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EKG Technician > Electrocardiogram Technician: Module 4 > Flashcards

Electrocardiogram Technician: Module 4 Flashcards

1
Q

What does vertical readings on the ECG graph paper represent?

A

Voltage and amplitude

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2
Q

What do horizontal readings on the ECG paper represent?

A

Time

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3
Q

In ECG Graphs, Distance equals

A

Time

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4
Q

In ECG Graphs, Height equals

A

Voltage (5mm = 0.5 MV)
(25 large boxes on 5 x 5 grid)

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5
Q

With ECG measurements, you are dealing with

A

Large and small boxes

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6
Q

Each large box on the ECG graph is made up of

A

A 5 x 5 grid of small boxes

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7
Q

Each large box or five small boxes in length represents

A

0.20 seconds in time

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8
Q

Each small box represents how much seconds in time

A

0.04 seconds in time

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9
Q

Voltage of each large box is

A

5 mm in voltage

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10
Q

Voltage of each small box is

A

1 mm in voltage

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11
Q

What are the three different ways to calculate heart rate with printed ECG?

A

The G-second method
1500 method
R-R interval / 300 method

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12
Q

What is the 6 second method?

A

Must identify a 6 second tracing

Then count the number of complete complexes

Multiply the number of complete complexities by 10 to get the heart rate.

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13
Q

What is the 1500 method

A

Count the number of small squares on ECG graph paper between two R waves

Divide 1500 by the number of small squares. Example 1500/18 would be 83 bpm

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14
Q

What is the 300 method of measurement?

A

For the R-R interval method, divide number of large boxes between two waves and into each other

For example: 300/3.5 = 85 bpm

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15
Q

When preparing ECG/EKG procedures, most clinics will have a room

A

Far from strong electrical equipment and x ray machines.

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16
Q

To avoid artifacts or interference with the ECG

A

Turn off any nonessential electrical equipment and keep them away from the machines.

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17
Q

No matter what medical procedure is being performed u must always

A

Identify the patient that it’s the correct patient.

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18
Q

Always use at least how many patient identifiers

A

Three

Such as patient name, date of birth, location, or patient identification number

Double and triple check patient identity

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19
Q

Once patient is identified, spelling being

A

correct needs to be identified

All spelling of names, location, date, time of recording, patient demographics and medications need to be correct.

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20
Q

You must also identify a patient’s height, weight, and

A

Special conditions or positioning during recording.

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21
Q

Clinics and facilities have billing and coding specialists to

A

Complete billing paperwork

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22
Q

Sometimes it can fall on technicians to obtain or enter

A

Basic billing information such as patient address, insurance information, and ICD codes.

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23
Q

Patient information should be listed as

A

Input into the ICD panel

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24
Q

EKG technicians like any other medical professional

A

Must document everything pertaining to a patient’s medical record, all information going into a medical record must be accurate and kept by facility for 7 years.

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25
Q

What is the first step of the electrode application and placement process?

A

Prepare skin with alcohol pad to remove excess oils. If patient has hair on chest, shave them with electrical razor

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26
Q

Where is the V1 lead placed

A

4th intercostal space between ribs and 4 and 5 on right side of sternal border.

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27
Q

Where is the V2 lead placed?

A

Mirrors the V1 lead on the left sternal border, 4th intercostal space.

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28
Q

Where is the V3 lead placed?

A

Between V2 and V4

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29
Q

Where is V4 and V5 placed?

A

V5 is placed at 5th in line with the V4 at the anterior axillary pit

30
Q

Where is V6 placed?

A

In line with V5 at the midaxillary line

31
Q

When conducting an ecg on females

A

lift their breast respectfully with back of hand and place electrodes in closest position possible. Avoid placing electrodes on breast tissue

32
Q

Limb electrodes will be places

A

on wrist and ankles. If alternative placement is needed, use the shoulders and upper legs.

33
Q

Limb electrodes must be

A

mirrored. Same position for left and right side

34
Q

Make note on ecg tracing for any

A

non-standard or alternative ECG electrode placements

35
Q

If patients need multiple ecgs taken,

A

evaluate before and after surgery or with medications

36
Q

What is the midclavicular line?

