HGTC NUR 221 EKG Heart Conduction System HGTC NUR 221
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| artifact | EKG waveforms from sources outside the heart
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| Where is the SA Node located? | in the right atrium
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| The starting point for electrical impulses | SA Node (sinoatrial node)
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| The heart's main pacemaker | SA Node (sinoatrial node)
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| Where is the AV Node located? | in the front of the right atrium
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| The conduction pathway that leads out of the AV node | bundle of HIS
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| True or False: The bundle of His has pacemaker cells | FALSE
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| What is the rate that the bundle of His initiates electrical activity? | 40-60 times per minute
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| Time which impulse travels from the SA node to the atria and downward to the ventricles | PR Interval (PRI)
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| What is the normal PR interval? | 0.12-0.20 (3-4 boxes)
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| Hallmark of atrial flutter | sawtooth pattern
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| What lab value to you check with atrial flutter? | electrolytes
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| What are the hallmarks of sinus rhythm? | "P" present, round and upright
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| Junctional rhythm | rhythms that initiated in the area of the AV junction
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| Who has a shorter QT segment- men or women? | Men have a shorter QT segment
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| What does a long QT segment increase a patient's risk for? | death from arrhythmias
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| In which direction do you read strips? | Left to right
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| How are heart rhythms classified? | regular or irregular
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| The sinoatrial node is located in the____________? | right atrium
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| The AV node is located in the___________? | right atrium
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| The intrinsic firing rate of the SA node is__________ bpm | 60-100
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| The intrinsic firing rate of the AV junction is__________ bpm | 40-60
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| The electrogardiogram is used to: | evaluate electrical activity in the heart
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| The normal conduction pattern of the heart follows the sequence: | SA node, Internodal pathways, AV node, bundle of His, Bundle branches, Purkinje fibers
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| The intrinsic firing rate of the Purkinje network is________ bpm | 20-40
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| The SA node recieves its blood supply mainly from the : | SA artery
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| abnormal heart rhythms are: | dysrhythmias
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| The length of a wave or the distance between 2 waves is defined as an ____________________ | interval
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| Waves may detect__________(above the baseline), or____________(below the baseline) | positively, negatively
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| The first wave on an ECG is a ___wave, and reflects_____________ | P wave, atrial contraction
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| The pacemaker of the heart | SA node
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| The ECG waveform includes a_________, _____________, and___________. | baseline, waves, and intervals
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| atrial contraction is reflected by the______________, normally the 1st wave on an ECG | P wave
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| What indicates that SA node is healthy and the atria are contracting (depolarizing) normally? | A single P wave, usually positively deflected
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| The time it takes for the electrical activity to move through the AV node, the bundle of His, and the left and right bundle branches is reflected in the________________ | PR Interval (PRI)
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| The normal QRS interval is_____to______ seconds | 0.06-0.10
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| There is normally____QRS interval for each P wave | 1
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| A prolonged QRS interval would indicate a ______ or _______ in the path of the electrical impulse | block or delay
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| The T-wave reflects: | ventricular relaxation (repolarization)
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| total absense of electrical activity | asystole
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| The chief chemical transmitter for the sympathetic nervous system is | Norepinephrine
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| Unoxygenated blood travels from the inferior and superior cavae into the: | right atrium
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| One cardiac cycle occurs every _______ seconds | 0.8
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| With the exception of______, all the body's blood vessels have alpha-adrenergic receptors whereas the heart and lungs have beta-adrenergic receptors | capillaries
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| blood travels from the left atrium through the ________ valve into the left ventricle | Bicuspid
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| Blood travels from the right atrium through the_____________ valve and into the right ventricle | Tricuspid
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| Starling's law of the heart is also referred to as: | the rubber band theory
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| Starling's law of the heart is : | when the volume of blood in the ventricles is increased, stretching the ventricular myocardial fibers and consequently causing a more forceful contraction
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| Stroke volume is estimated at approx. ____________ ml per beat | 70
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| The _________ nervous system is responsible for preparation of the body for physical activity (fight or flight) | sympathetic
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| What regulates the calmer (rest and digest) functions of our existence? | the parasympathetic nervous system
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| The____________receives blood from the right atrium and pumps it to the pulmonary system | right ventricle
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| The________ receives oxygenated blood from the left atrium and pumps it to the body system | left ventricle
