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Patient care > EKG > Flashcards

EKG Flashcards

1
Q

each small square on an EKG is?

A

1mm on each side

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2
Q

each 5th square on a EGK is…

A

is a larger darker sq. measuring 5mm

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3
Q

at normal speed one small square passes the stylus every

A

0.04 seconds

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4
Q

How many seconds is one large square on an EKG?

A

0.2 seconds

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5
Q

1 second on an EKG equals to?

A

5 large square passing the stylus (25 mm/ second)

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6
Q

standard speed on an EKG is…

A

25 mm/ second

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7
Q

standard speed may …

A

altered per providers request
-slow/fast heartbeat
spread the wave form out over a farther distance
allow interpretation of the tracing
otherwise use standard speed

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8
Q

What is standard amplitude (gain) on an EKG

A

measure voltage
one millivolt (mv) of electrical activity move the stylus upward 10 mm
2 large squares

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9
Q

EKG machine can…

A

vary in size & shape but have the same parts

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10
Q

12 leads on EKG’S can record

A

3,4,6 leads @ a time on one sheet of paper

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11
Q

What channel EKG do you use with Ambulatory care?

A

uses 3 channel EKG which records 3 leads @ once

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12
Q

What type of EKG machine do hospitals usually use?

A

use telemetry
single channel EKG records one lead @ a time & produces a running strip

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13
Q

EKG Electrodes

A

placed on 10 areas of the body
records heart activity from 12 different angles & planes
contains electrolyte gel that serves as conductor

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14
Q

Electrolyte gel

A

serves as conductor
apply first
expired gel & electrodes can produce artifacts

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15
Q

EKG Machine Calibration

A

you can adjust sensitivity
1 STD= deflection of the stylus 10 mm (2 Lg Sq)
1/2 STD = deflection of the styylus of 5 mm (1 Lg Sq)
2 STD= deflection of the stylus of 20 mm (4Lg Sq)

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16
Q

Example of EKG Machine Calibration

A

QRS is so tall the stylus is moving off the paper, change STD to 1/2
if too short change to 2 STD

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17
Q

heart layers

A

Pericardium
epicardium
myocardium
endocardium

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18
Q

pericardium

A

double sac encloses the heart and consists of a visceral pericardium and a parietal pericardium

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19
Q

epicardium

A

outermost layer of heart
inner most layer of pericardium
strong fibrous layers
connects diaphragm & mediastinum protection, stability, & lubrication between heart & organs in chest

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20
Q

myocardium

A

middle layer
involuntary straited muscle
physical contraction of heart

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21
Q

endocardium

A

inner most layer
lines chambers of heart & forms surface valves
smooth structure
protects inner surface
falicilites flow of blood through the heart

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22
Q

heart valves

A

control direction of blood flow through the heart
flaps make up a valve
extremely strong but also floppy require support to ensure tight close of flaps

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23
Q

chordae

A

special filaments connect the tricuspicl & mitral valves to the papillary muscle along the inside wall of the ventricles`

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24
Q

What are the valves in the heart?

A

tricuspid
mitral or bicuspid
pulmonary
aortic

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25
Q

tricuspid valve

A

seperates right artium and right ventricle

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26
Q

mitral valve

A

seperates left artium from the left ventricle

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27
Q

pulmonary valve

A

lies between right ventricle and pulmonary artery

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28
Q

aortic valve

A

lies between the left ventricle and the aorta

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29
Q

atrioventricular vavlves

A

tricuspid & mitral valves
lies between atrium and ventricles
semilunar valves
synchronized closure prevents blood from flowing backwards

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30
Q

semilunar valves

A

aortic & pulmonary
synchronized closure prevent backward blood flow

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31
Q

coronary circulation

A

most important circulation
supplies oxygenated blood to the myocardium (muscle of the heart)
happens during diastole

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32
Q

right & left coronary arteries do what ?

A

supply the heart blood ( nutrients & oxygen)

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33
Q

diastole

A

period of relaxation of the heart

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34
Q

systole

A

period of contraction of the heart

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35
Q

coronary vessels

A

right & left coronary arteries originate in the root of the aorta

36
Q

what happens during ventricular systole

A

semilunar flaps of the aortic valve occlude ( closses off ) THE ARIFICES ( OPENINGS)

37
Q

pressure inside the ventricles

A

high causing high pressure on the epicardium
compressing the coronary vessels

38
Q

coronary vessels on the epicardium during systole become?

A

during systole
tortuous (bending)
b/c it is contracting
attempting to perfuse is going to be hard

39
Q

right coronary artery

A

main artery
(RCA) carries oxygenated blood to right atrium, right ventricle, part of the left atrium & interior wall of left ventricle
perfuses sinoatrial node (SA node)

40
Q

left main coronary artery

A

(LMAC) 2nd main artery
carries blood to myocardium
snort & branches into the left cirumflex (LEX) & left anterior decending artery (LAD)

41
Q

left circumflex artery

A

carries oxygenated blood to postlateral back side as part of the left ventricle

42
Q

left anterior decending artery

A

(LAD) supplies anterior wall of the left ventricle
occlusion of LAD can lead to ventricular dysrhythmia & death

43
Q

ventricular dysrthyhmia

A

out of normal sinus rythm

44
Q

sinoatrial artery

A

perfuses SA node
branches from RCA (right coronary artery)
occulsion can manifest as sinus bradycardia ( low heart rate) on EKG

