Relias Dysrhythmia Basic A | 55 accurate solutions with diagrams | 100% accuracy | PassGuarantee

Normal sinus rhythm

Regular

Rate: 60-100

P Wave: Present, upright

PR Interval: 0.12-0.20 sec

QRS: <0.12 sec

Sinus Bradycardia

Regular

Rate: <60

P Wave: Present, upright

PR Interval: 0.12-0.20 sec

QRS: <0.12 sec

Sinus Tachycardia

Regular

Rate: 100-150

P Wave: Present, upright

PR Interval: 0.12-0.20 sec

QRS: <0.12 sec

Premature Atrial Contraction

IRREGULAR

Rate: depends on underlying rhythm

P wave: Present or hidden in T wave

PR Interval: 0.12-0.20 sec

QRS: <0.12 sec

Atrial Fibrillation

IRREGULAR

Atrial rate: UNMEASURABLE

Ventricular rate: variable

P wave: unable to see

PR Interval: N/A

QRS: <0.12 sec

A fib RVR

IRREGULAR

Ventricular rate: 100-175

P wave: unable to see

PR Interval: N/A

QRS <0.12 sec

Atrial Flutter

Usually REGULAR can be irregular

Atrial rate: 250-350

Ventricular rate: variable BUT < atrial rate

P Wave: Flutter

PR Interval: N/A

QRS: <0.12 sec

Supraventricular Tachycardia

Regular

Rate: 150-350

P wave: Hidden in QRS or T wave

PR: unable to determine

QRS: <0.12 sec

Junctional Rhythm

Regular

Rate: 40-60

P Wave: ABSENT or INVERTED

PR Interval: None or <0.12

QRS: <0.12 sec

Accelerated Junctional Rhythm

Regular

Rate: 60-100

P Wave: NONE or INVERTED

PR Interval: None or <0.12

QRS: <0.12 sec

Junctional Tachycardia

Regular

Rate: >100

P Wave: NONE or INVERTED

PR Interval: None or <0.12

QRS: <0.12 sec

Premature Ventricular Contraction

IRREGULAR

Rate: refer to underlying rhythm

P Wave: NONE

PR Interval: N/A

QRS: WIDE and BIZARRE , >0.12 sec

Ventricular Tachycardia

Regular

Rate: >100

P Wave: NONE

PR Interval: N/A

QRS: WIDE and BIZARRE, >0.12 sec

Ventricular Fibrillation

Chaotic

Coarse: big waves

Fine: small waves

Rate: unmeasurable

P Wave: NONE

PR Interval: N/A

QRS: N/A

Idioventricular

Regular

Rate: 20-50

P wave: NONE

PR Interval: N/A

QRS: WIDE, >0.12 sec

Accelerated Idoventricular Rhythm

Regular

Rate: 50-100

P wave: NONE

PR Interval: N/A

QRS: WIDE, >0.12 sec

1st Degree AV Block

Regular

Rate: 60-100

P Wave: Present, upright

PR interval: >0.20 sec CONSISTENTLY LONG

QRS: <0.12 sec

Husband stays late till 9 consistently

2nd Degree AV Block Type I Mobitz, Wenckebach

IRREGULAR

Rate: 60-100

P wave: Present, upright

PR Interval: Progressively longer until drop (PR interval longer and longer until drop)

QRS: <0.12 sec

Husband stays late till 9, then 11, then 1, then doesn't come home at all

2nd Degree AV Block Type II

Irregular or regular

Rate: <60

P wave: Present, upright

PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop

QRS: <0.12 sec

Husband stays late till 9 consistently, then wife goes out and doesn't come home

3rd Degree AV Block

Atrials and ventricles don't communicate

Rate: regular atrial

P wave: Present, upright

No relationship between P waves and QRS

PR Interval: VARIABLE

QRS: variable

P-P ad R-R consistent but NO correlation

Husband and wife live separate lives and don't communicate

SA Node

1st

60-100

AV Node

2nd

40-60

Bundle of His

3rd

40-45

Right and Left Bundle Branches

4th

40-45

Purkinje Fibers

5th

20-50

1 Small Box

0.04 sec

1 Big Box

0.20 sec

Junctional Rhythms

SA Node DID NOT FIRE

AV Node fired

NO P WAVE bc SA node didn't fire

Narrow QRS

P Wave

Amplitude 0.5-2.5 mm

Will be shorter than T wave

Shows firing of SA node

QRS

0.06-0.10 sec SHOULD BE <0.12 sec

Wide QRS: delay in ventricular contraction, delay of conduction through bundle branches or purkinje fibers

BUNDLE BRANCH BLOCK or BLOCK IN PURKINJE FIBERS (idioventricular)

Calculate Regular Rate

1500/ # boxes R-R

Calculate Irregular Rate

# of Rs in 6 sec strip X 10

Unifocal PVCs

Only 1 shape PVC

Bigeminy

PVC occurs every OTHER beat

Trigeminy

PVC occurs every THIRD beat

Couplet

2 PVCs together

Triplet

3 PVCs together

Multifocal

Multiple shapes

Monomorphic V Tach

Same Shapes V Tach

Polymorphic V Tach

Different Shapes V tach

Coarse V Fib

Chopy but not as high as polymorphic V tach

Fine V Fib

Fine and fibrillatory

Idioventricular Rhythms

Only purkinje fibers firing

WIDE QRS always

Atrially Paced

Spike comes before P

Ventricularly Paced

Spike comes before QRS and QRS will be wide

AV Paced

Spike before P and before QR

Failure to Capture

Spikes with no QRS

Failure to Sense

Spikes happen regardless of QRS on their own

How to determine the rhythm

Regular or irregular?

Rate?

P before every QRS? QRS for every P?

QRS wide or narrow?

QT Interval

0.34-0.43

P Wave

0.06-0.12 sec

PR Interval

0.12-0.20 sec

SA Node Firing Rhythms

Fires normally @ 60-100

-SR 60-100

-SB <60

-ST 100-150

-SVT 150-350

AV Node Firing, SA Node Failed Rhythms

Fires normally @ 40-60

-Junctional rhythm 40-60

-Accelerated junctional rhythm 60-100

-Junctional tachycardia 100-150

Only Purkinje Fibers Firing Rhythms (Everything else has failed)

Fires normally @ 20-50

-Idioventricular 20-50

-Accelerated idioventricular 50-100