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Nursing 460: EGK Rhythm Strips

by: ndp33

Nursing 460: EGK Rhythm Strips 460

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These notes describe the types of EKG rhythm strips.
Nursing Concepts IV: Health of Maturing Adults / Chronic Disease
Class Notes
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This 4 page Class Notes was uploaded by ndp33 on Thursday July 7, 2016. The Class Notes belongs to 460 at Niagara University taught by in Summer 2016. Since its upload, it has received 9 views. For similar materials see Nursing Concepts IV: Health of Maturing Adults / Chronic Disease in Nursing and Health Sciences at Niagara University.


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Date Created: 07/07/16
EKG Readings – How to Distinguish PVC: -no P wave seen, wide QRS interval V tach: -really fast heart rate, regular -no P wave, wide QRS interval -you see multiple PVCs in a row -don’t confuse with superventricular tachycardia, where you can see the T wave merging with P wave! Sinus arrhythmia: -NO prolonged PR intervals -regular HR -irregular rhythm because… it may vary with inspiration Idioventricular rhythm: -slow Anything junctional: -has a regular rhythm -the intervals or wave just may be irregular -eg junctional: junctional escape rhythm, accelerated junctional rhythm, etc. Junctional escape rhythm: -slow HR (40-60) -not sinus bradycardia because… PR interval is not measurable, P wave is not in normal position on EKG paper (may be inverted, may be present before, during or even after QRS) Accelerated junctional rhythm: -regular rhythm, normal HR (even though it says accelerated) -P wave is not normal (may be hidden (say, in QRS) or inverted); -PR interval not measureable Premature junctional complex: -Regular rhythm, but… -premature beats (look at P waves: P wave may be hidden, present before, during, or after; or inverted) Sinus tachycardia: -normal P and T waves, normal QRS; NORMAL RHYTHM -p wave may merge with T wave; DON’T GET CONFUSED WITH SUPRAVENTRICULAR TACHYCARDIA -BUT…rate varies with inspiration A fib: -DON’T ALWAYS ASSUME THE ISOMETRIC LINES WILL BE “WAVY” OR “FLUTTERLY” -Just note that P waves will be absent, PR interval is immeasureable; what would be P wave may appear curvy Atrial flutter: -no P waves present; -saw-toothed lines Premature atrial complex: -irregular rhythm, -HR USUALLY regular -premature beat (just look at P wave’s shape: may look abnormal) -ALSO PROLONGED PR INTERVAL Second degree heart block type I: -irregular rhythm, prolonged PR interval -normal P wave Second degree heart block type II: -irregular rhythm, prolonged PR interval -more P waves than QRS complexes; don’t get sinus arrest mixed up Third degree heart block: -looks like slow HR -NO NOT get confused with sinus bradycardia… you see multiple P waves, and that signals independent contraction of atria and ventricles -ABSENT PR INTERVAL Idioventricular rhythm: -slow -absent P wave, -wide QRS interval Accelerated idioventricular rhythm: -regular rhythm, -HR of 50-120 beats/min -absent P wave, -wide QRS interval V-tach: -absent P wave, -WIDE QRS interval Bundle branch block: -regular rhythm, regular HR, but… -wide QRS intervals (> 0.12 seconds) Sinus arrest: -only if rest of EKG is normal sinus rhythm, w/ exception of pause Pacemaker failure to capture: -irregular rhythm, slow or normal rhythm -pacemaker spikes aren’t followed by P waves or normal QRS complexes V-fib: -wavy line, -ABSENT P waves -NOTE: may LOOK like (but IS NOT) V-tach Torsade de Points (BUT: Torsade de Points has fluctuating QRS intervals), whereas V-fib has fluctuations in waveline Asystole: -what LOOKS like (but really IS NOT) a few P waves; DON’T MIX UP WITH V FIB


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