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Hemodynamics > Ch.18 Egans > Flashcards

Ch.18 Egans Flashcards

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1
Q

The _____ is the most important diagnostic tool that in some settings is obtained by the respiratory therapist

A

ECG

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2
Q

Why is the ECG so popular?

A
  • inexpensive
  • noninvasive
  • easy to obtain
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3
Q

Why is the ECG used?

A

To help evaluate a pt with signs and symptoms of cardiac disease

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4
Q

What can an ECG also be used for?

A

To detect abnormalities that already occur in pts w/ an MI or preoperative screening

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5
Q

The muscle cells of the heart normally are stimulated and pace by the electrical activity of the cardiac______?

A

Impulse conducting system

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6
Q

The cardiac muscle cells generate electrical imbalance across the cell membrane with a ________charge on the outside, and a _______charge on the inside

A

Positive ; negative

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7
Q

What is the resting or polarize state?

A

When there is no electrical activity

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8
Q

Stimulation of _______ cells causes an influx of ______into the interior portion of the cell?

A

Polarized ; Na+

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9
Q

An influx of Na+ into the interior portion of the cell is called what?

A

Depolarization

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10
Q

Depolarization causes the cardiac muscle cells to ________momentarily?

A

Contract

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11
Q

Depolarization is immediately followed by what?

A

Repolarization

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12
Q

What is a repolarization?

A

A rapid return of the cell to the “polarized” position in which an electrical imbalance across the membrane is reestablished

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13
Q

The impulse conduction system has three types of cardiac cells capable of electrical excitation. What are they?

A

• Pacemaker cells
• specialized rapidly conducting tissue
• AV muscle cells

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14
Q

The ability of the cells to depolarize without stimulation is known as_______?

A

Automaticity

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15
Q

The impulse conduction system is responsible for_____ and _______? It also does what?

A

Initiating the heartbeat ; controlling the heart rate ; coordinates the contraction of the heart chambers

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16
Q

A deceptive the impulse conduction system may lead to what?

A

Inadequate cardiac output and decreased tissue perfusion

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17
Q

Where is the SA node located?

A

Upper portion of the right atrium

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18
Q

T or F the SA node has the greatest degree of automaticity and paces the heart

A

True

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19
Q

The AV node is the _______ pacemaker

A

Backup

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20
Q

T or F the AV node has the second greatest degree of automaticity in a healthy heart

A

True

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21
Q

The AV node paces ventricular activity at a lower heart rate of _______?

A

40 to 60 bpm

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22
Q

Once the impulse exits the AV node where does it go?

A

It enters the bundle of His and rapidly moves to the bundle branches

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23
Q

The bundle branches_______ the purkinje fibers

A

Terminates

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24
Q

What is the equipment that is gathered for a 12 lead ECG?

