Understanding EKG Rhythms and Pacemaker Care NCLEX
NCLEX High Yield EKG Lecture: Master normal sinus rhythm, bradycardia, tachycardia, A-fib, V-fib, SVT, digoxin, anticoagulants, pacemakers & more! Perfect for nursing board prep. Simplified, high-yield, and test-focused.
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NCLEX
HIGH YIELD
EKG LECTURE
NORMAL SINUS RHYTHM:
This is a regular rhythm
HR: 60-100bpm
ECG of a Normal Sinus
Rhythm has a P wave (atrium) followed by a
QRST (ventricular)
— Atrium is predominately controlled by Calcium
Ventricle is predominately controlled by Potassium
(K+) —> ASK GRAPH
Smus Bradycardia
SINUS BRADYCARDIA:
HR is less than 60bpm
In athletes this is not
abnormal, it is expected.
Causes include: Medicines (BB, COB, Digoxin),
hypothyroidism, SA Node Dysfunction
HIGH YIELD
EKG LECTURE
NORMAL SINUS RHYTHM:
This is a regular rhythm
HR: 60-100bpm
ECG of a Normal Sinus
Rhythm has a P wave (atrium) followed by a
QRST (ventricular)
— Atrium is predominately controlled by Calcium
Ventricle is predominately controlled by Potassium
(K+) —> ASK GRAPH
Smus Bradycardia
SINUS BRADYCARDIA:
HR is less than 60bpm
In athletes this is not
abnormal, it is expected.
Causes include: Medicines (BB, COB, Digoxin),
hypothyroidism, SA Node Dysfunction
Treatment:
Asymptomatic - No Treatment
Symptomatic - lightheaded, dizzy, SOB,
hypotensive, unresponsive, pale, cool, AMS,
syncope, we must treat them.
Treatment:
Administer Atropine (anticholinergic drug)
How to admin: IV 0.5mg q 3-5min
Up to 3 Omg MAX (6 doses)
Contraindications:
Glaucoma
Gl Obstruction
Urinary retention
Atropine is contraindicated in pregnancy
If atropine does not work, put in a permanent
pacemaker:
Notice where the pacemaker is placed, underneath
the clavicle.
Post-op / post-procedure always look for AASH
Education:
- Don't put arms over head until
healed properly (~ 6wks)
• Carry Pacemaker ID card
•Take pulse daily
■ AVOID MRI
NCLEX HIGH YIELD
nclexliighyielcl.com
Asymptomatic - No Treatment
Symptomatic - lightheaded, dizzy, SOB,
hypotensive, unresponsive, pale, cool, AMS,
syncope, we must treat them.
Treatment:
Administer Atropine (anticholinergic drug)
How to admin: IV 0.5mg q 3-5min
Up to 3 Omg MAX (6 doses)
Contraindications:
Glaucoma
Gl Obstruction
Urinary retention
Atropine is contraindicated in pregnancy
If atropine does not work, put in a permanent
pacemaker:
Notice where the pacemaker is placed, underneath
the clavicle.
Post-op / post-procedure always look for AASH
Education:
- Don't put arms over head until
healed properly (~ 6wks)
• Carry Pacemaker ID card
•Take pulse daily
■ AVOID MRI
NCLEX HIGH YIELD
nclexliighyielcl.com
■ AVOID carrying cell phones in a pocket
near the pacemaker and hold it on the
opposite ear of the pacemaker
■ Notify airport security of handheld wands
• Keep dressing on for 1 week and dry
(showering ok with protective dressing)
NO BATHS
■ No driving for a week or until HCP clears
• No lifting anything above 5lbs. 4-6 weeks
■ No lifting arm above head for 4-6 weeks
*These are the first two pacemakers Dr. Zeeshan did
with his attending Dr. Kenneth Shah!
Shut Tactiycardia
SINUS TACHYCARDIA:
Sinus Rhythm with a HR
greater than 100bpm
Causes include: pain, stress,
anxiety, dehydration, caffeine, hyperthyroidism,
elicit drugs, amphetamines, the NCLEX, and more
Treatment:
Administer beta blockers:
end in the suffix -lol
Ex: metoprolol, atenolol, labetalol
Help decrease HR and lower BP
SE: bradycardia, bronchoconstriction, bronchospasm
near the pacemaker and hold it on the
opposite ear of the pacemaker
■ Notify airport security of handheld wands
• Keep dressing on for 1 week and dry
(showering ok with protective dressing)
NO BATHS
■ No driving for a week or until HCP clears
• No lifting anything above 5lbs. 4-6 weeks
■ No lifting arm above head for 4-6 weeks
*These are the first two pacemakers Dr. Zeeshan did
with his attending Dr. Kenneth Shah!
Shut Tactiycardia
SINUS TACHYCARDIA:
Sinus Rhythm with a HR
greater than 100bpm
Causes include: pain, stress,
anxiety, dehydration, caffeine, hyperthyroidism,
elicit drugs, amphetamines, the NCLEX, and more
Treatment:
Administer beta blockers:
end in the suffix -lol
Ex: metoprolol, atenolol, labetalol
Help decrease HR and lower BP
SE: bradycardia, bronchoconstriction, bronchospasm
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