Prophecy EKG Test solution guide_2022.

Normal sinus rhythm - Regular Rate: 60-100 P Wave: Present, upright PR Interval: 0.12-0.20 sec QRS:

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