ECG Test #3

How would frequent premature atrial complexes (PACs) affect a patient with coronary artery disease?

low cardiac output

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

A traveling blood clot in the lungs is known as:

pulmonary embolism

Multifocal atrial tachycardia (MAT) is usually triggered by congestive heart failure (CHF), acute mitral valve regurgitation, or an acute attack of:

emphysema

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

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

What medical condition place pressure on the atria, causing atrial dysrhythmias to occur?

Myocardial infarction, valvular problems, neurological influences

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)

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 (PAC)

What treatment is usually attempted for patients with atrial fibrillation?

Medication and/or electrical cardioversion

Which atrial dysrhythmia has a clearly changing P wave and a heart rate of 101 to 150 bpm?

Multifocal atrial tachycardia (MAT)

Which atrial dysrhythmia occurs when electrical impulses come from areas of reentry pathways or multiple ectopic foci?

Atrial fibrillation

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

What treatment is usually indicated for patients with atrial flutter?

Oxygen therapy

What atrial dysrhythmia has lowercase “f” waves, chaotic atrial electrical activity, and irregular R-R intervals

Atrial fibrillation

What term describes the ability of the heart to initiate an electrical impulse without being stimulated by another or independent source?

Automaticity

Which of the following statements describes the PR interval in a wandering atrial pacemaker rhythm?

It varies with the site of the atrial pacemaker

Patients who have atrial fibrillation may have a loss of stroke volume of between:

20 and 30%

A pattern in which every third complex is a premature beat is referred to as:

trigeminy

Some patients can tolerate the loss of atrial kick if the heart rate remains between:

60 and 100 bpm

What symptom might a patient with frequent PACs complain of?

Palpitations

Which statement correctly describes the P wave in multifocal atrial tachycardia?

It changes from beat to beat

A cardiac cell or group of cells that produces an ectopic beat is known as:

focus

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

Which atrial dysrhythmia has capital F waves and a classic sawtooth or picket fence appearance?

Atrial flutter

What is the major health risk for patients with atrial fibrillation?

Thrombus formation or embolism

The loss of atrial kick contributes to what percent decrease in cardiac output?

10-30%

Which atrial dysrhythmia has a changing P wave configuration with at least three variations in one lead and may also have an irregular rhythms?

Wandering atrial pacemaker (WAP)

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

What kind of impulse causes atrial dysrhythmias?

Ectopic

Which portion of the ECG tracing is primarily affected by atrial dysrhythmias?

P waves

Patients with new onset of atrial fibrillation often complain of:

dizziness and nausea

What is the rate of wandering atrial pacemaker rhythm (WAP)?

60 to 100 bpm

Which rhythm occurs when the atria quiver like a bowl of Jell-O?

Atrial fibrillation

What is the rate of multifocal atrial tachycardia (MAT)?

101 to 150 bpm

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)

How many different P wave configurations in the same lead indicate a wandering atrial pacemaker (WAP)?

3

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

What causes the different P wave morphologies in an ECG tracing that shows wandering atrial pacemaker?

The varying sites of the ectopic impulses

What is the atrial rate in atrial flutter?

250-350 bpm

What is the ventricular heart rate range for accelerated junctional rhythm?

60-100 bpm

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

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

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

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

What is the primary difficulty in classifying an SVT?

Determining the origin of the tachycardia

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

What type of rhythm would be present if abnormal impulses are ignored?

Underlying rhythm

What is the ventricular heart rate for junctional escape rhythm?

40-60 bpm

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