EKG lab Flashcards
The purpose of GXT is to determine
the physiological responses to controlled exercise stress
Most common clinical application of exs testing for gxt is for
Diagnosis of suspected or established CVD
In the lab, what will make you the student more familiar with the electical conductivity of the heart?
EKG
GXT test utilizes measurements included in
prev labs including resting and exs BP
3 Objectives of GXT are met by taking 12 lead EKG and they are:
1) Test is conducted in a safe and prudent manner
2) Accurate HR measurements are attained
3) Subjects with CVD are accurately id’d, this objective is the responsibility of the cooperating physician
The 12-lead EKG taken during exs is more likely to indicate unkown CV problems than an EKG
taken at rest
The EXS tech does not fulfill the role of ____, however, it is . .. ..
cardiologist, however, it is vital for the tech to understand the basic concepts of EKGy and to recognize the most critical EKG abnormalities that occur during GXT
There are how many general principles
7
If there is any doubt as to the benefit of testing or safety of testing, the test should (principle One)
not be performed at that time
The test protocol should be selected to accommodate the
individual patient’s ability to perform treadmill exs (walking pace, anticipated exs capacity), or cycle ergometer exs (2nd principle)
The exs test should begin at a MET level intensity considerbaly below the anticipated what or …
limitation or max capcity and increase gradually in 2 or 3 min stages, w/ observations made at each different stage. The increase in intensity at each stage may be as large as 2 to 3 METs in healthy populations or as small as 1/2 MET in those with disease
HR, BP, RPE, and patient appearance and sx should be
monitored regularly w/ gradin scales for severity of angina in cardiac patients and dyspnea in pulm patients are especially valuable
Contraindications for testing and indications for stopping exs should be
closely observed
All observatipns should be continued for at least
4 min of recovery unless abnormalities occur which require a longer post-test observation
The testing area should be what temp and humidty
22 degs C/ 72 degs F or less
humidity 60% or less if possible
what should your subject avoid for atleast 3 hrs prior to testing??
any food, tobacco, alcohol, and caffeine
What should subj sign prior to administration of the exs test?
informed consent form
informed consent form purpose
provide subject w/ adequate explanation and understanding of the test and the potential risk and discomforts involved
What protocol will be used in lab?
Bruce protocol
The subject’s BP and EKG is taken in the
supine, sitting and standing position prior to the start of the exs test.
Following the standing EKG recording, the subject is instructed to do what
hyperventilate for 15 seconds and another standing EKG recording is taken, which mimics EKG changes that will occur during exs
Prior to hyperventilation the subj is instructed to place their what
back to the table and to lean back against the table should they experience any lightheadedness during the hyperventialtion maneuver
When will be BP be measured?
exercise
at the 2:30 second mark of each stage
When will EKG be measured?
exercise
At 2:40 mark of each stage and at maximal exercise, so press ECG button on machine at 2:30- takes 10 seconds to acquire the measure
RPE is determined at (exercise)
2:45 second mark of each stage and at maximal exs
Progressive angina
indicating for stopping test
V-tach
indicating for stopping test
Significant drop (20 mm Hg) of systolic bp or a failure of SBP to rise w/ increase in exercise laod
indicating for stopping test
Lightheadedness, confusion, nausea, pallor or severe peripheral circulatory insuffiency
indicating for stopping test
ST-depression > 4 mm Hg horizontal, downslopping or elvation
indicating for stopping test
onset of 2nd or 3rd degree A-V block
indicating for stopping test
Increasing ventricular ectopy, multifrom PVCs
indicating for stopping test
Excessive rise in BP; SBP > 250 mm Hg; DBP > 120 mm Hg
indicating for stopping test
exs-induced LBBB
indicating for stopping test
subject requests to stop
indicating for stopping test
Failure of the monitoring sys
indicating for stopping test
Unexplained inaapropriated bradycardia (slow HR)
indicating for stopping test
Active recovery will take place at what
2 mph and 0 % grade for 2 min
active recovery bp will be measured at ?
1:30 and an EKG will be recorded at 1:50 of active recovery
seated recovery will take place for how long
3 min
in seated rec, subject should be
escorted to seat
during seated recovery, BP should be measured at
2:30 and ekg will be recorded at 2:50 of seated recovery
Why is supine recovery used in some protocols?
Increase in venous return in supine position may produce additional left ventricular preload and aid in the detection of ischemic EKG changes
THE SUPINE RECOVERY WILL
NOT BE USE IN THIS LAB AND IS ONLY FOR CLINICAL USE
