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MA 104
Chapters 4-6
| Question | Answer |
|---|---|
| what is meant by the term "controlled atrial fibrillation"? | the overall ventricular rate is less than 100 bpm |
| the most common type of SVT is | av nodal reentrant tachycardia (AVNRT) |
| atrial fibrillation is characterized by | an erratic wavy baseline and irregular ventricular rhythm |
| how are frequent PAC's usually managed | correcting the underlying cause |
| a wandering atrial pacemaker rhythm with a ventricular rate of 60-100 bpm may also be referred to as ____ | multiform atrial rhythm |
| to determine whether the ventricular rhythm on an ekg is regular or irregular, compare what intervals? | R to R |
| a beat originating from the AV junction that appears later than the next expected sinus beat is called a _____ | junctional escape beat |
| which medication increases heart rate by accelerating the SA node discharge rate and blocking the vagus nerve? | atropine |
| in a junctional rhythm viewed in lead II, where is the location of the P wave on the ekg if atrial and ventricular depolarization occur simultaneously? | during the QRS complex |
| a junctional escape rhythm occurs because | of the slowing of the rate of the hearts primary pacemaker |
| in a junctional rhythm viewed in lead II, where is the location of the P wave on the ekg if atrial depolarization precedes ventricular depolarization | before the QRS complex |
| the usual rate of nonparoxysmal junctional tachycardia is how many bpm? | 101-140 bpm |
| the AV junction consists of | av node and non branching portion of the bundle of His |
| if seen, the P wave of a rhythm originating in the AV junction will appear how in lead II | inverted |
| depending on the severity of the patient's signs and symptoms, management of slow rhythms originating from the AV junction may require intervention including what | intravenous atropine |
| idioventricular rhythm is described as having what characteristics | essentially regular ventricular rhythm with QRS complexes measuring 0.12s or greater; atrial rate not discernable; ventricular rate 20-40 bpm |
| what is meant by the term "pulsless electrical activity"? | unorganized rhytym on the cardiac monitor (other than PT), although a pulse is not present |
| how would you differentiate a junctional escape rhythm at 40 bpm from a ventricular escape rhythm at the same rate? | junctional escape rhythm will have a narrow QRS complex; the ventricular escape rhythm will have a wide QRS complex |
| accelerated idioventricular rhythm is describes as having what characteristics | essentially regular ventricular rhythm with QRS complexes measuring 0.12s or greater; atrial rate not discernable; ventricular 41-100 bpm |
| the rate of an idioventricular rhythm is | 20-40 |
| delivery of an electrical current timed for delivery during the QRS complex is called | syncronized cardioversion |
| sometimes when a premature atrial complex (PAC) occurs very prematurely and close to the T wave of the preceding beat, only a P wave may not be seen with no QRS after it (appearing as a pulse). This type of PAC is called | non-conduced / blocked PAC |
| an accessory pathway that has 1 end attached to normal conductive tissue is called a | bypass tract |
| PACS associated with a wide QRS complex are called _____ _____ PAC's, indicating that conduction through the ventricles is abnormal | abherrently conducted |
| a pause often following a PJC and representing the delay during which the SA node resets its rhythm for the next beat is called a | noncompensatory pause |
| if the AV junction paces the heart, the electrical impulse must travel in a backward direction to activate the atria. this is called | retrograde conduction |
| a beat originating from the AV junction that appears later than the next expected sinus beat is called a | junctional escape beat |
| individuals with preexcitation syndrome are predisposed to | tachydysrhythmias |
| in atrial fibrillation the AV nodes attempt to protect the ventricles from the hundreds of impulses bombarding it per minute by blocking many of the impulses generated by the irritable site of the atria | blocking many of the impulses generated by the irritable site of the atria |
| upon conversion of atrial fibrillation to sinus rhythm the patient should be observed for | signs of possible stroke |
| the presence of an accessory pathway should be considered in atrial fibrillation w a ventricular rate faster than | 180 bpm |
| in atrial fibrillation, fibrillatory waves are referred to as | f waves |
| the ventricular rhythm is atrial fibrillation is usually | irregulary irregular |
| the AV junction consists of the AV nodes and then non-branching portion of the | bundle of His |
| an escape rhythm is initiated by | lower pace maker site when the SA node slows or fails to initiate an impulse |
| the pacemaker cells in the AV junction are located | near the non-branching portion of the bundle of His |
| the term premature ventricular complex (PVC) is technically more correct than | premature ventricular contraction |
| medications to suppress an ventricular rhythm should be generally | avoided |