A

Starts at center of clavicle and passes through nipple in most patients.

37
Q

What is the anterior axillary line?

A

Starts at front axillary and down the left side of the chest

38
Q

What is the intercostal spaces?

A

The dents or dips between ribs

39
Q

What is the super sternal notch?

A

The dip at the base of the neck where the right and left clavicle attach to the sternum.

40
Q

What is the angle of Louis?

A

close to one inch below the supra sternal notch and manubrium upper part of sternum attach.

41
Q

If patient is in a hospital when you perform the EKG

A

raise bed rail

42
Q

When using an exam table

A

pull a leg extension and check grounding plug for safety and security.

43
Q

Check insulation wires for

A

cracks as that could be a safety issue for the patient

44
Q

What should an EKG Tech do before the procedure?

A

Prepare the room before patient enters
Provide infection control
Locate and check the equipment, load paper tray if needed and attach leads/electrodes
Identify yourself to the patient

45
Q

Every machine is different to operate so always

A

consult the user manual and check the ICD screen for any errors and insure the proper placement of electrodes.

46
Q

Once electrodes are in place and patient information is typed into the machine

A

hit run or auto button

47
Q

Artifacts can be caused by various issues and include

A

Wandering baseline
AC Interference
Somatic tremors
Interrupted baseline

48
Q

What is wandering baseline?

A

An artifact caused by weak or improper electrode application

49
Q

What is AC Interference?

A

Also known as alternating current, it is caused by improper grounding, dirty or corroded chips, wires being crossed, non essential electronics, and metals.

50
Q

What are somatic tremors?

A

artifacts caused by muscle or patient movement and resemble large spikes.

51
Q

What are interrupted baseline?

A

caused by loose electrodes

52
Q

What does make mean in regards to equipment maintenance?

A

Make sure to always follow your facilities policies and manufacturers directions for cleaning and sanitizing the machine

53
Q

What does try mean in regards to equipment maintenance?

A

Try to keep the machine as clean as possible to present a professional image and prevent any possible infection.

Clean clips and electrode adapters daily

54
Q

What does replace mean in regards to equipment maintenance?

A

Replace cracked or broken cables. Make sure to always store the machine neatly.

55
Q

Try to identify a child by their name

A

or what they would prefer to be called. Also let the child know that they are brave and doing good job during procedure.

55
Q

When working with children as patients

A

keep the directions as simple as possible. Avoid technical jargon

56
Q

For child you need to use electrodes that are

A

smaller/pediatric sized

57
Q

The paper speed for children need

A

to be adjusted to a faster speed (50 mm/sec) due to fast heart rate of a child.

58
Q

Proper electrode placement is important on children because

A

of their smaller size

59
Q

V3 for children can be placed on

A

right side of the chest

60
Q

Heart rhythm strip is produced by

A

lead 2, runtime is approximately 10 seconds. Used to check for dysthymias.

61
Q

For ECG on females, V1 and V2 can be placed higher on chest

A

Due to implants

Make note of any changes in the placement of electrodes on ECG chart

62
Q

If a female patient has a mastectomy (breast removal)

A

make note of it on the chart

63
Q

For amputees’ use an alternative placement and

A

document that alternative placement for limb leads are used

64
Q

When working with pregnant patients

A

make sure to note in their chart that they are pregnant

65
Q

For geriatric patients make sure to

A

apply electrodes as careful as possible and assist with removal to avoid damaging or tearing the skin.

66
Q

Any non-standard body position should

A

be noted on tracing, such as, any patients that maybe in a permanent fetal position.

67
Q

What is Dextrocardia?

A

A condition where the heart is on the right side of patient as opposed to left side.

Chest leads will be in reverse or mirrored with image V1 being on left side and v2 being on right with other leads following lead two

As with any changes, note changes of placement according to facility’s policies.

68
Q

Clinicans may need a more complete picture of the lead

A

They may order a 15 to 18 lead ECG. These obtain same image as 12 lead but also view the posterior (15 lead) and right side (18 lead ecg)

69
Q

When dealing with a patient with a seizure

A

protect the patient’s head, call for help, and report the seizure. After the seizure perform the ECG and note that it was post seizure.

EKG Technician (8 decks)

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