Chapter 7
Practice Rhythm Strips
1
Figure 7-10
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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2
Figure 7-10
Ventricular rate/rhythm
88 bpm/regular
Atrial rate/rhythm
88 bpm/regular
PR interval
0.28 sec
QRS duration
0.08 sec
Identification
Sinus rhythm with first-degree
AV block; ST-segment elevation
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3
Figure 7-11
Ventricular rate/
rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
4
Figure 7-11
Ventricular rate/
rhythm
107 bpm/regular
Atrial rate/rhythm 107 bpm/regular
PR interval
0.24 sec
QRS duration
0.08 sec
Identification
Sinus tachycardia with first-degree AV block
at 107 bpm
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5
Figure 7-12
This rhythm strip is from a 57-year-old man with a sprained ankle.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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6
Figure 7-12
Ventricular rate/rhythm 54 bpm/regular
Atrial rate/rhythm
54 bpm/regular
PR interval
0.28 sec
QRS duration
0.12 sec
Identification
Sinus bradycardia at 54 bpm with
first-degree AV block, notched P
waves and a wide, notched QRS
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7
Figure 7-13
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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8
Figure 7-13
Ventricular rate/rhythm
50–94 bpm/irregular
Atrial rate/rhythm
94 bpm/regular
PR interval
Lengthens
QRS duration
0.10 sec
Identification
Second-degree AV block type I
at 50–94 bpm; ST-segment
elevation
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
9
Figure 7-14
Ventricular rate/rhythm
38 bpm/regular
Atrial rate/rhythm
68 bpm/regular
PR interval
Varies
QRS duration
0.06 sec
Identification
Third-degree AV block at 38 bpm
with ST-segment depression and
inverted T waves
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
10
Figure 7-14
Ventricular rate/rhythm 38 bpm/regular
Atrial rate/rhythm
68 bpm/regular
PR interval
Varies
QRS duration
0.06 sec
Identification
Third-degree AV block at 38 bpm with
ST-segment depression and inverted
T waves
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11
Figure 7-15
These rhythm strips are from a 77-year-old woman complaining
of shortness of breath and weakness. BP 140/86.
Ventricular rate/
rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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12
Figure 7-15
Ventricular rate/rhythm
94 to 107 bpm/irregular
Atrial rate/rhythm
Unable to determine
PR interval
None
QRS duration
0.06 sec
Identification
Atrial fibrillation at 94-107
bpm with ST-segment
depression
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13
Figure 7-16
This rhythm strip is from a 69-year-old man complaining of
shortness of breath. Lung sounds reveal bilateral crackles.
Blood pressure 160/58. Identify the rhythm (lead II).
Ventricular rate/
rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
14
Figure 7-16
This rhythm strip is from a 69-year-old man complaining of
shortness of breath. Lung sounds reveal bilateral crackles.
Blood pressure 160/58. Identify the rhythm (lead II).
Ventricular rate/rhythm 107 bpm (sinus beats)/regular
Atrial rate/rhythm
107 bpm (sinus beats)/regular
PR interval
0.20 sec (sinus beats)
QRS duration
0.08 sec (sinus beats)
Identification
Sinus tachycardia at 107 bpm with
uniform PVCs
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15
Figure 7-17
This rhythm strip is from an 83-year-old woman with syncope.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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16
Figure 7-17
This rhythm strip is from an 83-year-old woman with syncope.
Ventricular rate/rhythm
<20–94 bpm/irregular
Atrial rate/rhythm
94 bpm/regular
PR interval
lengthening
QRS duration
0.08 sec
Identification
Second-degree AV block type I
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17
Figure 7-18
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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18
Figure 7-18
Ventricular rate/rhythm
36 bpm/regular
Atrial rate/rhythm
108/regular
PR interval
0.16 sec
QRS duration
0.08 to 0.10 sec
Identification
High-grade second-degree AV
block with 3:1 conduction at 36
bpm
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19
Figure 7-19
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
20
Figure 7-19
Ventricular rate/rhythm 68 bpm/regular
Atrial rate/rhythm
68 bpm/regular
PR interval
0.28 sec
QRS duration
0.06 sec
Identification
Sinus rhythm at 68 bpm with firstdegree AV block, ST-segment
depression
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
21
Figure 7-20
This rhythm strip is from an 83-year-old woman with syncope.
Identify the rhythm (lead II).
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
22
Figure 7-20
This rhythm strip is from an 83-year-old woman with syncope.
Identify the rhythm (lead II).
