Updated Dysrhythmia HCC Med Surg 2 Unit 1 Exam Review Questions and Answers, Exams of Cardiology

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Updated Dysrhythmia HCC Med Surg 2 Unit

1 Exam Review Questions and Answers

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Administrator [Date] [Course title]

1. What is the path- way of an electri- cal conduction **in the heart?

2. What is the pur-** pose of the 12 lead electrocar- **diogram (ECG)?
3. What is the pur-** pose of the 5 lead telemetry **moni- tor?
4. Describe the** components of the ECG graph paper: What does the horizontal axis **measure?
5. Describe the** components of SA node> R & L atrium (which causes contractions)>AV node> > Bundle of His> Bundle branches> Purkinje Fibers (which causes R & L ventricles to contract) -For diagnosis purposes -To provide a snapshot of the heart's electrical activity (in 12 views) -Provides continuous cardiac monitoring Placements: (depends on facility) White on right Clouds over green grass Brown ground Smoke over Fire (black lead over red) time and rate

the ECG graph paper: What does the vertical axis mea- sure?

6. Describe the components of the ECG graph paper: How much time does 1 large box represent?

R T I C A L

0.2 secs

7. Describe the components of the ECG graph paper: How much time does 1 small **box represent?

8. What does the P** **wave represent?
9. What does the** QRS complex represent? 0.04 secs atrial depolarization (atrial contraction) ventricular depolarization

10.What does the T wave represent? 11.What does the U wave represent? 12.What does the PR interval rep- resent? (normal ranges) 13.What does the QRS complex represent? Ventricular repolarization (ventricular relaxation) Purkinje fiber repolarization (hallmark for hypokalemia) 0.12-0.20 seconds -The time it takes for impulse to travel across atrium to ventricles 0.08-0.12 seconds -The time it takes impulse to travel across ventricles

18.What are the four classes of anti-dysrhyth- mia medica- tions? 19.What are the potential side/ad- verse effects for Procainamide (Sodium Ch Blocker)? 20.What are the potential side/ad- verse effects for Amiodarone (Potassium Ch Blocker)? 21.What are the potential side/ad- verse effects for Adenosine (Anti- dysrhythmic)? Class I: Sodium Channel Blockers: procainamide (Class IA), lidocaine (Class IB), propafenone (Class IC) Class II: Beta Adrenergic Blockers: propranolol (slows/controls HR) Class III: Potassium Channel Blockers: amiodarone, so- talol (decreases response to ectopic beat) Class IV: Calcium Channel Blockers: verapamil, diltiazem (decreases O2 demands & contraction/depolarization of the heart) -Lupus like syndrome -Neutropenia -Prolonged QT interval -Pulmonary toxicity -AV block > heart failure -Visual Problems -SB (Sinus Bradycardia) -Hypotension

-P

w av e pr es en t be for e ea ch Q RS & all lo ok th e sa m e

Q RS co m pl ex es lo ok ali ke

No rm al

QRS & PR

interval

What are the causes of Sinus Bradycardia? 26.What are the assessment find- ings of Sinus Bradycardia? 27.What is the treat- ment for Sinus Bradycardia? 28.What are the characteris- tics for Prema- ture Atrial Con- tractions

(PAC)?

29.What are the causes of a Premature Atri- al Contraction (PAC)? 30.What is the treat- ment for Prema- ture Atrial Con- tractions (PAC)? 31.What are the -Can occur in normal hearts -Caffeine, alcohol, nicotine -Hypoxia -CAD (Coronary Artery Disease) -Infections -Digoxin toxicity -None if PACs are infrequent -If more than 6/min; may treat the cause -Sodium channel blocker: procainamide ("Treat the PAC with PROC") -Atrial rate= 250- characteristics of -No P waves but "F waves" (saw tooth pattern) Atrial Flutter? 32.What are the causes of Atrial Flutter? -QRS complex does not follow every P wave -Not able to measure PR interval -Typically a regular rhythm -MI -Mitral valve disease -Thyroid crisis

-COPD

-Cardiac surgery -Digoxin toxicity

36. -Older adults (over 65) -HTN

What are the causes for Atrial Fibrillation? 37.What are the assessment find- ings for Atrial Fibrillation? 38.What is the treatment/man- agement of Atrial Fibrillation? 39.What are the characteris- tics of Supraven- tricular Tachycar- dia?

40.What are the clinical manifestations of Supraventricular Tachycardia? 41.What is the treatment for Supraven- tricular Tachycar- dia? 42.What are the -Palpitations -Dizziness -Shortness of breath -Anxiety -Chest pain or tightness -Lifestyle changes -Vagal maneuvers -Adenosine IV push (expect asystole) -Cardioversion -Ablation therapy -Occurs when the AV node becomes the pacemaker characteristics of -Atrial/Ventricular rate 40- Junctional Ar- rhythmias? 43.What are the causes of a Junc- tional Rhythm?

-If P wave if present: may be before, during, or after QRS; PR interval less than 0.12 seconds -Digoxin toxicity -MI -Cardiac surgery