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Module 7 > ECG > Flashcards

ECG Flashcards

1
Q

Automaticity

A

Is the ability to initiate an impulse spontaneously and continuously

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2
Q

Excitability

A

Is the ability to be electronically stimulated - electrically charging cells

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3
Q

Conductivity

A

Is the ability to transmit an impulse along a membrane in an orderly manner

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4
Q

Conduction system

A

Begins in the SA ( making the atria contract) , spreads to the atrium to the AV node ( AV contracts and blood is contracted out)
Goes to left and right bundle branch ( purkinje fibres)

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5
Q

Contractility is known as the

A

Switch in the house that mechanically turns things on

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6
Q

SA rate

A

60-100

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7
Q

AV rate

A

Fires at a rate of 40-60

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8
Q

purkinje fibres rate

A

20 - 40

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9
Q

SA , AV and purkinje fibers are know as the

A

Pace makers of the heart

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10
Q

What makes my AV node override SA fire

A

It can fire itself so if it fills full it will fire up which causes dysrhythmias

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11
Q

Stimulation of the vagus nerve causes

A

A decreased rate of firing of the SA node and slowed impulse conduction of the AV node ( parasympathetic nervous system)

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12
Q

Stimulation of the sympathetic nerves In the heart

A

Increases SA node firing , AV node impulse conduction and cardiac contractility

( sympathetic system)

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13
Q

What does the sympathetic system effect?

A

Pupils expand
Fast and shallow breaths
Heart pumps faster
Gut inactive

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14
Q

Parasympathetic system- how does this effect the body?

A

Pupils shrink
Slow deep breaths
Heart slows
Gut active

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15
Q

Central monitoring

A

Sent to a central place for them to look at and call back like telemetry

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16
Q

Bed side monitoring

A

Monitor at the bed side so we know as soon as possible when something happens

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17
Q

Telemetry monitoring

A

The observation of a patients HR and rhythm at a site distant from the patient

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18
Q

How many leads in electrocardiographic monitoring

A

5 leads

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19
Q

What should we avoid when putting on leads for electrocardiographic monitoring

A

Avoid bony prominences

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20
Q

P wave

A

SA sending out the impulse and causing the contraction of the atrium

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21
Q

QRS

A

Contraction( also known as DEPOLARIZATION) of the ventricles

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22
Q

T wave

A

Resting spot where the heart fills

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23
Q

U wave

A

Similar to the T wave but not seen often

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24
Q

When we are assessing the cardiac rhythm

A

Is the patient hemodynamically stable

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25
Q

What are we looking at when it comes to seeing if a patient is hemodynamically stable

A

BP, HR, SA, O2 monitor, cap refill,

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26
Q

Why should we not treat the monitor and not the patient

A

It may be normal for them

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27
Q

Best places to take pulse

A

Carotid & femoral ( only unconscious)

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28
Q

Normal sinus rhythm

A

60-100 bpm
Starts in the SA node

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29
Q

Causes of bradycardia

A

Medications , high activity level, hypothyroidism, , hypoglycemia, increased intracranial pressure, inferior myocardial infarction ( MI). Anaerobic athlete

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30
Q

1 med that causes bradycardia

A

Betablocker

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31
Q

Drug of choice for bradycardia

32
Q

Atropine

A

For bradycardia

Momentarily will fix HR but not long term so we may have to look at pace makers or stop offending drugs

33
Q

Manifestations of Brady cardia

A

Hypotension
Pale , cool skin
Weakness
Angina
Dizziness or syncope
Confusion or disorientation
Shortness of breathe

34
Q

Sinus Tachy cardia rhythm s/s

A

Dizziness
Dyspnea
Hypotension
Angina in pt with CAD

35
Q

Medication for sinus tachycardia

A

Beta blocker

36
Q

Sinus Tachy cardia bpm

A

101 -180 bpm

37
Q

Drugs that can cause Tachy cardia

A

Epi pen / epi and norepinephrine
Theophylline ( asthma med)
Hydralazine
Ingredience in OTC med pseudoephedrine
Atropine

38
Q

Manifestations of sinus Tachy cardia

A

Dizziness Dyspnea
Hypotension
Angina in pt with CAD

39
Q

Other causes of sinus tachycardia

A

Excercise
Dehydrated
Hypovolemic
Hypertension
Anemia
Hypoxia
Fear
Fever

40
Q

Treatment for sinus tachycardia

A

Treat the cause
A gal maneuver
Betablocker or calcium channel blockers ( must be ordered)

