2025-08-09·9 min read·Clinical Nursing
ECG/EKG Basics for the NCLEX: Reading Rhythm Strips
Learn to identify basic cardiac rhythms including sinus, atrial fibrillation, and ventricular tachycardia.
Normal Sinus Rhythm
Rate 60-100 bpm, regular rhythm, P wave before every QRS, PR interval 0.12-0.20 sec, QRS <0.12 sec.
Common Arrhythmias
- Sinus bradycardia: Rate <60, regular. Treat if symptomatic: atropine
- Sinus tachycardia: Rate >100, regular. Treat the underlying cause (pain, fever, anxiety)
- Atrial fibrillation: Irregularly irregular, no identifiable P waves. Risk of stroke → anticoagulation
- Atrial flutter: Sawtooth P waves, usually regular ventricular rate
- V-tach (ventricular tachycardia): Wide QRS, rate >100. WITH pulse: amiodarone, cardioversion. WITHOUT pulse: defibrillation
- V-fib (ventricular fibrillation): Chaotic, no identifiable waves. Immediate defibrillation + CPR
- Asystole: Flatline. CPR + epinephrine. Do NOT defibrillate asystole
NCLEX Key Points
- V-fib and pulseless V-tach → defibrillate
- Asystole → DO NOT defibrillate
- Atrial fibrillation → anticoagulate to prevent stroke
Study more at Cardiac Disorders cheat sheet and Cardiac Nursing deep dive.