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42 terms

EKG Basic Rythem Interpretation

Chapter 8
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Sinus Bradycardia occurs when the HR is
Less than 60
Sinus Tachycardia occurs when the HR is
100 - 180
Normal Sinus Rhythm (NSR) rate is
60 - 100
Sinus Arrythmia is NSR that occurs when
The HR varies with RESPIRATION
Sinus Tachycardia is Normal NSR that occurs when
The patient is ANXIOUS, IN PAIN OR HAS A FEVER
Sinus Bradycardia is Normal NSR that occurs in
ATHLETES OR WHEN THE PATIENT IS ASLEEP
In NSR the PR interval usually measures
.12 to .20 seconds or 3 to 5 small squares
In NSR the QRS interval usually measures
.4 to .10 seconds or about 1 to 2.5 small squares
In NSR every P wave is followed by a
QRS
Twelve small squares equals
.48 seconds
Five large squares equals
25 seconds
To determine the HR, measure the
R to R interval and DIVIDE the number of squares by 1500
If there are 20 small squares between QRS complexes, the HR is
75 bpm (1500/20)
If there are 30 small squares between QRS complexes, the HR is
50 bpm (1500/30)
Ten small squares equal
2 large squares
Large Squares equal one minute
300
If there are four large squares between QRS complexes, the HR is
75 bpm (300/4)
If there are two large squares between QRS complexes, the HR is
150 bpm (300/2)
If there are five large squares between QRS complexes, the HR is
60 bpm (300/5)
The hash marks above the grid at the top of the EKG paper occur every
3 seconds
PR Interval current goes through the
Atrium
QRS interval current goes through the
Ventricals
Time is represented by
Horizontal lines
Voltage is represented by
Vertical axis
The taller the waveform, the
MORE voltage is represents
How many seconds are needed to get a good interpretation
6 seconds or 2 hash marks
How many LARGE Boxes equal ONE minute
300
How many SMALL boxes equal ONE minute
1500
Flat Line
Asystole - Baseline or isoelectric line
Steps in determining the Systematic Rhythm Analysis
1. Determine HR; 2. Determine Regular intervals; 3. Measure duration of P wave and the QRS complex
Determine Heart Rate by
Counting R waves during a 6 second period and then multiply by 10 to get bpm
A more accurate way to determine the HR
Count LARGE squares between each beat and then memorize what HR is associated with each interval.
Mathematical Method to determine the HR
Count number of SMALL squares between two beats, or QRS complexes then divide that number by 1500 to get the bpm
Determine if Rhythm is Regular or Irregular by
Use a blank piece of paper and mark the R to R intervals for the first 3 R waves. Move the paper down one cycle. If the marks fall on R waves, the rhythm is regular
Marching Out
Using a piece of paper to determine regular heart rhythm
Calipers
A metal tool used to assist in the accurate measurement of waveforms. Can be locked.
ST Elevation (STEM)
Myocardial Infarction (heart attack)
ST Depression (STDIP)
Ischemia
Heart Block
A disturbance in the conduction system of the heart. May have several large positive or negative spikes that make up one QRS complex
Sinus Bradycardia
A heart rhythm that originates in the SA Node. The rhythm is regular and all waveforms have normal shape and duration, BUT the heart rate is LESS THAN 60 bpm
Sinus Tachycardia
A heart rhythm that original in the SA node. The rhythm is regular and all waveforms have normal shape and duration, BUT the heart rate is MORE THAN 100 bpm
Sinus Arrhythmia
Variation of NSR in which the rhythm is initiated from the sinus node and meets all criteria for NSR EXCEPT that it is IRREGULAR. The rhythm varies with RESPIRATION, speeding up with INSPIRATION and SLOWING WITH EXPIRATION.