45
Q

atrioventricular node artery

A

2nd path way
AV node artery perfuses the AV node
arises from RCA in vast majority of people
occulsion = high degree blook on EKG

46
Q

collateral circulation

A

alternate or “back up” blood vessels that take over when another artery or vein becomes blocked or damaged
large coronary artires are not interconnected small arteries grow & connect when blood flow decreases
coliateral vessels help give back for decreased o2 supply

47
Q

AV node

A

holds electrical signal from SA node for short period to allow ventricles to fill completely with blood following atrial depolarization
PR interval
P wave ends & Q wave begins
0.12- 0.02 seconds

48
Q

SA node

A

cluster of cells in right atrial wall
natural pacemaker of heart
deploarization in R utium 1st left
P wave on EKG = atrial deploarzation

49
Q

P wave on EKG

A

atrial depolarization

50
Q

internal pathways

A

electrical impluses travel from SA Av via intervocal pathways
connect SA/VA node

51
Q

3 internodal pathways

A

anterior
medial
posterior

52
Q

internal pathways
transmit impulses
from SA node to L atrium is?

A

bachmann’s bundle

53
Q

complete heart block of AV node means?

A

AV node is unable to conduct and electrical impulses from SA node

54
Q

bundle of his

A

next to AV node
transmits from atria to ventricles
divides into bundle branches on either side of septum between the ventricles

55
Q

right bundle branch

A

RBB
carries impulses from bundle of his to purkinje fibers
causes R ventricular deplorazation
RBB recives blood supply from LAD

56
Q

what is the difference between the right/left bundle branches?

A

the workload
right ventricle pumps blood = lungs
left ventricle pumps blood= entire body
b/c it has a greater muscular thickness

57
Q

left bundle branch

A

LBB
located in intraventricular septum
carries electrical impluses from bundle of his to purkinje fibers of the L ventricle
short divides L anterior & L posterior fascicle

58
Q

purkinje fibers

A

network of wide diameter & junctional conduction pathways
depolarizes ventricles
initates myocardial contraction

59
Q

without the SA/AV nodes stimulation the purkinje fibers fire @ how many BPM?

A

20-40 BPM

60
Q

polarization

A

resting state of the myocarcial wall
no electric activity occurs
flat line on EKG rythm strip

61
Q

depolarization

A

electrical system in the heart stimulates myocardial cells

62
Q

repolrization

A

reaching a resting state

63
Q

QRS

A

grouped together in the QRS complex
Big Wave

64
Q

P wave

A

contraction of atria
beginning of cardiac deploriarzation
begins when SA node fires
occurs before QRS complex
positive deflection

65
Q

one cycle

A

PQRST complex

66
Q

PR segment/ interval

A

return to baseline after atrial contraction
PR internal= time from beginning of atrial contraction depolarization to beginning of ventricular contraction depolrization

67
Q

P=P internal

A

time between the P waves
time between atrial depolrization cycles
analyzing rate and rythm

68
Q

R-R intervals

A

time between R waves
time between ventricular depolrization cycles
analyzing rate & rhythm

69
Q

T wave

A

ventricular repolrization
follows QRS complex
peak towards the end of the wave instead of middle

70
Q

U wave

A

not always visible
repolrization of bundle of his and purkinje fibers
small upward curve following T wave
can be cause of electrolyte imbalances

71
Q

QT interval

A

time between the beginning of QRS complex through the T wave
ventricles contract and relax
one complete ventricular cycle

72
Q

What kind of terminology should you use with pediatric patients

A

Age appropriate
- electrodes are “stickers”
- EKG is a “picture” of the energy or movement of the heart

73
Q

Are there pediatric electrodes

A

Yes

74
Q

Where do you put V6 on a pediatric patient when space is limited

A

Midaxillary line

75
Q

Where do you place V3 on a pediatric patient when space is limited

A

The right side in the same position
- document this as V3R

76
Q

Where should electrodes go on a patient with extremity amputations

A

Arm- upper chest
Leg- lower abdomen

77
Q

Should you be careful when placing electrodes on a patient that has had a mastectomy?

A

Yes, skin is fragile

78
Q

Where do you place V1 and V2 on a patient with breast implants

A

Place higher above implant

79
Q

If a patient has larger breast where should place the electrodes

A

Lift the breast up and place under

80
Q

Where should you never place the electrode on a patient that is pregnant

A

Never on the abdomen

81
Q

If your patient is in the later stages of pregnancy, how should you position them for a EKG

A

Place them slightly turned to left and put a small pillow/rolled towel under their right hip
- helps keep the weight of the uterus off the inferior vena cava

82
Q

Holter monitor

A

Portable cardiac monitor that the patient wheres for generally 24 hours, to diagnose problems
- patient carry’s a diary
- avoids high voltage magnets and metal detectors

83
Q

Telemetry

A

Constantly monitors the electrical activity of the heart
- 3 or 5 lead

84
Q

3 lead electrode placement

A

White - right shoulder
Black- left shoulder
Red - left right abdomen

85
Q

5 lead electrode placement

A

White- right shoulder
Black - left shoulder
Red- left Lower abdomen
Green- lower right abdomen
Brown- just to the right of the bottom of the sternum (similar info of the V1 in 12 lead tracing)

Patient care (9 decks)

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