Really need your help- dysrhythmia exam

Published

Hi everyone.

I am new to this forum but have been reading the forums for 1.5 years now. You guys are awesome and really helped me with passing the nclex!!

I just started a job in critical care and am scheduled to take a dysrhythmia exam in 1 week. I bought a practice book that helped me learn the different rhythms.

Here is my problem: when I do rhythms strips I DO get the overall rhythm correct most of the time (i.e. NSR with a run of VT or IVR...)

However, on almost every rhythm I get one of the following wrong:

HR, PR INTERVAL, or QRS COMPLEX (SECONDS).

I'm probably not measuring correctly but have been unable to improve that for a while now.

I really need your help!!!

Any hints, explanations or good resources would be tremendously appreciated!!

Thanks tons!

Up Vote Up Vote ×
Specializes in ER, ICU, Infusion, peds, informatics.

how are you getting it wrong? (too long, too short, completely off....)

are you using calipers? (very important when learning)

is it a math error, or are you having a hard time telling where to measure from?

Up Vote Up Vote ×

I like this site. I think it is pretty clear. I have used this for dysrhythmias for ACLS. I work in OB, so I need to start w/ the most basic.

http://rnceus.com/course_frame.asp?exam_id=16&directory=ekg

Up Vote Up Vote ×

edited

Up Vote Up Vote ×
Specializes in Education, FP, LNC, Forensics, ED, OB.

Check out this thread, too: Helpful Information for the Unit

Up Vote Up Vote ×

To measure HR I divide the number sm. boxes between 2 rr intervals by 1500. However, I often include 1 extra box or exclude 1 box because I'm not sure when to include boxes thatre half filled with the qrs complex.

Same with pr and qrs- I most of the time am off by .2 or so.

Up Vote Up Vote ×
Specializes in ER, ICU, Infusion, peds, informatics.
to measure hr i divide the number sm. boxes between 2 rr intervals by 1500. however, i often include 1 extra box or exclude 1 box because i'm not sure when to include boxes thatre half filled with the qrs complex.

same with pr and qrs- i most of the time am off by .2 or so.

being off by 0.2 is quite a bit. (do you mean 0.02?)

[color=#483d8b]when you measure with your calipers, "set" the calipers by measuring from the begining of the interval to the end of the interval.

[color=#483d8b]then, take the calipers (without changing the distance between the two points) and go to a "clean" part of the strip. put one of the points at the begining of a box, and let the other point fall where it falls. use that to determine the length of the interval, rather than trying to count "partial boxes" where the interval actual starts and stops.

[color=#483d8b]as for rate, the easiest thing to do is count the number of qrs complexes in a six second strip, and then multiply by 10. (unless you need to be more accurate than that). at least, that will give you a good double-check.

Up Vote Up Vote ×
being off by 0.2 is quite a bit. (do you mean 0.02?)

[color=#483d8b]when you measure with your calipers, "set" the calipers by measuring from the begining of the interval to the end of the interval.

[color=#483d8b]then, take the calipers (without changing the distance between the two points) and go to a "clean" part of the strip. put one of the points at the begining of a box, and let the other point fall where it falls. use that to determine the length of the interval, rather than trying to count "partial boxes" where the interval actual starts and stops.

[color=#483d8b]as for rate, the easiest thing to do is count the number of qrs complexes in a six second strip, and then multiply by 10. (unless you need to be more accurate than that). at least, that will give you a good double-check.

i mean .02! sorry:uhoh21:. i havent been using calipers but will go out today and get them. i do need to be more accurate with the rate so therefore i'm using the method i wrote. i use the method of counting the number of qrsx10 for irregular rhythms.

thanks tons for your help.

Up Vote Up Vote ×
+ Add a Comment