Week 3

Question 1

What is Step 1

Answer 1

Determine rhythm

Question 2

What can rhythm be?

Answer 2

1. regular (R-R intervals within 0.04 seconds)
2. regularly irregular (a pattern exists)
3. irregularly irregular (no pattern, chaotic)

Question 3

How do you determine rhythm?

Answer 3

Use piece of paper with lines

Question 4

What should be considered if rhythm is regularly irregular?

Answer 4

Respiratory Sinus Arrythmia

Question 5

Explain Respiratory Sinus Arrythmia

Answer 5

Changes in venous return and vagal tone: during inspiratory venous return increases causing vagal tone to decrease (increases HR). During expiration a reduction in venous return increases vagal tone (reduces HR).

Question 6

By how much does RSA change P-P interval

Answer 6

10%

Question 7

Step 2

Answer 7

Determine the rate

Question 8

How many large squares are in 1 minute?

Answer 8

300

Question 9

What speed does the ECG paper move at?

Answer 9

25 mm/s

Question 10

How do you calculate HR in a regular rhythm?

Answer 10

300/no. of large squares in R-R interval

Question 11

How do you calculate HR in a irregular rhythm?

Answer 11

count no. of QRS complex in 30 large squares then x 10

Question 12

Step 3

Answer 12

Evaluate the P wave

1. Are P-waves present?
2. Do they all have normal configurations?
3. Are they all similar shape and size?
4. Is there one P-wave for every QRS?

Question 13

Step 4

Answer 13

Determine duration of PR interval

1. is it between 0.12 - 0.2 seconds
2. is the PR interval constant?

Question 14

Step 5

Answer 14

Determine height and duration of QRS?

1. is the duration normal? 0.05 - 0.1 seconds
2. does a QRS complex appear after every P wave
3. Are all QRS complexes the same size and shape?
4. Are the QRS R/S waves too deep/high? 25 mm individually or 35 mm combined?

Question 15

Step 6

Answer 15

Is ST segment isoelectric

• 1.0 mm elevation
• 0.5 mm depression

at 80 ms past j-point (2 squares)
Is the ST segement upsloping/downsloping or horizontal?

Question 16

Step 7

Answer 16

Evaluation the T wave

1. Are T waves present
2. Do they have a normal shape
3. Do the have a normal amplitude (10mm precordial leads)
4. Do they all have the same amplitude?
5. Do the T waves have the same deflection as QRS complex?

Question 17

Step 8

Answer 17

Determine the QT interval

1. 0.35 - 0.44 seconds corrected

Question 18

Step 9

Answer 18

Evaluate any other components

1. origin of rhythm (SA node/AV node/ventricles)
2. rate (bradycardia/tachycardia)
3. rhythm abnormalities