Telemetry Practice Strips

UMass Memorial Medical Center
Telemetry Practice Strips
When preparing for the telemetry competency, remember to go back to basics. Analyze
each rhythm in the same sequence.
Step 1: Is the rhythm regular?
Step 2: Calculate the heart rate
Step 3: Are there P waves, is there one for each QRS, what is the PR interval?
Step 4: Is there a QRS with each P wave, are they all the same?
Step 5: Interpret, give the rhythm a name
For each of the following 6 second rhythm strips, determine the rate, PR interval (PRI),
QRS interval, interpretation and next course of action.
1.
Rate:
Interpretation:
Next course of action:
2.
PRI:
QRS:
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
3.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
4.
Rate:
Interpretation:
Next course of action:
5.
Rate:
Interpretation:
Next course of action:
6.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
7.
Rate:
Interpretation:
Next course of action:
8.
Rate:
Interpretation:
Next course of action:
9.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
10.
Rate:
Interpretation:
Next course of action:
11.
Rate:
Interpretation:
Next course of action:
12.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
13.
Rate:
Interpretation:
Next course of action:
14.
Rate:
Interpretation:
Next course of action:
15.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
16
Rate:
Interpretation:
Next course of action:
17.
Rate:
Interpretation:
Next course of action:
18.
Rate:
Interpretation:
Next course of action:
PRI:
QRS:
PRI:
QRS:
PRI:
QRS:
19.
Rate:
Interpretation:
Next course of action:
20.
Rate:
Interpretation:
Next course of action:
ANSWERS
1.
Rate: 100-110
PRI: 0.16
QRS: 0.08
Interpretation: Sinus Tachycardia (ST)
Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP
2.
Rate: Underlying rhythm rate 80
PRI: 0.2
QRS: 0.08
Interpretation: Sinus Rhythm (SR) with a burst of paroxysmal supraventricular tachycardia (PSVT)
Next course of action: Check patient, obtain VS and notify MD/LIP
3.
Rate: 70
PRI: unable
QRS: 0.08
Interpretation: Atrial Fibrillation (a-fib)
Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP
4.
Rate: 190
PRI: Unable
QRS: 0.08
Interpretation: Supraventricular Tachycardia (SVT)
Next course of action: Check patient, obtain VS and notify MD/LIP
5.
Rate: 80
PRI: 0.2
QRS: 0.06
Interpretation: SR with pause
Next course of action: Check patient, obtain VS and notify MD/LIP
6.
Rate: 70
PRI: 0.2
QRS: 0.1
Interpretation: SR with peaked T waves
Next course of action: Check patient, check potassium
7.
Rate: 70
PRI: 0.16
QRS: 0.08
Interpretation: SR with frequent premature atrial complexes (PAC)
Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP
8.
Rate: 110
PRI: unable
QRS: 0.08
Interpretation: Junctional Tachycardia
Next course of action: Check patient, obtain VS and notify MD/LIP
9.
Rate: 50
PRI: 0.32
QRS: 0.08
Interpretation: SB with 1st Degree AV Block
Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP
10.
Rate: 30
PRI: Unable
QRS: 0.16
Interpretation: 3rd Degree Heart Block
Next course of action: Check patient, obtain VS and notify MD/LIP immediately, prepare to pace the patient
11.
Rate: 50
PRI: variable
QRS: 0.08
Interpretation: 2nd Degree AV block Type 1 (Wenckebach)
Next course of action: Check patient, obtain VS and notify MD/LIP
12.
Rate: 40
PRI: 0.16
QRS: 0.06
Interpretation: 2nd Degree AV Block Type 2 (Mobitz)
Next course of action: Check patient, obtain VS and notify MD/LIP immediately, prepare to pace the patient
13.
Rate: 90
PRI: 0.16
QRS: 0.08
Interpretation: SR with PVC Couplets
Next course of action: Check patient, obtain VS and notify MD/LIP if couplets persist
14.
Rate: 70
PRI: Unable
QRS: >0.16
Interpretation: 100% Ventricularly Paced
Next course of action: Continue to monitor patient
15.
Rate: 70 (underlying)
PRI: 0.2
QRS: 0.06
Interpretation: SR with 6 beats of Ventricular Tachycardia (VT)
Next course of action: Check patient, obtain VS and notify MD/LIP
16.
Rate: 40
PRI: None
QRS: 0.4
Interpretation: Idioventricular
Next course of action: Check patient, obtain VS and notify MD/LIP immediately, if pulseless, call code
17.
Rate: 40
PRI: 0.2
QRS: 0.08
Interpretation: Sinus Bradycardia (SB)
Next course of action: Continue to monitor patient
18.
Rate: None
PRI: None
QRS: None
Interpretation: Ventricular Fibrillation (VF)
Next course of action: Call Code Blue, obtain AED and prepare to shock the patient
19.
Rate: None
PRI: None
QRS: None
Interpretation: Asystole
Next course of action: Call Code Blue, being CPR
20.
Rate: 70
PRI: Unable
QRS: 0.06
Interpretation: A-Flutter
Next course of action: Check patient, if new onset or patient is symptomatic, notify MD/LIP