EKG/ECG Flashcards
ECG/EKG
Electrical Activity starts in the _______node located in the _____Atrium.
Sinus Node
Right Atrium
ECG/EKG
This means movement of ions across the cell membrane.
DEpolarization
ECG/EKG
Ions move through channels. The 3 channels/electrolytes are:
Na
K
Ca
ECG/EKG
Movement of ions across cell membrane causes:
Contraction/ Heart beats
ECG/EKG
REpolarization means
REturning to previous REsting state
ECG/EKG
During REpolarization the cardiac muscles are ___
RElaxed
Parts of ECG/EKG
What is happening?
Atrial depolarization & contraction
P wave
Parts of ECG/EKG
What is happening?
Atrial REpolarization & RElaxation &simultaneous
Ventricular depolarization & contraction
QRS
Parts of ECG/EKG
What is happening?
Ventricular REpolarization & RElaxation
T Wave
Parts of ECG/EKG
What is happening?
Final state of REpolarization of the Ventricles
U Wave
ECG/EKG only shows you _____ activity,
Electrical activity of the heart
NOT MUSCULAR ACTIVITY!
Normal Sinus Rhythm
electrical impulses generated from the ___ node
Sinus
Normal Sinus Rhythm
- Rate?
- Rhythm?
- Is there a P wave before each QRS?
- Normal HR 60-100 bpm
- Rhythm is regular
- YES
Normal Sinus Rhythm
- Are the P waves upright & similar?
- What is the length of the PR interval?
- YES
5. ) 0.12 - 0.20 MEMORIZE!!
Normal Sinus Rhythm
6. What is the length of the QRS complex?
6.) 0.06 - 0.12 MEMORIZE!!
Normal Sinus Rhythm
Treatment
NO TREATMENT & NO MEDS
Atrial Flutter
What is the huge issue here?
BLOOD CLOTS
Heart is quivering = blood is not moving & tends to clot
Heart is not beating fully
Atrial Flutter
Abnormal activity in the ____ leading to abnormal ____cardia.
atriums
abnormal TACHYcardia
Atrial Flutter
- Rate?
- Rhythm?
- Is there a P wave before each QRS?
- Atrial: 250-400 bpm (twice as fast as ventricles)
Ventricular: variable - Atrial: regular
VENTRICULAR: IRREGULAR - Normal P waves are ABSENT
Atrial Flutter
- Are the P waves upright & similar?
- What is the length of the PR interval?
- saw tooth pattern
5. unable to measure
Atrial Flutter
6. What is the length of the QRS complexes?
6.) 0.06 - 0.12
These NCLEX Pxs have Atrial Flutter
- _____ disorder
- ______pathy
- _____ of the heart muscle
- Isch___
- Emph____
- Valve
- Cardiomyopathy
- Thickening
- COPD
- Ischemia
- Emphysemia
Nursing interventions for Atrial Flutter
Treatment of choice:
CARDIOVERSION
Nursing interventions for Atrial Flutter Slow the ventricular rate by using: \_\_\_\_\_zem \_\_\_\_\_amil \_\_\_\_\_lis \_\_\_\_\_blockers
diltiazem
verapamil
digitalis
beta
Nursing interventions for Atrial Flutter
_____ to reduce incidence of thrombus formation.
HEPARIN
Ventricular Tachycardia
abnormal electrical activity in the _____
ventricles
Ventricular Tachycardia
looks like wide ______.
QRS complexes
Ventricular Tachycardia
1. Rate?
- Rhythm?
- Is there a P wave before each QRS?
- Atrial: Q- unable to determine
Ventricular: 100-200bpm - Regular
- Absent
Ventricular Tachycardia
- Are the P waves upright & similar?
- What is the length of the PR interval?
- Absent
5. not measurable
Ventricular Tachycardia
6. What is the length of the QRS complexes?
- Wide greater than 0.12 sec
Stable V Tach= _____symptoms
NO symptoms
Unstable V Tach = ____symptoms
With symptoms
These pxs have V Tach: \_\_\_\_\_users \_\_\_\_\_trauma \_\_\_\_\_takers \_\_\_\_\_heart hx \_\_\_\_\_kalemia
Cocaine users Chest trauma DIGOXIN Enlarged Hypokalemia
Treatment for V Tach
DEFIBRILLATION
NEVER pick ____as a treatment for V Tach because it stimulates the ventricles.
NEVER EPINEPHRINE
Synchronized shock to the PEAK of the QRS Complex
C A R D I O V E R S I O N
NON SYNCHRONIZED shock at ANY PHASE of the cardiac cycle
D E F I B R I L L A T I O N
No electrical activity
Asystole
Treatment for Asystole
1st: Epinephrine
2nd: Atropine
CPR
Asystole
What is the pulse & BP of the patient?
ZERO 0
Asystole
If the monitor says asystole but the patient is clearly alive then check for?
ELECTRODE PLACEMENT
Electrical activity NOT coming from the heart
ARTIFACT
Artifact
DO NOT PUT electrodes over ____.
hairy areas & bony prominences
Artifact possible causes are: loose \_\_\_\_ muscle\_\_\_\_\_ client \_\_\_\_\_
loose electrodes
muscle tremors
client movements
Artifact
Treatment
identify the cause & correct placements
NCLEX Advanced Topics:
First Degree Heart Block (can happen in a normal px)
The difference bet. NSR : The PR Interval is ____ than normal.
longer/increased
**HR is slower, heart is so efficient
NCLEX Advanced Topics:
First Degree Heart Block
Is this an emergency?
NO!
NCLEX Advanced Topics:
First Degree Heart Block
What is the treatment?
MONITOR THE PX
NCLEX Advanced Topics:
First Degree Heart Block
What (2) meds can CAUSE FDHB?
- Beta Blockers
2. DIGOXIN (slow HR down)
NCLEX Advanced Topics:
Second Degree Heart Block
Other name
Mobitz Type 1 or Wenckebach
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 1 or Wenckebach)
The PR interval is ___,____ & then the QRS complexes ____.
long, longer
drops
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 1 or Wenckebach)
Is this an emergency?
YES, mild emergency
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 1 or Wenckebach)
What is the treatment?
Transcutaneous pacing
-electrodes are put on the skin
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 1 or Wenckebach)
We have a P wave that does not have QRS Complex
non conducted P wave
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 2)
The PR interval is ____ _____ & the QRS complex drops.
same length
NCLEX Advanced Topics:
Second Degree Heart Block (Mobitz Type 2)
Is this an emergency?
What is the treatment?
YEEEEEEEEEEESSSSS!
Transcutaneous pacing
-electrodes are put on the skin
NCLEX Advanced Topics:
Third Degree Heart Block
Is this an emergency?
MEDICAL EMERGENCY! WORST CASE!
*no tissue perfusion, px could die
NCLEX Advanced Topics:
Third Degree Heart Block
The ___ & _____ are beating ___ from each other.
atrium & ventricles
separately
NCLEX Advanced Topics:
Third Degree Heart Block
What is the treatment?
INTERNAL PACEMAKER