| sustained monomorphic VT is often associated with | underlying heart disease, particularly myocardial ischemia, and rarely occurs in patients without underlying structural heart dz |
| patients with type II atrial flutter often develope | atrail fibrillation |
| the delivery of an electrical current across the heart muscle over a very brief period to terminate an abnormal heart rhythm is called | defibrillation |
| a multifocal atrial tachycardia is characterized by | wandering pacemaker rhythm with a ventricular rate of more than 100 bpm |
| if the reentry circuit involves conduction through a large area of the heart, such as the entire right of left atrium it is called a | macroreentry circuit |
| a reentry circuit within a small area is called | microreentry circuit |
| the drug of choice when treating symptomatic patient with a junctional rhythm at a rate of 40 bpm is | atropine |
| pulsless v tach and ventricular complexes are treated with | cardiopulmonary resuscitation and defibrillation |
| when 3 or more ventricular escape beats occur in a row at a rate of 20-40 bpm the rhythm is said to be | idioventricular rhythm (IVR) aka ventricular escape rhythm |
| an extra bundle of working myocardial tissue that forms a connection between the atria and the ventricles outside the normal conduction system | accessory pathway |
| a disorder of impulse formation in which cardiac cells fire and initiate impulses before a normal SA node impulse | altered automaticity |
| blood pushed into the ventricles because of atrial contraction | atrial kick |
| dysrhythmia in which every other beat is a premature ectopic beat | bigeminy |
| PAC not followed by a QRS complex | blocked premature atrial complex |
| blowing or swishing sound | bruit |
| 3 or more sequential ectopic beats; also referred to as a salvo or run | burst |
| term used when one end of an accessory pathway is attached to normal conductive tissue | bypass tract |
| type of vagal maneuver in which pressure is applied to the carotid sinus for a brief period to slow conduction through the AV node | carotid sinus pressure |
| a pause for which the normal beat after a premature complex occurs when expected; also a complete pause | compensatory pause |
| 2 consecutive premature complexes | couplet |
| slurring of the beginning portion of the QRS complex, caused by pre-excitation | delta wave |
| irregularly shaped atrial waves associated with atrial fibrillation; occuring at a rate of 400-600 bpm | f waves (fibrillation waves) |
| atrial waves associated with atrial flutter; usually shaped like the teeth of a saw or a picket fence | F waves (flutter waves) |
| a pause that often follows a premature atrial complex that represents the delay during which the SA node resets its rhythm for the next beat | noncompensatory pause |
| an unpleasant awareness of one's heartbeat | palpitations |
| an early beat occurring before the next expected beat; can be atrial, junctional, or ventricular | premature complex |
| dysrhythmia in which every 4th beat is a premature ectopic beat | quadrigeminy |
| originating from a site above the bifurcation of the bundle of His, such as the SA node, atria, or AV junction | supraventricular |
| dysrhythmia in which every third beat is a premature ectopic beat | trigeminy |
| methods used to stimulate the vagus nerve in an attempt to slow conduction throughout the AV node, resulting in slowing of the heart rate | vagal maneuver |
| cardiac dysrhythmia that occurs becuase of impulses originating from various sites, including the SA node, the atria, and/or the AV junction; requires at least 3 different P waves seen in the same lead for proper diagnosis | wandering atrial pacemaker |
| type of preexcitation syndrome, characterized by a slurred upstroke of the QRS complex (delta wave) and a wide QRS | Wolff-Parkinson-White Syndrome (WPW) |
| dysrhythmia originating in the AV bundle with a rate between 61-100 bpm | accelerated junctional rhythm |
| a rhythm that begins in the AV bundle with a rate of less than 40bpm | junctional bradycardia |
| a rhythm that begins in the AV bundle; characterized by a very regular ventricular rate of 40-60 bpm | junctional escape rhythm |
| a rhythm that begins in the AV bundle with a ventricular rate of more than 100bpm | junctional tachycardia |
| moving backward, moving in the opposite direction to that which is considered normal | retrograde |
| dysrhythmias originating in the ventricles with a rate between 41-100 bpm | AIVR (accelerated idioventricular rhythm) |
| dysrhythmia similar in apperance to an IVR but occuring at a rate of less than 20bpm; dying heart | agonal rhythm |
| a total absence of ventricular electrical activity | asystole |
| delivery of an electrical current across the heart muscle over a very brief period to terminate an abnormal heart rhythm; aka unsynchronized or asynchronized counter shock bc the delivery of current has not relationship to the cardiac cycle | defibrillation |
| type of polymorphic VT associated with a prolonged QT interval; the QRS changes in shape, amplitude, and width and appears to "twist" around the isoelectric line, resembling a spindle | Torsades de pointes (TdP) |
| dysrhythmia originating in the ventricles with a ventricular respomse greater than 100bpm | ventricular tachycardia |
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