A

• portable ECG unit
• lead wires
• electrodes

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25
The 12 leads are subdivided into two groups:
6 extremity (limb) leads 6 chest (percordial) leads
26
The 12 leads are bipolar which means what?
They permit the measurement of electrical activity in two different directions
27
What are the limb leads called?
1,2,3,aVr, aVL, aVf
28
What are the six chest leads called?
V1, V2, V3, V4, V5, V6
29
Where is the V1 lead located?
The fourth intercostal space to the right of the sternum
30
Where is the V2 lead located?
In the fourth intercostal space just to the left of the sternum and ending with a V6
31
How large is one box on an ECG?
0.20 seconds
32
How large is one small box within one box on the ECG?
0.04 seconds
33
If the QRS complex is longer than three small boxes, what does that mean?
There are ventricular problems
34
The QRS complex on the ECG equals how many small boxes?
3 small boxes
35
What is the number one cause of sinus tachycardia?
Hypoxemia
36
What is the treatment for bradycardia?
Atropine
37
What are the steps to interpreting an ECG?
1. Identify the atrial and ventricular rates 2. Measure the PR interval 3. Evaluate the QRS complex 4. Evaluate the T-wave 5. Evaluate the ST segment 6. Identify the RR interval 7. Identify the mean QRS axis
38
A normal sinus rhythm has what type of P wave?
Upright
39
How long does the PR interval last?
0.12 to 0.20 seconds
40
How long does the QRS complexes last?
0.12 seconds
41
The ST segment is _____?
Flat
42
How long does the PR interval last?
0.12 seconds between QRS complexes
43
What is the normal adult heart rate?
60-100bpm
44
What is sinus arrhythmia?
It’s recognized by the irregular spacing between QRS complexes
45
How long does the RR interval last during a sinus arrhythmia?
More than 0.12 seconds
46
Sinus arrhythmia may occur with affects of breathing on the heart, or as a side effects of medication, such as______?
Digoxin
47
Most cases of sinus arrhythmia are______ and do not need treatment?
Benign
48
What is first-degree heart block?
The PR interval is longer than 0.20 seconds
49
What is another name for second-degree heart block?
Type 1(Wenckebach or Mobitz type 1)
50
What is third-degree heart block?
It indicates that the singnal between the atria and the ventricles is completely block
51
The atria and ventricles are paced by _____ sources?
Independent
52
In 3rd degree block the P-P and R-R intervals are _____ but have no correlation with each other
Regular
53
What is atrial flutter?
The rapid depolarization of the atria resulting from an ectopic focus that depolarizes at a rate of 250 to 350 times per minute
54
What kind of pattern will you see in atrial flutter?
Sawtooth baseline pattern
55
What kind of conditions can produce atrial flutter?
Rheumatic heart disease, coronary heart disease, pulmonary embolism, stress, renal failure, and hypoxemia
56
What is the treatment for atrial flutter?
Digoxin, beta blockers, calcium channel blockers
57
What is atrial fibrillation?
The atrial muscle quivers in an irregular pattern
58
The ventricular rate is often very______ in atrial flutter
Irregular
59
What is ventricular tachycardia?
A run of three or more PVCs
60
What do the waves look like on ventricular tachycardia?
A series of wide bizarre QRS complexes that have no preceding P wave
61
What is the ventricular rate for ventricular tachycardia?
100 to 250 bpm
62
What is ventricular fibrillation?
Erratic quivering of the ventricular muscle mass it causes the cardiac output to drop to zero
63
What is the most life-threatening arrhythmia?
Ventricular fibrillation
64
What kind of shape will you see in ventricular fibrillation?
Irregular fluctuations with a zigzag pattern
65
How do you fix ventricular fibrillation?
• Rapid defibrillation • cardiopulmonary resuscitation • administration of O2 • anti-arrhythmic medications
66
A V-tach is left untreated what could it progress to?
V-fib
67
What are some meds for V fib?
Amiodarone or adenosine
68
What is some medication for PVCs?
Lidocaine
69
What is PEA?
A serious condition characterized by a disassociation between the electrical and mechanical activity of the heart
70
What happens during PEA?
The heart generates an electrical signal that produces an ECG pattern on the monitor but the heart does not mechanically generate a pulse
71
PEA is relatively_______?
Rare
72
What kind of conditions will you see with PEA?
• Pneumothorax • MI • Drug overdose • Severe electrolyte or acid base disturbance
73
What are the Hs? **7 total**
• Hypovolemia • hypoxia • hyperkalemia • hypokalemia • hyperthermia • hypoglycemia • acidotic state too much H+ ions
74
What are your Ts? **6 total**
• Trauma • Tension pneumothorax • Toxins (poison) • Tamponade (cardiac) • Thrombosis (coronary) • Thrombosis (pulmonary)
75
Name this arrhythmia?
Normal sinus rhythm
76
Name this arrhythmia?
Sinus tachycardia
77
Name this arrhythmia?
Sinus bradycardia
78
Name this arrhythmia?
Sinus arrhythmia
79
Name this arrhythmia?
First-degree heart block
80
Name this arrhythmia?
Second-degree heart block type 2
81
Name this arrhythmia?
Third-degree heart block
82
Name this arrhythmia?
Atrial flutter
83
Name this arrhythmia?
Atrial fibrillation
84
Name this arrhythmia?
PVC
85
Name this arrhythmia?
Ventricular tachycardia
86
Name this arrhythmia?
Ventricular fibrillation

Hemodynamics (14 decks)

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