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Case Study Dysrhythmia

 

Gloria Milhouse, a 68-year-old woman, is driven to the ED by her husband, who states she “passed 
out” while riding in the car, and he had a difficult time rousing her. Suspecting a cardiac dysrhythmia, the MD places Mrs. Milhouse under observation on a cardiac monitor. During her interview, Mrs. Milhouse revealed that she passed out 2 weeks ago at home but recovered quickly. She admits to having frequent heart palpitations and a feeling that her heart is 
“racing.” She denies alcohol or tobacco use and drinks one cup of coffee daily. She is pale and anxious, her BP is 160/82, and her apical pulse is 114 and regular. 
 

1. Which of the following pathways does normal cardiac electrical conduction follow?
a. SA node – AV node – bundle of His – bundle branches – Purkinje fibers 
b. Purkinje fibers – bundle branches – bundle of His – AV node – SA node
c. AV node – bundle of His – SA node – bundle branches – Purkinje fibers 
 

2. While the technician is attaching the ECG electrodes and the nurse is starting an IV line, Mrs. Milhouse becomes anxious and complains of heart palpitations. The technician quickly attaches the remaining electrodes while the nurse assesses the patient. Her heart rhythm is regular, and her rate is rapid; she is pale and anxious, and states she feels “woozy.”
A few minutes later, Mrs. Milhouse announces her palpitations have stopped. The nurse analyzes her ECG strip and determines that Mrs. Milhouse is experiencing supraventricular tachycardia. 
 

A) Explain the ECG term below:
a. P = 
b. PR interval = 
c. QRS complex = 
d. T wave = 
e. U wave = 
f. QT interval = 
 

B) How could you estimate heart rate using a 1-minute ECG strip? 
 

C) How did the nurse determine that Mrs. Milhouse was having a run of SVT upon 
analyzing ECG strip? 

SCIENCE
HEALTH SCIENCE
NURSING
NURS 204