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NURSING PART 2 > ECG placement > Flashcards

ECG placement Flashcards

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1
Q

What is an Electrocardiogram?

A

Records cardiac electrical currents by means of metal electrodes placed on the surface of the body.

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2
Q

TRUE OR FALSE: Patient should be treated immediately based on their ECG record

A

FALSE: Patients should be treated according to their symptoms, not merely their ECG.

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3
Q

Meaning of ECG or EKG

A

Electrocardiogram or electrokardiogram

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4
Q

What is an ECG

A

An ECG or EKG is a series of waves and deflections recording the heart’s electrical activity from a certain “view.”

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5
Q

What lead system gives you the complete view?

A

A 12-lead ECG paints a complete picture of the heart’s electrical activity by recording information through 12 different perspectives.

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6
Q

4 positional types of leads

A
  1. Right
  2. Anterior
  3. Lateral
  4. Inferior
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7
Q

What is the 12-lead ECG?

A

These 12 views are collected by placing electrodes or small, sticky patches on the chest (precordial), wrists, and ankles.

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8
Q

Clinical purposes

A
  • To detect heart problems or blockages in the coronary arteries.
  • To draw a graph of the electrical impulses moving through the heart
  • To record heart rate and regularity of heart beats
  • To diagnose a possible heart attack or other heart disorders
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9
Q

How many electrodes are there in 12 lead system?

A

10

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10
Q

Chest lead placements

A

V1 – 4TH ICS Right sternal border
V2 - 4TH ICS Left the sternal border
V3 – Midway between V2 and V4
V4 – 5th ICS Left MCL
V5 – 5th ICS Anterior Axillary line
V6 – 5th ICS Left Mid Axillary line

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11
Q

Limb placements

A

R – Right arm
L – Left arm
F – Foot (left leg)
N – Neutral (Right
foot)

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12
Q

3 Lead system (Cardiac Monitoring)

A

smoke over fire (black lead above
the red lead)

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13
Q

What is a lead?

A

A lead is a glimpse of the electrical activity of the heart from a particular angle. Put simply, a lead is like a perspective.

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14
Q

12 Lead groups

A
  • Lead I
  • Lead II
  • Lead III
  • Augmented Vector Right
    (aVR)
  • Augmented Vector Left
    (aVL)
  • Augmented vector foot
    (aVF)
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15
Q

What are the standard leads (bipolar)

A
  • Lead I - lateral wall
  • Lead II - inferior wall
  • Lead III - inferior wall
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16
Q

What are the augmented leads (unipolar)

A

aVR - no mans land
aVL - lateral wall
aVF - inferior wall

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17
Q

What are the chest leads (unipolar)

A

V1 - septal wall
V2 - septal wall
V3 - anterior wall
V4 - anterior wall
V5 - lateral wall
V6 - lateral wall

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18
Q

What leads are placed in the septal wall or to the septum?

A

V1, V2

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19
Q

What are leads placed in the anterior wall?

A

V3, V4

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20
Q

What leads are placed in inferior wall?

A

Lead II - inferior wall
Lead III - inferior wall
aVF (augmented vector foot)

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21
Q

What leads are placed in lateral wall?

A

Lead I - lateral wall
aVL - lateral wall (augmented vector left)
V5 - lateral wall
V6 - lateral wall

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22
Q

American Heart Association color and placement of leads

A

RA - white
LA - black
RL - green
LL - red

V1 - red
V2 - yellow
V3 - green
V4 - blue
V5 - orange
V6 - violet/purple

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23
Q

International Electrotechnical Commission

A

R - red
L - yellow
N - black
F - green

V1 - red
V2 - yellow
V3 - green
V4 - brown
V5 - black
V6 - violet/purple

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24
Q

An imaginary formation of three limb leads in a triangle used in electrocardiography, formed by the two shoulders and the pubis

A

Einthoven’s triangle

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25
Q

is ECG an invasive or non-invasive procedure?

A

Non-invasive

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26
Q

How should we position the patient during ECG placement

A

Semi-fowler’s position

27
Q

What should we do as we place the pads?

