EKG

Question 1

what is the primary pacemaker for the heart?

Answer 1

the SA node

Question 2

2 body systems that control heart rate

Answer 2

PNS / SNS

Question 3

what happens during atrial depolarization?

Answer 3

cells become more negative – atrium contracts –> filling of ventricles

Question 4

Sa node fires- what part of ekg?

Answer 4

p wave

Question 5

ventricles fillings a lil more = what part of ekg?

Answer 5

PR segment

Question 6

______ _______ slow down the electrical impulses on their way to ventricles (why do i care?)

Answer 6

transitional cells
◦ This delay allows atrial contraction and ventricular filling
–> represented by PR segment

Question 7

what is the PR interval composed of? (2 parts)

Answer 7

p wave and PR segment

Question 8

how long should the PR interval be?

Answer 8

0.2 - 0.10 seconds

Question 9

what part of EKG represents ventriclular depolarization (contraction)?

Answer 9

QRS complex

Question 10

can the ventricles start an impulse?

Answer 10

yes! they contain nodal cells which can cause the ventricles to start an impulse but its not what we want - es muy mal

Question 11

which part of the EKG represents ventricular repolarization?

Answer 11

T wave

Question 12

which part of the EKG represents early ventricular repolarization?

Answer 12

ST segment

Question 13

how many pictures of the heart does a 12 lead show us? how many electrodes are there?

Answer 13

◦ 12 lead system has 10 electrodes but shows us 12 pictures

Question 14

how often do we change the electrodes?

Answer 14

q24 hours

Question 15

the top 2 leads are placed where?

Answer 15

on the out portion of the 2nd intercostal

Question 16

what does a positive deflection look like on an ekg?

Answer 16

line rises up

Question 17

what does a negative reflection look like on an ekg?

Answer 17

dip down

Question 18

what is it called when a line moves straight across an EKG?

Answer 18

isoelectric

Question 19

tiny little box. = _____ seconds

Answer 19

0.04

Question 20

1 big box. = ______ seconds

Answer 20

0.20

Question 21

5 big boxes = ______ seconds

Answer 21

1.0 seconds

Question 22

30 big boxes = _______ seconds

Answer 22

6 seconds

Question 23

how can we calculate the heart rate on an ekg?

Answer 23

count the # of QRS complexes in 6 seconds (30 big boxes) and multiply by 10 = Heart Rate

Question 24

what should the PR segment look like?

Answer 24

isoelectric

Question 25

which parts of QRS complex are sometimes not visible?

Answer 25

Q and S

Question 26

will R be a positive or negative defelction?

Answer 26

positive

Question 27

What is happening during the QRS complex?

Answer 27

= ventricular depolarization = ventricular contraction = squeezing blood out

Question 28

what should the ST segment look like on a normal EKG?

Answer 28

isoelectric

Question 29

what should the T wave look like? what does T wave represent?

Answer 29

• SHOULD be positive, round and symmetrical
= Ventricular repolarization

Question 30

______ wave Represents slow repolarization of Purkinje fibers in ventricles

Answer 30

U
—> its not normal!

Question 31

what does the QT interval represent?

Answer 31

=time it takes for ventricular depolarization and repolarization to occur (contract and rest)

Question 32

normal range for QT interval?

Answer 32

0.36-0.44 seconds

Question 33

this is an emergency that can happen with a prolonged QT interval and it looks like a party streamer

Answer 33

Torsades de Pointe

Question 34

causes of artifact on EKG

Answer 34

• Check your patient before you panic… ASSESS
• Interference on the monitor
• Movement
• Old electrodes –> change the electrodes everyday
• Poor contact of electrodes
• Faulty equipment

Question 35

8 basic steps of EKG analysis

Answer 35

1.Determine HR
2.Determine Rhythm
3.Analyze P waves
4.Measure PR Interval
5.Measure QRS Duration
6.Examine ST Segment
7.Assess T wave
8.Measure QT interval

Question 36

Step 1 of ekg interpretation - heart rate- how do we do it?

Answer 36

◦ 6-second strip (30 big boxes) rule- count the QRS complexes and multiply X 10

Question 37

step 2 ekg interpretation- how do we determine the heart rhythm?

Answer 37

◦ Is it regular? Irregular?
◦ March out the beats… P –P interval (first), R-R interval (peak)

Question 38

step 3 ekg interpretation - how do we analyze the p waves?

Answer 38

◦ Regular occurrence and shape?
◦ 1:1 ratio with QRS? - for every p wave there should be a QRS complex
◦ Do they all look similar to one another?

Question 39

step 4 eky interpreation - how do we measure the PR interval?

Answer 39

◦ Place caliper points at beginning of P wave and end of PR segment
◦ Count blocks (# of blocks X 0.04) –> Should be 0.12-0.20 seconds
◦ Are they constant? > 0.20? (taking heart longer time to contract atria) < 0.12?

Question 40

step 5 ekg interpretation- how do we measure the QRS duration? what is normal?

Answer 40

◦ Place caliper points at beginning of QRS and at end of QRS
◦ Count blocks (# of blocks X 0.04)

Should be between 0.04 and 0.10 seconds
◦ Are they constant? More than 0.10? Less than .04?

Question 41

step 6 ekg interpretation - what are we looking for in the ST segment?

Answer 41

◦ Is it isoelectric? (good) Is it elevated? Is it depressed? (is it elevated or depressed= > one small block (1 mm = 1 lil box), two or more leads?)

Question 42

step 7 ekg interpretation- what are we looking for in the T wave?

Answer 42

◦ is it rounded and fairly symmetrical? (first bump after isoelectric ST)

Question 43

step 8 of ekg interpretation - how do we measure the QT interval?

Answer 43

◦ Place Caliper points at beginning of QRS complex and end of T wave
◦ Count small boxes and multiply by 0.04
◦ Can compare to R-R interval and divide by 2 for normal (or 0.36-0.44)
‣ should be < 1/2 of r-r interval

Question 44

step 9 ekg interpretation =

Answer 44

shake your head and say thank god i’m done looking at that