Essential NCLEX ECG Rhythm Overview

Nov 15, 2024

Key NCLEX ECG Rhythm Strips

1. Normal Sinus Rhythm

  • Memory Trick: Evenly spaced normal beats.
  • Cause: Being very healthy.
  • Treatment: None required, continue monitoring.

2. Bradycardia

  • Memory Trick: Below 60 beats per minute; "Brady Bunch" for slower.
  • Treatment: Atropine if symptomatic (low perfusion).
    • Memory Trick: Atropine puts heart rate high, "atop a pine tree."
  • Causes: Vasovagal maneuver, calcium channel blockers, beta blockers.

3. Ventricular Fibrillation (V-Fib)

  • Memory Trick: "Fib" flopping around like a squiggly line.
  • Treatment:
    1. Defibrillation immediately (stop CPR).
    2. Drugs: Lidocaine, Amiodarone, Procainamide (LAP).
  • Causes: Untreated VTAC, post-MI, electrolyte imbalances, pro-arrhythmic meds.

4. Ventricular Tachycardia (VTAC)

  • Memory Trick: Tombstone pattern.
  • Causes: Post-MI, hypoxia, hypokalemia, low magnesium.
  • Treatment:
    1. Early defibrillation.
    2. Shock for VTAC with no pulse; cardioversion for VTAC with a pulse.
  • Remember: "Double D's of deadly defibrillation."

5. Atrial Fibrillation (AFib)

  • Memory Trick: No P wave, fibrillation "flopping."
  • Causes: Valvular disease, heart failure, pulmonary hypertension, COPD, post-surgery.
  • Treatment:
    1. Cardioversion after TTE to rule out clots.
    2. Long-term: Digoxin, monitor ATP (Apical pulse, Toxicity, Potassium).
    3. Anticoagulants like Warfarin, monitor INR.

6. Atrial Flutter

  • Memory Trick: Saw tooth appearance.
  • Cause/Treatment: Same as atrial fibrillation.

7. Supraventricular Tachycardia (SVT)

  • Memory Trick: Super fast.
  • Causes: Stimulants, exercise, hypoxia, heart disease.
  • Treatment:
    1. Vasovagal maneuver.
    2. Adenosine (rapid push and flush).
    3. Cardioversion as last resort.

8. Torsades de Pointes

  • Memory Trick: "Tornado of points."
  • Causes: Post-MI, hypoxia, low magnesium.
  • Treatment: Magnesium sulfate.

9. Asystole

  • Memory Trick: "Assist fully" for a flat line.
  • Treatment: Epinephrine, atropine, CPR (no defibrillation).

Key NCLEX Terms

  • P wave: Atrial rhythm.
  • QRS: Ventricular rhythm.
  • Lack of QRS: Asystole.
  • Wide, bizarre QRS: Ventricular tachycardia.
  • Chaotic rhythm no P waves: Atrial fibrillation.
  • Chaotic rhythm no QRS: Ventricular fibrillation.
  • Bizarre: Tachycardia.
  • Sawtooth: Atrial flutter.

Final Tips

  • Focus on safety: Treatment to prevent loss of life or limb.
  • Understand treatment protocols for all rhythms, not just identification.
  • Practice with quizzes and study guides available at SimpleNursing.

Note: For detailed videos and study resources, visit SimpleNursing.com.