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Heart PPT Flashcards

1
Q

The SA node is the _____ pacemaker.

A

primary

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2
Q

Electrical _____ = depolarization -> mechanical contraction = systole

A

stimulation

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3
Q

Electrical _____ = repolarization -> mechanical relaxation = diastole

A

relaxation

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4
Q

Cardiac Conduction System

A 
SA Node
Atria
AV Node
Bundle of His
Bundle of Branches
Purkinje fibers
Ventricles
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5
Q

_____ is the noninvasive, first line of investigation that provides information about the function of cardiac conduction system.

A

EKG

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6
Q

EKG’s can help identify enlarged chambers or thickened heart muscle, ______, and ischemic heart disease or MI.

A

arrhythmias

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7
Q

Each electrode creates an imaginary line or ____ looking at the electrical activity directly in front of it.

A

“lead”

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8
Q

To assure good conduction with electrode placement, don’t use _____, prep area with clean dry guaze, clip hair if needed. You also want to avoid ______. Don’t shave because it makes a difference in connection by taking the top layer of skin off.

A

alcohol

bony areas

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9
Q

With the 3 lead monitor what are the placements of the electrodes.

A

white on the right

smoke over fire

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10
Q

What are the 5 lead EKG placements of electrodes?

A

Smoke over fire, white on the right. Snow over grass. V1 4th Intercostal space

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11
Q

A 12-Lead ECG has _____ leads, but gives 12 images.

A

10 leads

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12
Q

_____: fourth intercostal space, right sternal border

A

V1

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13
Q

____: level with V5 at left midaxillary line

A

V6

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14
Q

_____: fourth intercostal space, left sternal border

A

V2

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15
Q

____: directly between leads V2 and V4

A

V3

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16
Q

_____: level with V4 at left anterior axillary line

A

V5

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17
Q

____: fifth intercostal space, left midclavicular line

A

V4

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18
Q

Errors in diagnosis can occur from incorrect lead placement or ______.

A

patient movement

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19
Q

While telemetry and EKGs are important to monitor, you must always _____ your patients condition.

A

consider/assess

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20
Q

EKG paper is graph paper made up of boxes ______

A

1 mm by 1 mm.

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21
Q

On EKG paper the ______ axis corresponds with time and rate.

A

horizontal

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22
Q

On EKG paper the ______ axis corresponds with amplitude/voltage of the impulse.

A

vertical

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23
Q

On EKG paper each small box =s ____ seconds.

A

0.04 seconds

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24
Q

On EKG paper five small boxes =’s or one big box ____ seconds.

