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Respiratory – Circulatory interaction
Rate INCREASES with INSPIRATION (IN=IN)
normal sinus rhythm
normal sinus rhythm
Regularity: Interrupts the regularity of underlying rhythm
P-Wave: can be flattened, notched, or unusual. May be hidden within the T wave
PRI: measures between .12-.20 seconds and can be prolonged; can be different from other complexes
QRS: <.12 seconds
– notice absence of P-wave for a complete cycle (a missed cycle)
length of pause ≠ multiple of normal rate (block)
-impulse from AV node w/ retro/antegrade transmission
– P wave often inverted/buried/follow QRS
– slow rate
– narrow QRS (not wide like ventricular)
– KEY: will be regular (consistent)
– AV junction produces a rapid sequence of QRS-T cycles
– p-wave often inverted/buried/follow QRS
PRI<0.12 or none
Normal QRS
Sudden appearance of a nonconducted P-wave
P-waves are nl, but some aren’t followed by a QRS complex
PR & RR intervals are constant
P wave: Obscured by ventricular waves
QRS: Wide QRS – “Twisting of the Points”
Conduction: Ventricular only
Rhythm: Slightly irregular
*looks like vtach but slow*
– no P waves (from vent foci)
– Wide QRS
(serious, death like rhythm)
– called “dying heart” rhythm…occasional ventric beat b4 death (asystole)
P wave: Obscured by ventricular waves (occur during ventricular contraction) – SA node slower than faster ventricular pacing than should be
QRS: Wide QRS
Conduction: Ventricular only
Rhythm: Regular- benign rhythm that is sometimes seen during acute MI or early after reperfusion. – Rarely sustained, does not progress to vfib, rarely requires treatment
Rate: 60-100
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
Rate: <60
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
Rate: 100-150
P Wave: Present, upright
PR Interval: 0.12-0.20 sec
QRS: <0.12 sec
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 rate: UNMEASURABLE
Ventricular rate: variable
P wave: unable to see
PR Interval: N/A
QRS: <0.12 sec
Ventricular rate: 100-175
P wave: unable to see
PR Interval: N/A
QRS <0.12 sec
Atrial rate: 250-350
Ventricular rate: variable BUT < atrial rate
P Wave: Flutter
PR Interval: N/A
QRS: <0.12 sec
Rate: 150-350
P wave: Hidden in QRS or T wave
PR: unable to determine
QRS: <0.12 sec
Rate: 40-60
P Wave: ABSENT or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Rate: 60-100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Rate: >100
P Wave: NONE or INVERTED
PR Interval: None or <0.12
QRS: <0.12 sec
Rate: refer to underlying rhythm
P Wave: NONE
PR Interval: N/A
QRS: WIDE and BIZARRE , >0.12 sec
Rate: >100
P Wave: NONE
PR Interval: N/A
QRS: WIDE and BIZARRE, >0.12 sec
Coarse: big waves
Fine: small waves
Rate: unmeasurable
P Wave: NONE
PR Interval: N/A
QRS: N/A
Rate: 20-50
P wave: NONE
PR Interval: N/A
QRS: WIDE, >0.12 sec
Rate: 50-100
P wave: NONE
PR Interval: N/A
QRS: WIDE, >0.12 sec
Rate: 60-100
P Wave: Present, upright
PR interval: >0.20 sec CONSISTENTLY LONG
QRS: <0.12 secHusband stays late till 9 consistently
Rate: 60-100
P wave: Present, upright
PR Interval: Progressively longer until drop (PR interval longer and longer until drop)
QRS: <0.12 secHusband stays late till 9, then 11, then 1, then doesn’t come home at all
Rate: <60
P wave: Present, upright
PR Interval: PR interval consistently LONGER like type 1 but then a QRS will drop
QRS: <0.12 secHusband stays late till 9 consistently, then wife goes out and doesn’t come home
Rate: regular atrial
P wave: Present, upright
No relationship between P waves and QRS
PR Interval: VARIABLE
QRS: variableP-P ad R-R consistent but NO correlationHusband and wife live separate lives and don’t communicate
60-100
40-60
40-45
40-45
20-50
AV Node fired
NO P WAVE bc SA node didn’t fire
Narrow QRS
Will be shorter than T wave
Shows firing of SA node
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)
WIDE QRS always
Rate?
P before every QRS? QRS for every P?
QRS wide or narrow?
-SR 60-100
-SB <60
-ST 100-150
-SVT 150-350
-Junctional rhythm 40-60
-Accelerated junctional rhythm 60-100
-Junctional tachycardia 100-150
-Idioventricular 20-50
-Accelerated idioventricular 50-100
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