front 1 EKG or ECG stands for: | back 1 Electrocardiogram |
front 2 What can an EKG detect? | back 2 abnormalities of the heart like ischemia dysrhythmia, ischemia, electrolyte imbalance, effects of cardiac medications, damage caused by an MI |
front 3 Define arrhythmia | back 3 abnormal cardiac rhythm (think a= without, without rhythm) |
front 4 Define ischemia | back 4 lack of blood supply |
front 5 What is the electrical pathway of the heart's conduction system? | back 5 SA node->AV node->Bundle of His->Right and Left Bundle Branches->Purkinje fibers |
front 6 When the SA node is stimulated, what mechanical action happens in the heart? | back 6 Atria contract |
front 7 What has to happen for the ventricles to contract? | back 7 Electrical conduction has to pass through the AV node, down the Bundle of His, through the right and left bundle branches, into the purkinje fibers. Once they reach the Purkinje fibers, then the ventricles will contract. |
front 8 Electrodes | back 8 sticky skin sensors that attach to the patient |
front 9 What is the purpose of the gel on the electrodes? | back 9 to read the heart's electricity and to amplify the waveforms |
front 10 EKG machine is also called an: | back 10 electrocardiograph |
front 11 Name the 2 types of EKG machines: | back 11 Single channel and multichannel |
front 12 When we do an EKG we are looking at the heart from : | back 12 12 different points of view or angles |
front 13 How many electrodes are used to perform an EKG? | back 13 10 |
front 14 What is an amplifier? | back 14 Magnifies the heart's electrical signal so it can be recorded. |
front 15 What is the stylus? | back 15 records the motion on the graph paper by burning the impression into the heat-sensitive paper. |
front 16 Name the limb leads. | back 16 RA, LA, LL, RL |
front 17 What is unique about EKG paper? | back 17 It is head-sensitive and pressure-sensitive. |
front 18 How big is a small block on EKG paper? | back 18 1mm x 1 mm |
front 19 How big is a large block on EKG paper? | back 19 5mm x 5 mm |
front 20 What speed does normal EKG paper run? | back 20 25mm per second |
front 21 Why would a CCMA increase the speed of the EKG paper? | back 21 If the heart rate were very fast, the speed would be increased to 50mm per second. |
front 22 How much TIME does each small square on EKG paper represent? | back 22 0.04 seconds |
front 23 How much TIME does each large square on EKG paper represent? | back 23 0.2 seconds |
front 24 What is another name for amplitude? | back 24 Gain |
front 25 Define amplitude/gain. | back 25 how tall the tracing is. It is represented by 1x, 2x, or 3x. |
front 26 How big is the normal amplitude/gain on an EKG? | back 26 2 large boxes or 10 small boxes |
front 27 What is the purpose of standardization? | back 27 it is the process of making sure that an EKG on one machine will compare to the EKG on another machine. |
front 28 What does the standardization mark look like? | back 28 Upside down U or a rectangle with the bottom out of it. |
front 29 Name the chest or precordial leads (wires): | back 29 V1, V2, V3, V4, V5, V6 |
front 30 What are the leads RA, LA, RL, LL collectively called? | back 30 Limb leads |
front 31 A 6 second strip in Lead II is called a | back 31 rhythm strip |
front 32 Which lead (view) is a rhythm strip usually taken in? | back 32 Lead II |
front 33 Which lead (wire) is always the ground | back 33 right leg |
front 34 Which 3 leads (views) make up Einthoven's Triange? | back 34 Lead I, II, and III |
front 35 Which 3 leads (views) are the augmented leads? | back 35 AVR, AVF, AVL |
front 36 Which leads (views) are the Precordial or Vector leads? | back 36 V1, V2, V3, V4, V5, V6 |
front 37 What education should you give to your patient before starting the EKG? | back 37 It is a non-invasive test that won't hurt, have to lie still, clothing should be removed from the waist up, no jewelry, gown open in the front. Any lotion needs to be removed with alcohol pads. Empty their bladder 10 minutes prior to the exam. |
front 38 How should the patient be positioned when performing an EKG? | back 38 supine position, arms at the sides, or semi-fowlers |
front 39 Where to do the limb leads go? | back 39 Right leg, Left leg, Right arm, Left arm |
front 40 Where is V1 placed? | back 40 4th intercostal space on the right sternum |
front 41 Where is V2 placed? | back 41 4th intercostal space on the left sternum |