A

0.2 seconds

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25
On EKG paper five big boxes ='s _____ seconds.
1.0 seconds
26
30 big boxes on the EKG strip ='s ____ seconds.
6.0 seconds
27
The accurate and quickest way to determine heart rate you should count _____ in six second strip, multiply by 10. If your rhythm is irregular, counting ____ intervals is more accurate.
QRS complexes | RR
28
The most accurate way to determine the heart rate is to count the small boxes between QRS complexes (RR intervals) and divide by _____.
1500 | i.e. 1500/25 = 60 bpm
29
To determine the rhythm look at the ___ or ____ intervals.
R-R or P-P
30
Regular intervals are the same or with a
0.8 second
31
To determine the rhythm you can use paper or _____.
calipers
32
P wave ='s ______
atrial depolarization
33
The _____ is when depolarization of the atria and electrical impulse is moving from the SA node towards the ventricles.
P wave
34
P waves can be different shapes, sizes, depending on ______.
atrial conduction
35
Beats that have originated in the atria usually have narrow ______.
QRS complexes
36
P wave is normally less than _______.
0.11 seconds
37
PR interval lasts from the beginning of P to the beginning of _____.
QRS
38
The ______ interval represents time from SA stimulation through atrial depolarization and AV node conduction.
PR interval
39
A PR Interval normally lasts _______.
0.12 - .20 seconds
40
The ______ represents ventricular depolarization.
QRS complex
41
The shape of the QRS complex depends on the _____.
lead selected
42
If the ______ is abnormal is can represent myocardial necrosis.
QRS complex
43
The QRS complex should be less than ____.
.12 seconds
44
A _____ represents ventricular repolarization.
T wave
45
When a T waves is tall, peaked it indicates _______.
hyperkalemia
46
When a T waves is inverted it it indicates ______.
injury
47
_____ segment represents early ventricular repolarization.
ST
48
The ST segment goes from the end of the QRS to the beginning of the _____.
T wave
49
______ should be flat against isoelectric line.
ST segment
50
ST depression can indicate
hypokalemia MI ventricular hypertrophy
51
ST elevation can indicate
MI pericarditis hyperkalemia
52
The ______ represents total time for ventricular depolarization and repolarization.
QT interval
53
The ____ interval begins at the start of the QRS to the end of T wave.
QT
54
With a prolonged QT there is a risk for
Torsades de Pointes | Sudden death
55
The ____ interval should be 0.32 - 0.40 seconds for HR 65-95 bpm.
QT
56
The _____ is not always present & easy to mistake for P wave
u waves
57
The U wave follows the _____ and is thought to be the result of slow repolarization of Purkinje fibers
T wave
58
A U wave may be result of electrolyte imbalance (hypokalemia), _____, or heart disease
HTN
59
What should you do if you see artifact on the telemetry monitor?
Assess the patient
60
Normal Sinus Rhythm the HR should range from _____ to _____ with a regular rhythm.
HR 60 to 100
61
With a normal sinus rhythm the P:QRS ration should be ______.
1:1
62
With a normal sinus rhythm the _____ are upright and uniform, 1 before each QRS.
P waves
63
The ______ is the ideal or normal rhythm.
Normal sinus rhythm
64
______ and arrhythmias are used interhangeably.
dysrhythmia
65
Dysrhythmias can be premature complexes, bradydsrhythmias, or _________.
tachydysrhythmias
66
Common dysrhythmias can be classified as sinus, atrial, ______, or ventricular.
AV nodal/junctional
67
With dysrhythmias a patient may or ____ have symptoms (depending on cause and rhythm).
may not
68
Dysrhythmias can be caused by
``` heart disease electrolyte imbalance medications hypoxia drugs stress caffeine ```
69
______ are early rhythm complexes that occur when cells other than the SA node fires an early impulse
Premature complexes
70
What are the three classifications of premature complexes?
Atrial (PAC) junctional (PJC) ventricular (PVC)
71
A ______ creates a ‘pause’ that may cause skipped beats or a ’flip flop’ feeling in the chest
premature complex
72
Bradydysrhythmias occur when the heart rate is less than ____.
60 bpm
73
Bradydysrhythmias can cause decreased perfusion if rate is too slow to provide _______ and BP.
adequate cardiac output
74
Bradydysrhythmias can lead to myocardia ischemia and _____, hypotension, and heart failure.
infarction
75
Tachydysrhythmias occur when the heart rate is over ______.
100 bpm
76
Tachydysrhythmias is especially dangerous in pts with ______>
CAD
77
________ increase the work of the heart and O2 demand of myocardium.
Tachydysrhythmias
78
Sustained Brady & Tachydysrhythmias can result in....
``` Chest pain and/or palpitations Anxiety, restlessness Changes in VS Signs of HF Signs of shock AMS or loss of consciousness ```
79
Care of the Patient with a Dysrhythmia
``` VS & telemetry monitoring Assess chest pain, perfusion, laboratory values (which ones?), activity tolerance, respiratory distress Evaluate effectiveness of medications Psychosocial needs Education ` ```
80
P waves proceed _____ waves.
QRS
81
How do you treat sinus bradycardia?
treat underlying cause atropine fluid replacement pacing
82
Causes of sinus bradycardia?
``` Valsalva maneuver vagal stimulation MI Meds (BB & CCB) athletes increased ICP hypothyroid ```
83
Sinus Tachycardia bpm
100-120
84
How to treat sinus tachycardia?
treat underlying symptoms - if necessary
85
Causes of sinus tachycardia?
``` fever blood loss sepsis shock exercise CHF pain anxiety meds caffeine nicotine alcohol recreational drugs ```

MS II (10 decks)

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