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chapter 7&8
| Question | Answer |
|---|---|
| What medical conditions place pressure on the atria, causing atrial dysrhythmias to occur? | Myocardial infarction, valvular problems, neurological influences |
| What kind of impulse causes atrial dysrhythmias? | Ectopic |
| In a premature atrial complex (PAC), the P wave may be biphasic. This means that: | the waveform has both positive and negative deflections on the ECG tracing. |
| A pattern in which every third complex is a premature beat is referred to as | trigeminy |
| Which atrial dysrhythmia has a cardiac complex that occurs too soon and may have abnormal P waves, but other than being ''early,'' has no other abnormal features? | Premature atrial complexes (PAC) |
| A cardiac cell or group of cells that produces an ectopic beat is known as a | focus |
| How many different P wave configurations in the same lead indicate a wandering atrial pacemaker (WAP)? | Three |
| WAP is a normal finding in children, older adults, and well-conditioned athletes. It may also be found in patients with | organic heart disease and drug toxicity. |
| Multifocal atrial tachycardia (MAT) is sometimes confused with which of the following dysrhythmias? | Wandering atrial pacemaker (WAP) |
| What is the rate of wandering atrial pacemaker rhythm (WAP) | 60 to 100 beats per minute |
| Which statement correctly describes the P wave in multifocal atrial tachycardia | It changes from beat to beat. |
| What is the rate of multifocal atrial tachycardia (MAT)? | 101 to 150 beats per minute |
| Multifocal atrial tachycardia (MAT) is usually triggered by congestive heart failure (CHF), acute mitral valve regurgitation, or an acute attack of: | emphysema. |
| Which atrial dysrhythmia has capital F waves and a classic sawtooth or picket fence appearance? | Atrial flutter |
| What is the atrial rate in atrial flutter? | 250 to 350 beats per minute |
| What term describes the ability of the heart to initiate an electrical impulse without being stimulated by another or independent source? | Automaticity |
| What occurs immediately prior to ventricular systole when blood is ejected from the atria into the ventricles? | Atrial kick |
| The loss of atrial kick contributes to what percent decrease in cardiac output? | 10% to 30% |
| Which rhythm occurs when the atria quiver like a bowl of Jell-O? | Atrial fibrillation |
| What atrial dysrhythmia has lowercase "f" waves, chaotic atrial electrical activity, and irregular R-R intervals? | Atrial fibrillation |
| What is the major health risk for patients with atrial fibrillation | Thrombus formation or embolism |
| What treatment is usually attempted for patients with atrial fibrillation | Medication and/or electrical cardioversion |
| A traveling blood clot in the lungs is known as | pulmonary embolism. |
| A stroke caused by a hemorrhage in the brain, or more often by a clot lodged in a cerebral artery, is known as a | cerebrovascular accident (CVA). |
| Which of these health issues is not a possible complication of having a thrombus form in the atria as a result of atrial fibrillation? | Congestive heart failure |
| Patients with new onset of atrial fibrillation often complain of | dizziness and nausea. |
| What treatment is usually indicated for patients with atrial flutter | Oxygen therapy |
| How would frequent premature atrial complexes (PACs) affect a patient with coronary artery disease? | Low cardiac output |
| What symptom might a patient with frequent PACs complain of | Palpitations |
| Which atrial dysrhythmia results from a reentry pathway that is similar to finding a shortcut to work or school, bypassing the normal traffic route to get to the destination faster? | Atrial flutter |
| Which of the following terms describes electrical impulses that originate in the atria and initiate an early impulse that interrupts the inherent regular rhythm? | Premature atrial complexes (PACs) |
| Which atrial dysrhythmia has a changing P wave configuration with at least three variations in one lead and may also have an irregular rhythm? | Wandering atrial pacemaker (WAP) |
| Which atrial dysrhythmia has a clearly changing P wave and a heart rate of 101 to 150 beats per minute? | Multifocal atrial tachycardia (MAT) |
| Which rhythm is often a transient dysrhythmia that will lead to a more serious atrial dysrhythmia if not treated? | Atrial flutter |
| Which atrial dysrhythmia occurs when electrical impulses come from areas of reentry pathways or multiple ectopic foci | Atrial fibrillation |
| Patients who have atrial fibrillation may have a loss of stroke volume of between | 20% and 30%. |
| Which atrial dysrhythmia shows chaotic, disorganized activity between normal, but irregular, QRS complexes? | Atrial fibrillation |
| In which of the atrial dysrhythmias is the atrial rate impossible to determine? | Atrial fibrillation |
| Some patients can tolerate the loss of atrial kick if the heart rate remains between | 60 and 100 beats per minute. |
| In which atrial dysrhythmia does the pacemaker site shift between the SA node, other sites in the atria, and/or the AV junction? | Wandering atrial pacemaker |
| When labeling an ECG tracing that shows PACs, what additional information should you document on the tracing? | The underlying rhythm and the type of PACs |
| If ectopic impulses are occurring in the heart at a rate that is faster than the SA node, | the ectopic beat overrides the SA node and causes the atria and ventricles to depolarize. |
| Which portion of the ECG tracing is primarily affected by atrial dysrhythmias | P waves |
| What causes the different P wave morphologies in an ECG tracing that shows wandering atrial pacemaker | The varying sites of the ectopic impulses |
| Which of the following statements describes the PR interval in a wandering atrial pacemaker rhythm | It varies with the site of the atrial pacemaker. |
| You have performed an ECG on a 68yrd and you quickly identify the rhythm as atrial fibrillation. The patient's heart rate is 192 and he appears pale and unresponsive. the first treatment goal for this patient is to: | slow the heart rate. |
