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Medical Nursing > ECG > Flashcards

ECG Flashcards

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1
Q

What does ECG stand for and what does it do?

A

Electrocardiography

measures and records the electrical activity of the heart

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2
Q

What does the p wave represent?

A

Atria depolarising

Width of p wave indicates time travelled

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3
Q

What does the P-R interval represent?

A

Complete depolarisation of the atria

return to base line

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4
Q

What does the QRS wave represent?

A

Ventricle depolarisation

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5
Q

What does the T wave represent?

A

Ventricle repolarisation

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6
Q

What are ectopic beats?

A

Out of place not produce by the SAN, group f cells in the heart that assume the role of pace maker.
Occurs prematurely before SAN recovers

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7
Q

What do ectopic beats look like on an ECG?

What

A

Wide and bizzare no p wave

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8
Q

What type of equipment can be used to measure an ECG?

A

Multiparameter monitors
paper trace monitoring
telemetry (monitoring patients from a distance)

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9
Q

How do you obtain an ECG?

A 
Place the patient in right lateral 
gently place the electrode onto the skin 
apply spirit 
remove sources of interference
ensure good skin contact
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10
Q

What colour electrodes go on which limb?

A

yellow left fore
Red right fore
Black right hind
Green left hind

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11
Q

How should you deal with the ECG troubleshooting?

A 
Check settings on the machine 
leads on the correct limbs
minimise patient movement 
panting or purring 
check contact of the electrodes
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12
Q

When are ECGs used?

A 
Diagnostic work up 
Triage 
Anaesthesia
Monitoring inpatients known arrhythmia
Critical patients 
Newly identified pule deficits
COR 
Metabolic or electrolyte abnormalities 
During pericardiocentesis and central line placement 
Hands off monitoring (blood transfusion)
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13
Q

What is the fire cracker analogy?

A

fuse is similar to your heart
lit at the SAN travels to the AVN and throught the heart causing adjacent muscles to contract
muscles must be recharged (re-polarised) before another beat

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14
Q

Describe the conduction system of the heart

A

SAN controls the heart rate
AVN (slows the impulse down)
bundle of His (spreads the depolarisation wave towards the ventricles)
Right and left bundle branches (depolarisation of right and left ventricle)
Purkinjie fibres (depolarisation of the myocardium)

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15
Q

What are the two types of cardiac cells?

A 
Myocardial cell (walls of the atrium and ventricles responsible fro contraction and stretch-ability) 
Electrical cells (make up the conduction system of the heart, spontaneously generate electrical impulses, transmitting pulse from one cell to the next.
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16
Q

What is the resting potential?

A

Where the cardiac muscles arrange ions (NA, K ca) to prepare itself for action

17
Q

What does the Q wave represent?

A

Depolarisation of the septum

Small wave that travels away from +ve electrode negative deflection

18
Q

What does the R wave represent?

A

Large amount of ventricles depolarising

Travels towards +ve electrode

19
Q

What does the s wave represent?

A

Finishing of the ventricle depolarisation

travelling away from the electrode +ve

20
Q

How should you interpret and ECG?

A 
Look at the rate Tahcy?brady
Is there a p wave for every QRS 
Regular or irregular rhythm 
Sinus or ventricular arrhythmia?
intermittent/continuous
21
Q

List the common types of ECG traces

A 
Sinus bradycardia
Ventricular tachycardia
Idioventricular rhythms
Ventricular premature complexes (VPC)
Supreventricular tachycardia
AV Block or bundle branch blocks
Sick sinus syndrome
Atrial or ventricular fibrillation
Hyperkalaemia arrhythmia
Asystole
22
Q

What are examples of ectopic beats?

A

VPC
APC
JPC (premature junctional complexes)
SVT (supraventricular tachycardia)

23
Q

What is a VPC and what do they look like?

A

ventricular premature beat

Wide and bizare QRS complex with an absent p-wave

24
Q

What are JPC and APCs and what do they look like?

A

Atrial premature contraction
Junctional premature contraction
QRS narrower with no p-wave

25
Q

Why do escape beats occur?

A

Act as a rescue when the SAN is failing with a bradycardia.

wide and bizarre with an absent p-wave

26
Q

What is a sinus rhythm?

A

P for every QRS complex
Regular, regular rhythm
Normal

27
Q

What is a sinus arrhythmia?

A

p for every QRS
regular, irregular rhythm
normal for some breeds
co-insides with resp rate

28
Q

What are the characteristics of a VPC?

A

Absent p-wave
wide and bizare QRS complex
Pulse quality weak
pulse deficits

29
Q

What are the characteristics of ventricular tachycardia?

A 
Irregular, irregular rhythm 
fast rate above 180 
wide and bizarre complexes 
absent p-waves 
VPC, run of 3 in a row 
Pulse deficits 
R on T= VPC is so early it is superimposed on the previous T (life threatening)
30
Q

Describe atrial fibrilation

A

Fibrillating base line
normal QRS
p waves are hidden
irregular, irregular rhythm

31
Q

Describe ventricle fibrilation

A

Coarse of fine irregular, rapid, bizarre movement
no normal wave or complexes
no palpable pulses
Death

32
Q

Describe the first degree av block

A

Normal P QRS

prolonged P-R interval

33
Q

Describe second degree av block (two types)

A 
Mobiz type I 
P-r interval gets longer and longer then snaps back 
Mobiz II 
P-R interval the same 
occasional p waves without QRS
34
Q

Describe third degree av block

A

p waves sometimes followed by an escape beat or a tall QRS-T
p waves occur faster
actual heart rate will be slow

35
Q

Describe the Hyperkalaemia arrhythmia

A

T wave beomes progressively taller with higher levels of potassium
then get large PR interval and wide QRS
then absent p wave

36
Q

Describe sick sinus syndrome

A 
SAN does not work 
escape beats 
Serve bradycardia, tachycardia and periods of arrest 
failure of escape beats 
Tx pacemaker
37
Q

Why is a pacemaker used what are the potential risks and nursing considerations?

A

Sick sinus syndrome
Treatment bradycardia
Expensive
last 5-10 years
Risks- infection, lead dislodgement, failure, GA risks, lead fracture, venous thrombosis
Nursing considerations
Care neck restraint, never take a jugular sample, remove once animal euthanized

Medical Nursing (22 decks)

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