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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
What are we looking at when it comes to seeing if a patient is hemodynamically stable
BP, HR, SA, O2 monitor, cap refill,
26
Why should we not treat the monitor and not the patient
It may be normal for them
27
Best places to take pulse
Carotid & femoral ( only unconscious)
28
Normal sinus rhythm
60-100 bpm Starts in the SA node
29
Causes of bradycardia
Medications , high activity level, hypothyroidism, , hypoglycemia, increased intracranial pressure, inferior myocardial infarction ( MI). Anaerobic athlete
30
#1 med that causes bradycardia
Betablocker
31
Drug of choice for bradycardia
Atropine
32
Atropine
For bradycardia Momentarily will fix HR but not long term so we may have to look at pace makers or stop offending drugs
33
Manifestations of Brady cardia
Hypotension Pale , cool skin Weakness Angina Dizziness or syncope Confusion or disorientation Shortness of breathe
34
Sinus Tachy cardia rhythm s/s
Dizziness Dyspnea Hypotension Angina in pt with CAD
35
Medication for sinus tachycardia
Beta blocker
36
Sinus Tachy cardia bpm
101 -180 bpm
37
Drugs that can cause Tachy cardia
Epi pen / epi and norepinephrine Theophylline ( asthma med) Hydralazine Ingredience in OTC med pseudoephedrine Atropine
38
Manifestations of sinus Tachy cardia
Dizziness Dyspnea Hypotension Angina in pt with CAD
39
Other causes of sinus tachycardia
Excercise Dehydrated Hypovolemic Hypertension Anemia Hypoxia Fear Fever
40
Treatment for sinus tachycardia
Treat the cause A gal maneuver Betablocker or calcium channel blockers ( must be ordered)
41
Fatal maneuver
Ask the pt to bear down or cough really hard to help get the hr Tachy cardia under control
42
What should we not do when a pt has sinus tachycardia
Ice water to face or massaging carotid artery unless physician is in the room
43
Rate of heart rate for PSVT
151 -220 bpm
44
PSVT distinguished
Above the ventricles Rate 151-220 No p wave Sudden onset from sinus tachycardia very
45
Drug of choice for PSVT
Adenosine Calcium channel blocker Amiodarone
46
What is important to keep in mind of adenosine?
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
What do you want in the room when administering adenosine?
Pt attached to cardiac monitor Pulse oximeter, pulse ox on 12 lead ekg machine(does not have to be attached Defibrillator or AED
48
What is the first and second dose of adenosine?
6 mg and next dose is 12 mg
49
Drugs to control ventricular rate by blocking the AV in atrial fibrillation
Amiodarone Ibutilide
50
Anticoagulant for an atrial fibrillation
Warfarin
51
PVCs type (premature ventricular contractions)
Multi focal Couplet Ventricular tachycardia Ventricular bigeminy Ventricular trigeminy
52
Multi focal PVS
A PVC that occurs after QRS in different shapes or multiple focals
53
Couplet PVC
PVC that occurs one after another 2 at a time
54
PVC ventricular tachycardia
4 or more PVC that occur
55
Ventricular bigeminy
PVC every other beat
56
Ventricular trigeminy PVC
Occurs every other three beats
57
First initiation of v fib by nurse
CPR
58
What would we never do to someone who has asystole
Defibrillate them.. nothing to shock
59
Hs for pulseless electrical activity
Hypovolemia Hypoxia Hydrogen ion ( acidosis ) Hyper/hypokalemia Hypoglycemia Hypothermia
60
Ts in pulseless electrical activity
Toxins Tamponade ( cardiac) Thrombosis ( MI and pulmonary) Tension pneumothorax Trauma
61
First drug of choice in a code
Epinephrine
62
Defibrillation biphasic
120-200 joules “Bi”-two Electricity enters one pad, goes to another and back around to the initial pad
63
Monophasic defibrillation
Start at 360 joules
64
What do you start immediately after first shock?
CPR
65
Synchronized cardioversion shock when
P wave ( tell everyone to stand clear when machine is charging and say clear when done charging))
66
Pacemakers
Sense the spontaneous beats or ventricular beats and capture and give it juice to contract ( pacer pt makes a strike straight down)
67
When a pt comes in needing a shock and they have a permanent implanted pacemaker what is important to keep in mind
Don’t put the pads over the pace maker
68
Who are we pacing for transcutaneous pacemaker?
Someone who comes in with a third degree heart block
69
Isometric line
Considered the baseline that everything returns to
70
What happens if baseline is unstable or the isometric line
Pt is breathing hard , problems with leads
71
Most lethal dysrhythmias
Asystole V tach Third degree block PEA
72
Atrial dysrhythmias
Atrial flutter Atrial fibrillation Paraoxymal supraventricular tachycardia
73
Sinus dysrhythmias
Do not effect the rhythm Sinus bradycardia Sinus tachycardia
74
Ventricular rhythms
Ventricular fibrillation Ventricular tachycardia Premature ventricular contraction
75
Ventricular fibrillation symptoms
Unresponsive Pulseless Apneic
76
What rhythm do you cardiovert
Psvt Atrial flutter A fib
77
What are your shockable rhythm
V tach V fib

Module 7 (24 decks)

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