ECG Strips and Key Concepts for NCLEX

1. Normal Sinus Rhythm

• Memory Trick: Normal beat, evenly spaced.
• Treatment: None, just monitor.
• Causes: Healthy heart.

2. Bradycardia

• Memory Trick: Brady = Below 60 bpm (like the slow TV show "Brady Bunch").
• Treatment: Atropine (if symptomatic with low perfusion: pale, cool, clammy).
• Causes: Vasovagal maneuvers, calcium channel blockers, beta blockers.

3. Ventricular Fibrillation (V-Fib)

• Memory Trick: FIB = Flopping, squiggly line.
• Treatment:
  • Immediate defibrillation (before drugs)
  • Drugs: Lidocaine, Amiodarone, Propanamide
• Causes: Untreated V-Tach, post-MI, electrolyte imbalances, pro-arrhythmic medications.

4. Ventricular Tachycardia (V-Tach)

• Memory Trick: VAC = Tombstone pattern.
• Causes: Post-MI, hypoxia, low potassium (hypokalemia), low magnesium.
• Treatment:
  • Early defibrillation
  • Shock for V-Tach without pulse (defibrillate)
  • Cardiovert if V-Tach with pulse (synchronize and sedate first)

5. Atrial Fibrillation (A-Fib)

• Memory Trick: No PVE = Fibrillation.
• Causes: Valvular disease, heart failure, pulmonary hypertension, after heart surgery.
• Treatment:
  • Cardio version after TTE to rule out clots.
  • Digoxin for deeper contraction (monitor apical pulse, toxicity signs).
  • Anticoagulants like Warfarin.

6. Atrial Flutter

• Memory Trick: Saw tooth pattern with two T's.
• Causes and Treatments: Similar to A-Fib.

7. Supraventricular Tachycardia (SVT)

• Memory Trick: Super fast = Supra ventricular.
• Causes: Stimulants, exercise, hypoxia, heart disease.
• Treatment:
  • Vaso vagal maneuvers
  • Adenosine (rapid push, may stop heart rate momentarily)
  • Cardioversion (synchronize first)

8. Torsades de Pointes

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

9. Asystole

• Memory Trick: Assist fully - flatline.
• Treatment: Epinephrine, Atropine, CPR.
• Note: No defibrillation as there's no electrical activity.

Key NCLEX Tips

• Rhythm Keywords:
  • P-wave = Atrial rhythm.
  • QRS = Ventricular rhythm.
  • Chaotic = Fibrillation.
  • Bizarre = Tachycardia.
  • Saw tooth = Atrial flutter.
• NCLEX Focus: Know how to treat and ensure patient safety. Recognize and manage life-threatening conditions.