Medical & Nursing Studies
25 flashcards
~13 min
Cardiac Arrhythmias Flashcards
Master cardiac rhythm recognition with this essential arrhythmia flashcard deck designed for nursing students, cardiac nurses, and NCLEX candidates. Understanding ECG patterns and knowing how to respond to arrhythmias is a critical competency in medical-...
About this deck
Master cardiac rhythm recognition with this essential arrhythmia flashcard deck designed for nursing students, cardiac nurses, and NCLEX candidates. Understanding ECG patterns and knowing how to respond to arrhythmias is a critical competency in medical-surgical, telemetry, ICU, and emergency nursing practice. This deck covers normal sinus rhythm, common atrial and ventricular arrhythmias, heart blocks, and life-threatening rhythms — including their ECG characteristics, causes, symptoms, and nursing interventions. Based on American Heart Association (AHA) guidelines and standard critical care nursing references.
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Rate: 60–100 bpm. Regular rhythm. P wave before every QRS. PR interval: 0.12–0.20 sec. QRS: < 0.12 sec. This is the baseline against which all arrhythmias are compared.
NSR with heart rate > 100 bpm. Normal P waves, regular rhythm. Causes: fever, pain, anxiety, dehydration, anemia, hyperthyroidism. Treat the underlying cause.
NSR with heart rate < 60 bpm. Normal P waves, regular rhythm. Causes: athletes (normal), hypothyroidism, increased ICP, digoxin toxicity, beta-blockers. Treat if symptomatic (Atropine).
Irregular rhythm caused by changes in breathing — heart rate increases with inspiration and decreases with expiration. Normal in children and young adults.
Early, abnormal P waves that interrupt the normal rhythm. Usually benign. Causes: caffeine, stress, alcohol, electrolyte imbalance. No treatment usually needed.
Chaotic, disorganized atrial activity with no distinct P waves — replaced by irregular fibrillatory waves. Irregularly irregular ventricular rhythm. Rate: 350–600 atrial impulses/min. Major risk: thrombus formation and stroke. Treatment: rate control, anticoagulation.
Regular, rapid atrial activity at 250–350 bpm producing classic sawtooth (flutter) waves. Usually 2:1, 3:1, or 4:1 conduction to ventricles. Treatment: cardioversion, rate control, anticoagulation.
Rapid heart rate 150–250 bpm originating above the ventricles. Narrow QRS, regular rhythm. Causes: stress, caffeine, WPW syndrome. Treatment: Valsalva maneuver, adenosine, cardioversion.
PR interval > 0.20 seconds (> 5 small squares). Every P wave is followed by a QRS. No dropped beats. Usually benign — monitor only. Causes: vagal tone, digoxin, inferior MI.
Progressive lengthening of the PR interval until a QRS is dropped. Then the cycle repeats. Usually benign but monitor. Causes: inferior MI, increased vagal tone, digoxin toxicity.
Constant PR interval with sudden, unexpected dropped QRS beats (no progressive lengthening). More serious than Mobitz I. Risk of progressing to complete heart block. May require pacemaker.
Complete dissociation between P waves and QRS complexes — atria and ventricles beat independently. Life-threatening. Requires immediate transcutaneous pacing and likely permanent pacemaker.
Early, wide, bizarre-looking QRS complexes > 0.12 seconds with no preceding P wave. Causes: hypoxia, hypokalemia, caffeine, MI. Occasional PVCs are benign; frequent/multifocal PVCs require treatment.
3 or more PVCs in a row at a rate > 100 bpm. Wide, bizarre QRS complexes. May be pulseless. With pulse: Amiodarone, cardioversion. Pulseless V-Tach: DEFIBRILLATE immediately + CPR.
Chaotic, disorganized ventricular activity — no identifiable P waves, QRS, or T waves. No cardiac output. IMMEDIATELY DEFIBRILLATE + CPR. This is a cardiac arrest rhythm.
A form of polymorphic V-Tach with QRS complexes that appear to "twist" around the baseline. Associated with prolonged QT interval. Treatment: IV Magnesium sulfate, remove offending drugs.
Complete absence of electrical activity — a flat line on ECG. No cardiac output. CPR + Epinephrine. Note: Confirm in 2 leads — never shock asystole (defibrillation will not help).
Organized electrical activity on ECG but no pulse (no mechanical cardiac output). CPR + Epinephrine + treat reversible causes (5 H's and 5 T's).
H's: Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia. T's: Tension pneumothorax, Tamponade, Toxins, Thrombosis (pulmonary), Thrombosis (coronary/MI).
Wide QRS > 0.12 seconds with a broad, notched R wave in lateral leads (I, aVL, V5, V6). The left ventricle is activated late. May indicate cardiac disease or MI.
Cardioversion: Synchronized shock delivered during QRS complex. Used for unstable arrhythmias WITH a pulse (A-Fib, SVT, V-Tach with pulse). Defibrillation: Unsynchronized shock. Used for pulseless V-Tach and V-Fib.
Atropine 0.5 mg IV (first-line). If atropine fails: transcutaneous pacing or dopamine/epinephrine infusion.
Used to terminate SVT. Given as a rapid IV push (over 1–2 seconds) followed immediately by a 20 mL NS flush, in the largest vein available (antecubital). Causes brief asystole — warn the patient.
Check apical pulse for 1 full minute — hold if < 60 bpm. Check digoxin level (therapeutic 0.5–2 ng/mL). Monitor for toxicity: nausea, bradycardia, visual changes (yellow-green halos).
QT interval > 440ms (men) or > 460ms (women). Indicates slow ventricular repolarization. Dangerous because it predisposes to Torsades de Pointes and sudden cardiac death. Many drugs prolong QT (antipsychotics, antibiotics, antiemetics).