A
  • Chest skin should be dry, hairless, and oil-free.
  • Electrodes should have full contact with the
    patient’s skin. For better electrode adhesion and
    oil-free skin, rub the area with an alcohol prep pad.
28
Q

What pads should we put on first to the patient?

A

Limbs first and then chest leads

29
Q

Do we need to remove the jewelry of the patient?

A

Yes. These must be removed before starting the procedure. Likewise, all personal belonging must be given after the procedure ends

30
Q

What to document?

A

Document (Name, Age, Sex, Date and time
performed)

31
Q

Precautions for ECG placing

A
  • The recording equipment and other nearby electrical equipment should be properly grounded to prevent electrical interference.
  • Double-check color codes and lead markings to be sure connectors match.
  • Make sure that the electrodes are firmly attached, and reattached them if loose skin contact is suspended. Don’t use cables that are broken, frayed, or bare.
32
Q

What is the conduction pathway of the heart?

A
  1. Pacing
  2. Conductive
  3. Non-conductive
  4. Contractile
33
Q

What is Depolarization?

A

The electrical charge of a cell is altered by a shift of electrolytes on either side of the cell membrane. This change stimulates muscle fiber to contract.

34
Q

What is Repolarization

A

Chemical pumps re-establish an internal negative charge as the cells return to their resting state.

35
Q

Chemical pumps re-establish an internal negative charge as the cells return to their resting state.

A

Repolarization

36
Q

The electrical charge of a cell is altered by a shift of electrolytes on either side of the cell membrane. This change stimulates muscle fiber to contract.

A

Depolarization

37
Q

Impulse Conduction of the heart

A
  1. Sinoatrial node (SA)
  2. Atrio-ventricular node (AV)
  3. Bundle of His
  4. Bundle branches
  5. Purkinje fibers
38
Q

Depolarization:___________

A

Dsicharge

39
Q

Repolarization:____________

A

Recharge

40
Q

Normal duration of P wave

A

P wave normal duration is 0.06 to 0.12 seconds

41
Q

Characteristics of P wave

A

Concave and small

42
Q

Clinical Significance: Atrial depolarization

A

P wave

43
Q

Clinical Significance of P wave

A

Clinical Significance: Atrial depolarization

44
Q

normal duration of PR interval

A

PR interval normal duration is 0.12 to 0.20 seconds

45
Q

Characteristics of PR interval

A

Characteristics: Period from the start of the P wave to the beginning of the
QRS complex

46
Q

Clinical significance of PR interval

A

Clinical Significance: AV conduction time

47
Q

normal duration of QRS complex

A

QRS Complex normal duration is 0.06-0.12 seconds

48
Q

characteristics of QRS complex

A

Characteristics: R waves are deflected positively and the Q and S waves
are negative

49
Q

Clinical significance of QRS complex

A

Clinical Significance: Ventricular depolarization

50
Q

Clinical Significance: Ventricular depolarization

A

QRS complex

51
Q

Characteristics: R waves are deflected positively and the Q and S waves
are negative

A

QRS complex

52
Q

Normally not depressed more than 0.5 mm and not elevated no more than 1 mm

A

ST Segment

53
Q

Characteristics: Isoelectric

A

ST Segment

54
Q

Characteristic of ST segment

A

Isoelectric

55
Q

Clinical Significance: Early ventricular repolarization

A

ST Segment

56
Q

Clinical Significance of ST segment

A

Clinical Significance: Early ventricular repolarization

57
Q

Normal values are between 0.30 and 0.44 (0.45 for women) seconds

A

QT segment

58
Q

Clinical Significance: Ventricular depolarization and repolarization

A

QT segment

59
Q

Characteristics: Rounded and asymmetrical

A

T wave

60
Q

characteristics of T wave

A

Characteristics: Rounded and asymmetrical

61
Q

Clinical Significance: Ventricular repolarization

A

T wave

62
Q

clinical significance of T wave

A

Clinical Significance: Ventricular repolarization

63
Q

three stages of a single heartbeat

A

1.Atrial depolarization
2.Ventricular depolarization
3.Atrial and ventricular repolarization

NURSING PART 2 (12 decks)

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