41
Q

Fatal maneuver

A

Ask the pt to bear down or cough really hard to help get the hr Tachy cardia under control

42
Q

What should we not do when a pt has sinus tachycardia

A

Ice water to face or massaging carotid artery unless physician is in the room

43
Q

Rate of heart rate for PSVT

A

151 -220 bpm

44
Q

PSVT distinguished

A

Above the ventricles
Rate 151-220
No p wave
Sudden onset from sinus tachycardia very

45
Q

Drug of choice for PSVT

A

Adenosine
Calcium channel blocker
Amiodarone

46
Q

What is important to keep in mind of adenosine?

A

Give it time for heart to start beating regularly
Rapid half life 2-3 seconds
Needs to be given in 1-3 seconds
Rapid follow with a flush with 20 mL of saline
Use the closest port to the skin and use the next port up to do the flush ( do at the same time)

47
Q

What do you want in the room when administering adenosine?

A

Pt attached to cardiac monitor
Pulse oximeter, pulse ox on
12 lead ekg machine(does not have to be attached
Defibrillator or AED

48
Q

What is the first and second dose of adenosine?

A

6 mg and next dose is 12 mg

49
Q

Drugs to control ventricular rate by blocking the AV in atrial fibrillation

A

Amiodarone
Ibutilide

50
Q

Anticoagulant for an atrial fibrillation

51
Q

PVCs type (premature ventricular contractions)

A

Multi focal
Couplet
Ventricular tachycardia
Ventricular bigeminy
Ventricular trigeminy

52
Q

Multi focal PVS

A

A PVC that occurs after QRS in different shapes or multiple focals

53
Q

Couplet PVC

A

PVC that occurs one after another 2 at a time

54
Q

PVC ventricular tachycardia

A

4 or more PVC that occur

55
Q

Ventricular bigeminy

A

PVC every other beat

56
Q

Ventricular trigeminy PVC

A

Occurs every other three beats

57
Q

First initiation of v fib by nurse

58
Q

What would we never do to someone who has asystole

A

Defibrillate them.. nothing to shock

59
Q

Hs for pulseless electrical activity

A

Hypovolemia
Hypoxia
Hydrogen ion ( acidosis )
Hyper/hypokalemia
Hypoglycemia
Hypothermia

60
Q

Ts in pulseless electrical activity

A

Toxins
Tamponade ( cardiac)
Thrombosis ( MI and pulmonary)
Tension pneumothorax
Trauma

61
Q

First drug of choice in a code

A

Epinephrine

62
Q

Defibrillation biphasic

A

120-200 joules
“Bi”-two
Electricity enters one pad, goes to another and back around to the initial pad

63
Q

Monophasic defibrillation

A

Start at 360 joules

64
Q

What do you start immediately after first shock?

65
Q

Synchronized cardioversion shock when

A

P wave ( tell everyone to stand clear when machine is charging and say clear when done charging))

66
Q

Pacemakers

A

Sense the spontaneous beats or ventricular beats and capture and give it juice to contract

( pacer pt makes a strike straight down)

67
Q

When a pt comes in needing a shock and they have a permanent implanted pacemaker what is important to keep in mind

A

Don’t put the pads over the pace maker

68
Q

Who are we pacing for transcutaneous pacemaker?

A

Someone who comes in with a third degree heart block

69
Q

Isometric line

A

Considered the baseline that everything returns to

70
Q

What happens if baseline is unstable or the isometric line

A

Pt is breathing hard
, problems with leads

71
Q

Most lethal dysrhythmias

A

Asystole
V tach
Third degree block
PEA

72
Q

Atrial dysrhythmias

A

Atrial flutter
Atrial fibrillation
Paraoxymal supraventricular tachycardia

73
Q

Sinus dysrhythmias

A

Do not effect the rhythm

Sinus bradycardia
Sinus tachycardia

74
Q

Ventricular rhythms

A

Ventricular fibrillation
Ventricular tachycardia
Premature ventricular contraction

75
Q

Ventricular fibrillation symptoms

A

Unresponsive
Pulseless
Apneic

76
Q

What rhythm do you cardiovert

A

Psvt
Atrial flutter
A fib

77
Q

What are your shockable rhythm

A

V tach
V fib

Module 7 (24 decks)

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