), which is a CCB & Cordarone (Amiodarone),
which is an antidysrhythmic
- Cardioversion (electrically in sync mode)
Management of chronic atrial dysrhythmias
COMPLETE ANSWERS GRADED A++
Normal K+ level
3.5-5.0
Effects of hyperkalemia on an EKG
- P-waves are widened & of low amplitude due to slowing of conduction
- QRS complex (widens, fusion of QRS-T, loss of ST segment)
- Tall tented T waves
Hyperkalemia EKG
Effects of hypokalemia on an EKG
- ST depression & flattening of the T wave
- Negative T waves
- A U-wave may be visible
Hypokalemia EKG
Normal calcium level
8.4-10.5
Effects of hypercalcemia on an EKG
- Shortened QRS
- Low R wave
- Disappearance of P waves
- Tall, peaking T waves
Effects of hypocalcemia on an EKG
,- Prolongation of the QT-interval
- T wave flattening & inversion
- Prolonged ST & ST-depression
Premature Atrial Complex
- NOT sinus rhythm because this rhythm is not initiated by the SA node
- Another cell generates an electrical impulse & it traveled a similar pathway because
the QRS complexes look the same, so the rhythm happened normally when it got to the
AV node
- Patient will complain of irregular heart beat
Causes of premature atrial complex
- Caffeine
- Stress
- Fatigue
Treatment for premature atrial complex
- Reduce modifiable risk factors & follow-up
Atrial flutter
- Sawtooth appearance
- 3 P-waves to 1 QRS
- The atria depolarizes (contracts) 3 times for every 1 time the ventricles depolarize
(contract)
Causes of atrial flutter
- Coronary artery disease
- HF
,- Problem with conduction from the SA node to the AV node (AV node says they are
going to respond regularly bc if the AV node response to every SA impulse, the HR
would be insane; so the AV node says "I'm only responding to every 3 impulses")
- Valvular disorder
- Some type of damage or irritation to the atria
Risks assoc. with atrial flutter
- A-fibb because the atria are working too hard
Do we need to report atrial flutter?
DUH
Treatment for atrial flutter
- Beta-blockers/calcium-channel blockers
- Meds may not fix this, so if they don't, the reason is ectopic focus
- With ectopic focus, they ablate the cells to prevent them from continuing to mess up
the rhythm
- Cardioversion (electricity vs. chemical-meds)
- Defribillation
Defribillation is only used when...
there is NO T-wave
Why is defribillation only used when there is no T-wave?
It shocks the patient as soon as you hit the button, unlike an AED where it monitors the
rhythm, then shocks in accordance to the T-wave
Atrial Fibrillation
, - JIGGILATION
- P-jiggle (NO P-WAVE)
- Blood collects in the atria
- The AV node doesn't even know what to do, so the ventricular response is irregular
because it's saying, "what are you doing up there SA node?"
- Worse than atrial flutter
What a HUGE risk of atrial fibrillation?
- If the blood in the atria are not moving down to the ventricles, it collects in the atria,
then it can clot
What are some causes of atrial fibrillation?
- HF
- HTN
- Coronary artery disease
- Valvular disease
Treatment for atrial fibrillation
- Fix the underlying cause, but patient can go home on this because the blood still goes
to the ventricles, so we do still have CO
- They will be on anticoagulants ALL THE TIME
Management of acute atrial dysrhythmias
- Medications like Cardizem (Diltiazem), which is a CCB & Cordarone (Amiodarone),
which is an antidysrhythmic
- Cardioversion (electrically in sync mode)
Management of chronic atrial dysrhythmias