front 42 Where is V3 placed? | back 42 Between V2 and V4 |
front 43 Where is V4 placed? | back 43 Mid-clavicular line on the left side, 5th intercostal space |
front 44 Where is V5 placed? | back 44 Anterior Axillary left side, 5th intercostal space |
front 45 Where is V6 placed? | back 45 Mid-axillary line on the left side, 5th intercostal space |
front 46 What order do you place the chest leads? | back 46 V1, V2, V4, V3, V5, V6 |
front 47 How are right-sided EKG leads placed? | back 47 Exactly the same as the left except on the right side. |
front 48 What additional documentation must occur with the right-sided EKG? | back 48 Labeled with an "R". |
front 49 Why would a right-sided EKG be done? | back 49 right-sided MIs, inferior MIs, patients less than 8 years old. |
front 50 How are posterior EKG leads placed differently than a left sided EKG? | back 50 Limb leads and V1-V3 are the same. V4 = V7- posterior axillary line, V5=V8- midscapular line, V6=V9- left spinal border. |
front 51 Why would a posterior EKG be ordered? | back 51 when a posterior MI is suspected |
front 52 What does the P wave represent? | back 52 atrial depolarization (atrial contraction) |
front 53 What does the QRS complex represent? | back 53 ventricular depolarization (ventricular contraction) |
front 54 What does the T wave represent? | back 54 Ventricular repolarization (ventricular relaxation) |
front 55 An elevation or depression of the ST segment can indicate what? | back 55 ischemia or injury to the heart muscle |
front 56 What is the "normal" heart rhythm? | back 56 Normal sinus rhythm |
front 57 What is a normal heart rhythm that is less than 60 bpm? | back 57 sinus bradycardia |
front 58 What is a normal heart rhythm that is greater than 100 bpm? | back 58 sinus tachycardia |
front 59 What are the two shockable, life-threatening cardiac rhythms? | back 59 Ventricular Tachycardia and Ventricular Fibrillation |
front 60 What is a "flat line" rhythm? | back 60 asystole |
front 61 What is the rhythm that has small "spikes" before the P wave or QRS complex? | back 61 Paced rhythm |
front 62 What are the 3 ways we learned to calculate a heart rate on an EKG? | back 62 1500 method, Sequence method, 6-second rule |
front 63 Explain the 1500 method. | back 63 Count the small boxes between R waves and divide by 1500 |
front 64 Explain the sequence method for calculating a heart rate | back 64 Use the big boxes and follow this sequence: 300, 150, 100, 75, 60. If the QRS falls between two large boxes, figure out the average. |
front 65 Explain the 6-second method for calculating a heart rate. | back 65 Count the number of QRS complexes on a 6-second strip and multiple by 10. |
front 66 What is a holter monitor? | back 66 An ambulatory ECG that monitors patients for 24-48 hours |
front 67 What events should be documented in the diary of a patient wearing a holter monitor? | back 67 exercise, sexual activity, stressful events, emotional events, s/s of chest pain, SOB, dizziness. |
front 68 What should be included in the documentation of a patient wearing a holter monitor? | back 68 Date, time, and what occurred during the event |
front 69 What instructions should you tell your patient if they are wearing a holter monitor? | back 69 Wear loose clothing, do not shower or get it wet, use tape to help secure the leads if needed, if the leads come off-they must return to the physician's office. |
front 70 What is a Cardiac Stress Test? | back 70 The patient exercises while wearing a monitor to determine if the heart is receiving enough blood during stressful events. |
front 71 What are some potential complications of stress testing? | back 71 SOB, nausea, syncope (fainting), heart attack. |
front 72 What equipment must be in the room during a stress test? | back 72 Emergency Equipment (crash cart): monitors, oxygen, defibrillator, intubation tray, ambu bag, emergency meds |
front 73 If you don't know how to use your ECG machine or holter monitor, where should you look? | back 73 At the manufacturer's user manual |
front 74 Define artifact | back 74 abnormal waveform on an EKG tracing |
front 75 Somatic Tremor | back 75 artifact caused by voluntary or involuntary muscle movement. |
front 76 Wandering Baseline | back 76 when the tracing shifts from the baseline, usually caused by poor connection with the skin. |
front 77 AC Interference | back 77 uniform spikes on an EKG caused by electrical interference. |