Ventricular rate/rhythm
38 to 75 bpm/irregular
Atrial rate/rhythm
75 bpm/regular
PR interval
Lengthens
QRS duration
0.06 to 0.08 sec
Identification
Second-degree AV block, type I at
38 to 75 bpm
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
23
Figure 7-21
This rhythm strip is from the same patient as the previous
rhythm strip. Identify the rhythm (lead II).
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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24
Figure 7-21
This rhythm strip is from the same patient as the previous
rhythm strip. Identify the rhythm (lead II).
Ventricular rate/rhythm
36 bpm/regular
Atrial rate/rhythm
72 bpm/regular
PR interval
0.20 to 0.22 sec
QRS duration
0.06 to 0.08 sec
Identification
2:1 AV block, probably type I at 36
bpm
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25
Figure 7-22
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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26
Figure 7-22
Ventricular rate/rhythm
50 bpm/regular
Atrial rate/rhythm
167 bpm/regular
PR interval
Varies
QRS duration
0.06 sec
Identification
Third-degree AV block at 50
bpm; S-T segment elevation
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27
Figure 7-23
This rhythm strip is from a 77-year-old woman who stated she felt fine.
She stopped at a blood pressure machine in Wal-Mart and the machine
would not read her pulse rate. She later went to her physician’s office
and then to the emergency department.
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
28
Figure 7-23
This rhythm strip is from a 77-year-old woman who stated she felt fine.
She stopped at a blood pressure machine in Wal-Mart and the machine
would not read her pulse rate. She later went to her physician’s office
and then to the emergency department.
Ventricular rate/rhythm
30 bpm/regular
Atrial rate/rhythm
68 bpm/regular
PR interval
0.28 sec
QRS duration
0.16 sec
Identification
2:1 AV block, probably type II at 30 bpm;
ST-segment elevation
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
29
Figure 7-24
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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30
Figure 7-24
Ventricular rate/rhythm
<20–60 bpm/irregular
Atrial rate/rhythm
60 bpm/regular
PR interval
0.16 sec
QRS duration
0.12 sec
Identification
Second-degree AV block type II at
<20 to 60 bpm; ST-segment
depression
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31
Figure 7-25
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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32
Figure 7-25
Ventricular rate/rhythm
28 to 58 bpm/irregular
Atrial rate/rhythm
58 bpm/regular
PR interval
Lengthens
QRS duration
0.06 to 0.08 sec
Identification
Second-degree AV block type I at
28–58 bpm, ST-segment depression
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33
Figure 7-26
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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34
Figure 7-26
Ventricular rate/
rhythm
48 to 83 bpm/irregular
Atrial rate/rhythm
167 bpm/regular
PR interval
0.24 sec
QRS duration
0.12 sec
Identification
Second-degree AV block type II at 48 to
83 bpm; ST-segment depression
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35
Figure 7-27
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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36
Figure 7-27
Ventricular rate/rhythm 36 bpm/regular
Atrial rate/rhythm
72 bpm/regular
PR interval
0.32 sec
QRS duration
0.10 sec
Identification
2:1 AV block, probably type 1 at 36
bpm
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37
Figure 7-28
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
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38
Figure 7-28
Ventricular rate/rhythm
45 bpm/regular
Atrial rate/rhythm
115 bpm/regular
PR interval
Varies
QRS duration
0.16 sec
Identification
Third-degree AV block at 45 bpm
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
39
Figure 7-29
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
40
Figure 7-29
Ventricular rate/rhythm
60 to 98 bpm/irregular
Atrial rate/rhythm
111 bpm/regular
PR interval
Lengthens
QRS duration
0.08 sec
Identification
Second-degree AV block type I at 60
to 98 bpm; ST-segment depression
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
41
Figure 7-30
Ventricular rate/rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
42
Figure 7-30
Ventricular rate/rhythm 34 bpm/regular
Atrial rate/rhythm
68 bpm/regular
PR interval
0.14 to 0.16 sec
QRS duration
0.10 sec
Identification
2:1 AV block probably type I at 34
bpm; ST-segment depression; tall T
waves
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
43
Figure 7-31
Ventricular rate/
rhythm
Atrial rate/rhythm
PR interval
QRS duration
Identification
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
44
Figure 7-31
Ventricular rate/rhythm
40 bpm/regular
Atrial rate/rhythm
83 bpm/regular
PR interval
0.24 sec
QRS duration
0.10 sec
Identification
2:1 AV block, probably type I; STsegment depression
Mosby items and derived items © 2011, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.
45
Questions?
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