EKG Interpretation Flashcards
Describe Blood flow through the heart?
Blood enters the heart from the Body > Deoxygentated Blood enters the Right Atria of heart. The blood goes through the tricuspid valve into the right ventricle. The valve closes when the ventricle fills with blood. Blood is ejected and sent to lungs to receive oxygen via the pulmonary arteries through the pulmonic valve.Blood returns to the left atria of heart through the pulmonary veins (ONLY VEINS THAT CARRY OXYGENATED BLOOD) which carries the oxygenated blood back to the heart. The blood exits the right atria and goes into the left ventricle through the mitral valve. After the left ventricle fills with blood it sends the oxygenated blood back to the body via the Aortic Valve.
The ___ node send 60-100 impulses contracts both atria and sends impulses to ____ node which contracts both ventricles through the Bundle of His and along the Purkinje Fibers. This is electrical conduction through the heart.
SA
AV
______ can be done resting, ambulatory, or while exercising.
Shows one picture of the heart at a specific point in time. Single View.
______ EKG shows twelve pictures of the heart in one point in time. 12 different Views.
EKG
12 Lead
EKGs are used to diagnose what 7 cardiac abnormalities?
Conduction Abnormalities Dysrythmias Cardiac hypertrophy Pericarditis Myocardial Infarction (site and extent) Pacemaker performance Effectiveness of drug therapy
BASELINE ON EKG SHOULD BE EQUIVALENT FROM THE LEFT SIDE OF THE STRIP TO THE RIGHT.
Baseline ST ________ or ________ is an indicator of a serious abnormality such as an MI or Ischemia.
Elevation
Depression
____ WAVE TO ____ WAVE ON THE EKG STRIP SHOWS THE ATRIA CONTRACTING.
____ WAVE TO ____ WAVE ON THE EKG STRIP SHOWS THE VENTRICLES CONTRACTING.
P to Q
Q to T
Measuring EKG Intervals:
__________ - Measured from the 1st positive deflection to 1st negative deflection. Starts at the beginning of the P wave until the beginning of the Q wave.
PR INTERVAL
Measuring EKG Intervals:
_________- Measure from the 1st negative defection to R Wave then the S is the next negative deflection. The S must return to the baseline for a normal EKG.
QRS INTERVAL
Measuring EKG Intervals:
________- The EKG strip returns to baseline.
ST INTERVAL
Measuring EKG Intervals:
________- NOT PRESENT on a NORMAL EKG. Only present in electrolyte abnormalities specifically potassium.
U WAVE
If the S wave does not return to baseline in the QRS Interval you must notify the doctor.
S depression occurs with _________.
S elevation is a sign of a _________.
myocardial ischemia
myocardial infarction
EKG LEAD PLACEMENT: \_\_\_\_\_ under Rt clavicle 1st ICS. \_\_\_\_\_ under Lt Clavicle 1st ICS. \_\_\_\_\_ on the far Lt of Umbilicus. \_\_\_\_\_ on the far Rt side of the umbilicus.
_____ must be placed at the 4th ICS on the Rt Sternal Border
WHITE
REMEMBER: WHITE IS ON THE RIGHT.
BLACK
REMEMBER: BLACK IS OPPOSITE OF WHITE SO IT WILL GO ON THE OPPOSITE SIDE OF THE WHITE LEAD.
RED
REMEMBER: SMOKE OVER FIRE. RED OVER BLACK.
GREEN
REMEMBER: GREEN GRASS UNDERW WHITE CLOUDS.
YELLOW OR BROWN
REMEMBER: THIS IS THE ONLY ONE YOU HAVE TO COUNT.
DO NOT PLACE THE EKG LEADS ON THE _____ THIS DOES NOT CONDUCT ELECTRICITY.
BONE
WHAT IS THE LENGTH OF EACH EKG INTERVAL?
PR Interval: _______
QRS Interval: _______
QT Interval: _______
- 12 - 0.20 seconds
- 04 - 0.11 seconds
- 36 - 0.44 seconds
What is the conversion of boxes to seconds? One small/mini box = \_\_\_\_ 5 small boxes = \_\_\_\_\_ 5 large boxes = \_\_\_\_\_ PQRSTU = \_\_\_\_\_\_
- 04 seconds
- 02 seconds
1 second
1 second
REVIEW:
P WAVE : Firing of the ___ node causing Atrial depolarization. Electrical impulse across the atria.
PR: Atrial depolarization and a delay from the ___ node.
Ex. During a flutter of the atrial such as fibrillation or flutter the AV Node can slow the heart rate down a little bit.
QRS: Ventricular Depolarization. Hides repolarization of the Atria.
T Wave: Ventricular Repolarization. Ventricles relax.
U wave: May follow T wave.
QT Interval: QRS Complex to the T wave.
SA
AV
__ wave is the 1st negative deflection.
__ wave is a positive deflection.
__ wave is a negative deflection.
Q
R
S
Analyzing a Rhythm Strip:
_______: Measure from R to R to R. If they measure the same it’s a regular rhythm if they are not exactly the same distance this would be considered an abnormal rhythm.
Regular Rhythm
How do you determine the Heart Rate With a 6 second strip?
6 seconds goes into a minute 10 times? You do not count the first BEAT and the Last BEAT to make it a six second EKG strip and you multiply the amount of R waves by 10 to get the heart rate.
Ex. 8 QRS Intervals in a six second strip. 8 x 10 = 80 bpm
How do you determine the Heart Rate Without a 6 second strip?
Count the number of small boxes between an R2R interval. Divide that number by 1500.
Ex. 20 boxes % 1500 = HR 75
How to correctly analyze a rhythm strip?
Do I have a P wave for every single QRS? Yes
Measure the PR interval? Is it within normal range?
Measure the QRS interval? Is it within normal range?
Measure the QT interval? Is it within normal range?
Identify the rhythm? It would only be one of what 5 rhythms?
What do you do after analyzing the EKG strip?
Normal Sinus Rhythm.
Normal Sinus Tachycardia.
Normal Sinus Bradycardia.
Atrial Fibrillation.
Document the rate and the rhythm and if it’s NSR sign it and put the strip in the chart.
Heart rate between 60-100 BPM. Nurse would continue monitoring this patient.
What Sinus Rhythm Does this Indicate?
Normal Sinus Rhythm
Heart rate less than 60 BPM. The beats are father apart on the EKG strip. In a healthy pt this would be normal. Nurse would go look at the patient and check BP and look for symptoms of decreased circulation and to see how they are tolerating the HR.
What Sinus Rhythm Does this Indicate?
Normal Sinus Bradycardia
Heart rate greater than 100-160 BPM. The beats are closer together on the EKG strip. Nurse would check vitals, notify the Dr, because this rapid rate reduces ventricular filling which decreases cardiac output.
What Sinus Rhythm Does this Indicate?
Normal Sinus Tachycardia
