Daily Lesson Plan

:Lesson plan title

Sinus Interpretation and Dysrhythmias

:Purpose of the lesson

This lesson will prepare learners in interpretation of rhythms on an ECG, and be able to identify
P and T waves, and QRS complexes for use in clinical practice. Nursing students’ presenting in
an intensive care unit need to recognize the basic concepts for interpretation of normal sinus
.rhythms to advance to the more complicated and lethal rhythms

:Theoretical framework

Benner’s stages of clinical competence (from Novice to Competent) are applicable to

:this Lesson

:Teaching Methods

 Lecture
 Group Discussion
 Simulation
:Instructional Aids

 White board
 Handouts
 Computer based simulation
 Projector

:General goal

To teach nursing students how to interpret normal rhythms’ on an ECG, understand and interpret
.the concepts of a P wave, QRS complex and T wave

:Specific objectives

At the completion of this lesson, the learner will be able to:

 Identify waveforms of the cardiac cycle correctly.
 Correctly identify ECG strips of normal sinus rhythm.
 Identify at least two pacemaker malfunctions.
 Interpret 100% accuracy all the abnormal Sinus rhythms strips.

Length of time:

3 hours, (0800-1100)

Activity Topic Time

Lecture / Group Discussion Introduction 0815 - 0800
Electrocardiogram Waveforms,
Lecture / Group Discussion 0845 – 0815
.Segments, Intervals

Group Discussion / Simulation Analyzing a Rhythm Strip 0910– 0845

practice :Analyzing rhythm
Lecture / Group Discussion Sinus Arrhythmias 0940 - 0910

Lecture Pacemaker malfunction 0955 - 0940

Presentation/ Simulation practice Abnormal sinus rhythms 0955-1020
Rhythm Strip Practice Practice ECG 1020-1040
Review the lesson and address
Closure 1100- 1040
further question
Resources:

 Newberry, L. 2010. Sheehy’s Emergency Nursing: Principles and Practice. 6th Edition.
USA: Mosby.
 Lynn-McHale Wiegand, DJ and Carlson, KK. 2005. AACN Procedure Manual for
Critical Care. USA: Evolve Elsevier.
 Hampton, J. (2008). The ECG made easy (7th ed.). Edinburgh: Elsevier/Churchill
Livingstone.
 ECG Simulator - SkillSTAT. (n.d.). Retrieved April 8, 2015, from
http://www.skillstat.com/tools/ecg-simulator.

Evaluation:

Multiple-choice (A Selected Response Item Type)

 Contains an incomplete phrase or ask a question, followed by a number of responses,
may have more than one answer that is correct.
 Only the best answer or option.
 Useful to measure learning at cognitive levels of knowledge, comprehension, application,
and analysis.
 Quiz on Sinus Arrhythmias

Student Name: Grade: /10

Take a following question quiz to test your rhythm strip interpretation skills.
Please review each Rhythm Strip and select your answer from the choices provided. You must
complete all of the questions in order to view your results.

:Remember to run through this checklist as you first scan any ECG

 Check the R—R interval --Is the rhythm regular or irregular?

 Check the P waves—are the P waves visible and do they all look alike?
 Check the QRS--- Do the QRS waves all look alike? Are any of the QRS waves wide or
bizarre looking?
 Check the relationship between the P and QRS—is there a P wave for every QRS? Is the
P-R interval normal and consistent?
As you prepare to write up the measurements, take these steps:

 Determine rate
 Determine if rhythm is regular or irregular: check the R-R intervals
 Interpret the rhythms

:Question 1

.The heart rate of this dysrhythmia is ___ beats per minute

 30
 40
 65
 70

.This dysrhythmia has a/an _____ rhythm

 Regular
 Very irregular
 Occasionally irregular
 Regular irregular
:This dysrhythmia is
 normal sinus rhythm
 sinus arrest
 sinus dysrhythmia
 sinus bradycardia

:Question 2

.The heart rate of this dysrhythmia is ___ beats per minute

 30
 40
 65
 70

.This dysrhythmia has a/an _____ rhythm

 Regular
 Very irregular
 Occasionally irregular
 Regular irregular

:This dysrhythmia is
 normal sinus rhythm
 sinus arrest
 sinus dysrhythmia
 sinus bradycardia
:Question 3

.The heart rate of this dysrhythmia is ___ beats per minute

 69
 60
 79
 75

.This dysrhythmia has a/an _____ rhythm

 has a QRS complex that is narrower than normal
 cause it to be regularly irregular
 irregular irregular
 irregular

:This dysrhythmia is
 sinus rhythm
 sinus dysrhythmia
 junctional rhythm
 wandering atrial pacemaker

:Question 4

.The heart rate of this dysrhythmia is ___ beats per minute

 94
 110
 125
 140

.This dysrhythmia has a/an _____ rhythm

 Regular
 Very irregular
  Occasionally irregular
 Regular irregular

:This dysrhythmia is
 normal sinus rhythm
 sinus tachycardia
 sinus dysrhythmia
 sinus bradycardia

:Question 5

.The heart rate of this dysrhythmia is ___ beats per minute

 88
 79
 100
 84

.This dysrhythmia has a/an _____ rhythm

 Regular
 Very irregular
 Occasionally irregular
 Regular irregular

:This dysrhythmia is
 sinus rhythm with artifact
 sinus tachycardia
 sinus dysrhythmia
 Atrial fibrillation

Good Luck