ekg strip reading

normal sinus rhythm

sinus tachycardia

s/s: decreased cardiac output: syncope, hypotension, dizziness, fatigue, hypokalemia, fever

nursing interventions: treat underlying cause. ex: tylenol for fever

sinus bradycardia

s/s: normal for athletes, hypothermic, ICP, digoxin

causes: decreased cardiac output, decreased cardiac perfusion

NSR w/ premature ventricular contraction (PVC)

irregular heartbeat that occurs when ventricles contract unexpectedly

• 3+ in a row (non-sustained) → v-tach

s/s: palpitations, skippy heartbeat, hypokalemia, hypomagnesemia

nursing interventions: monitor electrolytes & treat, check labs

a-fib

no p-wave for every QRS

s/s: quivering of atrium, turbulent blood flow secondary to it; risk of stroke, can cause HF, valve issues

nursing interventions: anti-coags

• rapid a-fib → cardizem

a-flutter

shark-toothed, no p-wave interval

s/s: hypokalemia, alcoholism, HF

nursing interventions: ablation therapy, anticoags, cardioversion

sinus arrhythmias

R-R not equal

v-fib

s/s: actively going into cardiac arrest

nursing interventions: cardioversion

junctional (or idioventricular)

asystole

v-tach

complete heart block or 3rd degree heart block

sinus bradycardia w/ a pause

accelerated junctional

>100 bpm = junctional tachycardia

junctional escape

1st degree heart block

complete heart block or 3rd degree heart block

2nd degree AV block type II (mobitz II)

2nd degree AV block type I (Mobitz type I or Wenckebach)