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| Refers to the volume of blood pumped out of one ventricle of the heart in a single beat or contraction and is estimated at 70 CC per beat | stroke volume
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| The amount of blood pumped by the left ventricle in 1 minute | Cardiac output
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| The______________ regulates functions of the body that are involuntary or not under conscious control | autonomic nervous system
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| What bodily functions are regulated by the autonomic nervous system? | Heart rate and blood pressure
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| Cardiac output (CO) is calculated by multiplying_________x__________ | stroke volume (SV) x heart rate (HR)
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| A CO of 5600cc per minute is how many liters per minute? | 5.6
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| Inadequate cardiac output may be indicated by what symptoms? | shortness of breath, dizziness, decreased blood pressure, chest pains, cool and clammy skin
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| The resistance against which the heart must pump is__________ | afterload
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| The pressure in the ventricles at the end of diastole is___________ | preload
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| Normal Adult CO (Cardiac Output) is_________ | 4-8 L/min
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| About what percentage of total CO flows passively from the atria to the ventricles? | 70%
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| The right ventricle pumps blood into the…… | Pulmonary Artery
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| How many impulses per minute are normally generated by the SA node? | 60-100
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| What does the P wave represent? | atrial depolarization
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| What is the normal duration of the QRS complex? | 0.06 to 0.10 seconds
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| What does the T wave represent? | ventricular repolarization
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| How long is a normal PR interval? | 0.12 to 0.20 seconds
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| Which part of the ECG varies with heart rate? | QT interval
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| What does each small box on the vertical axis of ECG paper represent? | 1mm
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| An inverted P wave most likely indicates that….. | the impulse originates in the AV junction.
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| Signs or symptoms of decreased CO due to SVT include…… | confusion
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| Which is the first I.V. drug used to treat most forms of stable narrow-complex SVT? | Adenosine
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| Diltiazem is classified as a(n)………………. | calcium channel blocker
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| Which intervention is appropriate for a patient in VF? | CPR
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| Which intervention is appropriate for VT in a hemodynamically stable patient? | I.V. amiodarone
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| The I.V. drug of choice for most patients with symptomatic bradycardia is…………… | atropine
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| Which statement is correct about AV dissociation? | P waves have no consistent relationship with QRS complexes.
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| When caring for a patient with a dysrhythmia, remember to always treat the ______________, not the_______________ | patient, monitor
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| When caring for a patient with a dysrhythmia, administer____________ as indicated, ensure patent______________, obtain______________, and notify the patient's healthcare provider. | supplemental oxygen, IV access, a 12-Lead ECG
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| Depolarization is a(n)__________________ event | electrical
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| Electrical impulses are generated by the exchange of which ions? | primarily potassium, sodium, chloride, and calcium
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| myocardial contraction or systole is a(n) | mechanical event
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| Diastole is the ____________ phase of the cardiac cycle | resting
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| The horizontal axis on ECG represents___________, and one small box equals___________, and a large one (representing 5 small boxes) equals________________ | time, 0.04, 0.20
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| The vertical axis on an ECG measures amplitude or ______________. Each small box represents __________, each large box represents______________ | voltage, 1mm, 5mm
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| Normal Sinus rhythm: | HR between 60-100 bpm with regular atrial and ventricular rhythms and P waves that are uniform, round and upright
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| The absence of P waves means ____________ has been lost | atrial kick
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| SVT: | regular rhythm that originates above the ventricles and has a rate greater than 150/bpm
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| What drug usually terminates SVT? | adenosine
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| How do you give adenosine? | by rapid IV push due to its short half-life
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| A fast, ugly, irregular rhythm is most likely to be_____________________ | uncontrolled atrial fibrillation (AF) not to be confused with Atrial Flutter!
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| Hallmarks of AF: | isn't always fast, just irregular with no identifiable P waves and a generally normal QRS complex
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| One concern with AF | Clots likely- often seen in patients on blood thinners
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| Rapid AF is often treated with_____________ to control the ventricular rate. | diltiazem
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| diltiazem is classified as a _______________ that causes peripheral vasodilation, so it can worsen the______________ that may be associated with AF | calcium channel blocker, hypotension - Monitor the patients BP closely!
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| Ventricular Tachycardia (VT) occurs when the____________ take over as the hearts pacemaker | ventricles
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| The most common cause of VT is………… | coronary artery disease
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| Causes of sinus bradycardia include: | increased vagal tone associated with myocardial infarction, adverse drug reactions, electrolyte inbalances, hypoxemia, hypoglycemia, hypothyroidism
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| For symptomatic bradycardia, the drug of choice is______________________ | IV atropine
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