Here is a thread with lots of references that might be useful:
Having a system of analyzing each rhythm strip is important.
Look at the same things in the same order each time.
Review the cardiac electrical system and how the impulse originates and is conducted through the heart.
Blaufuss has several wonderful tutorials that, although advanced, may give you an overall picture of what is happening during each cycle. The SVT tutorial is a great visual enhancement. Blaufuss Multimedia - Heart Sounds and Cardiac Arrhythmias
I reviewed each of the rhythm strips and have provided some tips and hints below:
What is the rate: atrial rate? ventricular rate?
Are they the same (is there 1:1 conduction between them)? Normal rate = 60-100 beats per minute(bpm).
slower than 60=bradycardia. Faster than 100= tachycardia
Are there more P waves than QRS's? and are the P waves rapid (around 240bpm) and look like a picket fence? Likely atrial flutter. May have consistent conduction (for example every fourth P wave is conducted and a QRS follows = pulse will be regular) or variable conduction (pulse will be irregular).
Are there QRS's that are regularly irregular, and you cannot discern a clear P wave before each QRS?
May be atrial fibrillation. No P waves (baseline is jiggly but no discernible P wave before each QRS) and the ventricular rate is irregular (impulse is randomly getting through the AV node).
What is the PR interval (normal 0.12-0.20 or, 3-5 small boxes)? Is it the same for each beat?
Longer than 0.20 (200milliseconds) = 1st degree AV block.
Varying interval might be a 2nd degree AV block, Type II (Wenckebach) or Type I.
NO correlation between the P and the QRS = 3rd degree AV block or Complete Heart Block.
NO QRS after each P wave = 3rd degree block and an EMERGENCY. that heart is NOT beating!
If a rhythm strip is NSR (normal sinus rhythm) and every beat is quite regular, except ONE:
could be a
PVC (Premature Ventricular Contraction: wide and bizzare shape, no P wave before, and occurs earlier than the next anticipated beat.)
PAC (Premature Atrial Contraction): P wave followed by a QRS, but appears earlier than the next anticipated beat. QRS may be normal or wide (caused by aberrant conduction after the P wave).
NO discernible P waves or QRS's = asystole (absence of electrical activity)