ECG MONITORING Flashcards
ECG/EKG
RECORD OF THE HEART’S ELECTRICAL ACTIVITY, BUT SAYS NOTHING ABOUT THE MECHANICAL PUMPING ABILITY OF THE HEART
THREE TYPES OF ECG MONITORING LEADS
BIPOLAR, SEGMENTED, AND PRECORDIAL
P WAVE IS INVERTED IN LEAD
AVR
P WAVE IS UPRIGHT IN LEAD
I, II, III, AND AVF
P WAVE AMPLITUDE IS GREATEST IN LEAD
II
ONE SMALL BOX
0.04 SEC
1 LARGE BOX
(5 SMALL BOXES) = 0.2 SEC
Q WAVE
THE FIRST NEGATIVE DEFLECTION
R WAVE
THE FIRST POSITIVE DEFLECTION
S WAVE
THE FIRST NEGATIVE DEFLECTION AFTER THE R WAVE
IF THE QRS IS GREATER THAN 0.12 SECS, THE ORIGIN IS MOST LIKELY FROM
THE VENTRICLES
IF THE QRS IS GREATER THAN 0.12 SEC, THIS MAY SIGNIFY WHAT?
DELAYED CONDUCTION IN ONE OR MORE OF THE BUNDLE BRANCHES
IF THE QRS IS LESS THAN 0.08, THEN THE ORIGIN IS FROM
THE ATRIUM OR AV NODE
ST ELEVATION
MYOCARDIAL INFARCTION
ST DEPRESSION
MYOCARDIAL ISCHEMIA
A LONGER QT INTERVAL MEANS
A SLOWER VENTRICULAR REPOLARIZATION AND A LONGER RELATIVE REFRACTORY PERIOD; POTENTIAL FOR LETHAL ARRHYTHMIAS
U WAVE
RECOVERY PERIOD OF THE PURKINJE FIBERS;
HYPERCALCEMIA, HYPOKALEMIA, OR DIGITALIS TOXICITY
IF P WAVES ARE NOT PRESENT, THE ORIGIN MAY BE IN THE
AV JUNCTION OR VENTRICLES
ALL AV HEART BLOCKS HAVE
REGULAR P-P INTERVALS
IF THE PR INTERVAL IS LESS THAN 0.12
JUNCTIONAL RHYTHM
IF THE PR INTERVAL IS GREATER THAN 0.12
POSSIBLE SR
IF THE P WAVES LOOK DIFFERENT
WONDERING/MULTIFOCIAL ATRIA
THE NORMAL LENGTH OF THE PR INTERVAL IS
0.12 AND 0.20 (3-5 SMALL BOXES)
IF THE PR INTERVAL IS GREATER THAN 0.20
1ST DEGREE HEART BLOCK
LONGER, LONGER, BLOCK IS A
2ND DEGREE WENKEBACH (MOBITZ I)
CONSISTENT PR INTERVALS THEN BLOCK IS A
2ND DEGREE MOBITZ II
INCONSISTENT PR INTERVALS IS A
COMPLETE HEART BLOCK (3RD DEGREE)
NORMAL QRS DURATION IS
0.04 TO 0.12 SECONDS (1-3 SMALL BOXES)
IF THE QRS IS GREATER THAN 0.12
THE BEAT ORIGINATES FROM THE VENTRICLES (WIDE COMPLEX)
IF THE QRS DONT LOOK THE SAME AND ARE WIDE
MULTIFOCAL
STROKE VOLUME
THE AMOUNT OF BLOOD EJECTED BY THE LEFT VENTRICLE WITH EACH CONTRACTION
PRELOAD
VOLUME/PRESSURE IN THE VENTRICLES AT THE END OF DIASTOLE
AFTERLOAD
THE RESISTANCE THE VENTRICLES HAVE TO PUSH AGAINST TO GET THE VALVES TO OPEN TO GET THE BLOOD OUT THE VENTRICLES
FRANK STERLING LAW
MORE STRETCH = MORE CONTRACILITY; THE MORE STRETCH, THE HARDER IT WILL CONTRACT TO EMPY
SYMPATHETIC NERVOUS SYSTEM
EPINEPHRINE AND NOREPINEPHRINE
ADRENERGIC RECEPTORS
ALPHA - VASOCONSTRICTION
BETA- VASODILATION
INCREASE HR
PARASYMPATHETIC NERVOUS SYSTEM
ACETYCHOLINE
CHOLINERGIC
DECREASE HR
CHRONOTROPIC
MEDICATIONS THAT AFFECT HEART RATE (INCREASE OR DECREASE HR)
INOTROPIC
MEDICATIONS THAT AFFECT THE STRENGTH OF THE CONTRACTION
DROMOTROPIC
MEDICATIONS THAT AFFECT THE SPEED OF CONDUCTION VIA THE AV NODE AND THE RATE OF ELECTRICAL IMPULSES THAT PASS THROUGH IT