| You are about to perform an ECG on a patient who has been hospitalized for acute congestive heart failure. Which of the following atrial dysrhythmias is this patient most likely to develop? | Multifocal atrial tachycardia |
| You are asked to perform an ECG on a 7-year-old child. The child is active and appears to be in good health. When you check the ECG tracing, you notice that it shows a wandering atrial pacemaker rhythm. What should you do | Follow your facility's usual procedure for ECG reporting. |
| What is the normal, inherent rate of the AV node | 40 to 60 bpm |
| Junctional rhythms occur because the electrical impulse comes from the AV junction instead of the | SA node |
| In junctional rhythms, where does the electrical current initiate | AV junction |
| What causes the inverted P wave morphology found with junctional rhythms | Electrical impulses are coming from the AV node, causing atrial depolarization to flow retrogradely. |
| What does the term "retrograde" mean | Backward |
| What are the distinguishing characteristics of PJCs? | They cause the underlying rhythm to be irregular; the P wave is inverted and may appear before, during, or after the QRS complex. |
| What symptoms will a patient have if PJCs occur more than four to six times per minute | Hypotension, irregular pulse |
| Which of the following is a single early electrical impulse that originates in the AV junction, occurring before the next expected sinus impulse and causing an irregularity in the rhythm? | PJC |
| What type of rhythm occurs when the SA node fails to initiate the electrical activity and one of the backup pacemaker sites takes over | Junctional escape rhythm |
| What is the ventricular heart rate for junctional escape rhythm? | 40 to 60 bpm |
| What are the distinguishing characteristics of junctional escape rhythm? | The rhythm is regular; the P wave may occur before, during, or after the QRS; and the P wave is inverted. |
| What symptoms might occur in a patient with junctional escape rhythm? | Hypotension, confusion, and disorientation |
| What is the ventricular heart rate range for accelerated junctional rhythm | 60 to 100 bpm |
| What is the difference between accelerated junctional rhythm and junctional escape rhythm? | Heart rate |
| Why is it unlikely that a patient would have symptoms of low cardiac output with accelerated junctional rhythm? | The heart rate is the same as normal sinus rhythm. |
| What is the ventricular heart rate with junctional tachycardia? | 100 to 180 bpm |
| What is the difference between accelerated junctional rhythm and junctional tachycardia? | Heart rate |
| The effect of junctional tachycardia on the patient depends on | The rate of the rhythm |
| What is the term for a fast, "fluttering" heartbeat sensation felt by a patient? | Palpitation |
| When is junctional tachycardia considered to be serious or life threatening | After a recent myocardial infarction |
| Which of the following is one criterion for classifying a dysrhythmia as an SVT? | Heart rate between 150 and 250 bpm |
| Which of the following dysrhythmias is not considered part of the SVT classification? | Ventricular tachycardia |
| What symptom might a stable patient complain about when experiencing SVT? | Palpitations |
| What is the origination point of an SVT? | Atria or junctional region |
| What might you be asked to do when a patient has a supraventricular dysrhythmia? | Increase the paper speed so the tracing can be analyzed more accurately |
| In terms of treating the patient, when a patient has a supraventricular tachycardia, when should the specific type of dysrhythmia be identified? | When the patient first complains of any signs or symptoms |
| What is the term for an ectopic focus originating above the ventricles in the atria or junctional region? | Supraventricular |
| What is the term for a condition in which a patient's blood pressure is not adequate to maintain good blood supply to the vital organs? | Hypotension |
| The PR interval can be measured only if the P wave occurs ________blank the QRS complex. | Before |
| Which dysrhythmia does not have a consistent PR interval that measures less than 0.12 seconds? | Supraventricular tachycardia |
| Which of the following originates from the AV junction? | Junctional escape rhythm |
| According to your patient's chart, she has junctional tachycardia and her normal resting heart rate is 86 bpm. Your ECG tracing shows a current resting heart rate of 148 bpm. What should you look for in this patient? | Signs and symptoms of low cardiac output |
| Which of the following treatments may be needed to terminate junctional tachycardia? | Medication |
| Wolff-Parkinson-White syndrome is an example of which type of dysrhythmia | Reentry dysrhythmia |
| What is the primary difficulty in classifying an SVT? | Determining the origin of the tachycardia |
| Which of the following statements is true of all junctional dysrhythmias? | The QRS measurement is within normal limits. |
| What type of heart rate is characteristic of a patient who has junctional escape rhythm | Slower than normal |
| A patient has an accelerated junctional rhythm. When you record the ECG, the tracing shows that the P waves follow the QRS complexes and that the distance from each P wave to the next R wave is 0.6 seconds. What is the PR interval? | The interval cannot be determined. |
| What is the collective term for the AV node and the surrounding tissue, including the bundle of His? | AV junction |
| If the electrical impulse is initiated at the midpoint of the AV junction, where would you expect the P waves to appear on the ECG tracing? | Within the QRS complex |
| Reentry dysrhythmias occur as a result of which of the following situations? | A blockage or short circuit in the normal electrical conduction pathway |
| How does the preexcitation of the ventricles in reentry dysrhythmias appear on an ECG tracing | Delta wave |
| What type of rhythm would be present if abnormal impulses are ignored | Underlying rhythm |
| Which of the following is the best definition of reentry dysrhythmias? | Blockage or short circuit of the normal electrical conduction pathway |
Created by:
Jamiyrah08