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CET > Mod 2 - EKG Acquisition > Flashcards

Mod 2 - EKG Acquisition Flashcards

1
Q

what is the sac around the heart called

A

pericardium

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2
Q

what are the layers of the heart wall from inner to outermost

A

endocardium, myocardium, epicardium

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3
Q

what is the purpose of the chordae tendineae

A

support valve leaflets

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4
Q

the tricuspid valve is between the

A

right atrium and right ventricle

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5
Q

the bicuspid valve separates the

A

left atrium and left ventricle

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6
Q

aka bicuspid valve

A

mitral valve

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7
Q

the pulmonary valve is between the

A

right ventricle and pulmonary arteries

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8
Q

the aortic valve is in between the

A

left ventricle and aorta

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9
Q

aortic and pulmonary valves are both ___ valves

A

semilunar

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10
Q

the coronary arteries perfuse during ____ compared to the rest of the circulatory system which perfuses during _____

A

ventricular diastole; ventricular systole

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11
Q

the right and left coronary arteries stem from the

A

root of the aorta

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12
Q

the right coronary artery carries blood to

A

right atrium, right ventricle, part of left atrium, inferior wall of left ventricle, SA & AV node

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13
Q

the left main coronary artery splits into the

A

left circumflex artery and left anterior descending artery

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14
Q

the left main coronary artery carries oxygenated blood to the

A

myocardium

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15
Q

the left circumflex artery supplies blood to

A

posterolateral aspect of left ventricle

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16
Q

the left anterior descending artery supplies blood to the

A

anterior wall of the left ventricle

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17
Q

LAD is called the widow maker bc occlusion can lead to

A

ventricular arrhythmias and death

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18
Q

occlusion of the right coronary artery can cause

A

extreme sinus bradycardia

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19
Q

the P wave is a result of

A

atrial depolarization

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20
Q

what is the AV junction

A

AV node and bundle of His

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21
Q

what can function as a backup pacemaker if the SA node fails

A

AV junction

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22
Q

the AV junction fires at

A

40-60 bpm

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23
Q

what is the purpose of AV node

A

hold electrical signal from SA node to allow ventricles to fill

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24
Q

what does the PR interval signify

A

time needed for impulse to travel from SA to AV node

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25
Q

what is the expected PR interval

A

0.12-0.2 seconds

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26
Q

what can cause the PR interval to increase

A

AV node not conducting impulses

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27
Q

how do complete heart blocks happen

A

AV node can’t conduct impulse from SA to ventricles

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28
Q

the AV node is perfused by the

A

av artery

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29
Q

occlusion of the AV node artery causes

A

high-degree heart block on EKG

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30
Q

the large coronary arteries are not interconnected, but ppl with this disease may cause collateral circulation through the formation of small arteries

A

coronary heart disease

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31
Q

define AUTOMATICITY

A

ability of cardiac cells to spontaneously generate electrical activity not from a node

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32
Q

define ECTOPIC BEATS

A

beats caused by area of heart other than SA node

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33
Q

how can ectopic beats manifest on an EKG

A

premature atrial, junctional, or ventricular complexes

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34
Q

what are the 3 internodal pathways that connect the SA and AV node

A

anterior, medial, and posterior

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35
Q

what is the internodal pathways connecting the right and left atrium

A

Bachmann’s bundle

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36
Q

aka Bachmann’s bundle

A

interatrial tract

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37
Q

aka bundle of His

A

atrioventricular bundle

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38
Q

the left bundle branch splits into the

A

left anterior fascicle and left posterior fascicle

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39
Q

the left anterior fascicle runs along the

A

anterior surface of the heart

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40
Q

the left posterior fascicle receives additional blood from the RCA in addition to the LAD causing it to be

A

more resistant to ischemia

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41
Q

in the absence of the SA and AV node, the purkinje fibers at a rate of

A

20-40/min

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42
Q

each small box on the y-axis represents

A

0.1 mV

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43
Q

each small box on the x-axis represent

A

0.04 seconds

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44
Q

1 large box on the x axis represents

A

0.2 seconds

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45
Q

1 large box on the y-axis represents

A

0.5 mV

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46
Q

the standard paper speed is

A

25 mm/seconds

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47
Q

aka standard amplitude

A

gain

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48
Q

what is the standard amplitude

A

10 mm/1mV

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49
Q

what is the standard calibration box size

A

10 mm tall by 5 mm wide

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50
Q

define PRECORDIAL LIEADS

A

6 EKGs placed on anterior chest to record unipolar electrical activity of the heart at a specific location

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51
Q

define AUGMENTED LEADS

A

unipolar leads created by combining 2 of 3 limb leads to create a positive electrode

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52
Q

define WILSON’S CENTRAL TERMINAL

A

reference point created by 3 limb leads and is center of Einthoven’s triangle

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53
Q

what is the reference point of all unipolar leads

A

wilson’s central terminal

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54
Q

unipolar leads are all

A

positive

55
Q

which leads are bipolar

A

standard limb (1,2,3)

56
Q

what does a thick band of color usually pink or red on the border of the EKG graph paper indicate

A

the paper is running low

57
Q

the paper speed can be set to ____ to slow the appearance of an EKG in a person experiencing tachycardia

A

50 mm/sec

58
Q

some ekgs can be set to ___ to interpret a pt with bradycardia

A

12.5 mm/sec

59
Q

when should you increase the amplitude to 20 mm/mV

A

tracing produces very small waveforms

60
Q

when is a decrease in amplitude to 5 mm/mV warranted

A

waveforms too large and exceed height of paper

61
Q

which demographic often requires a decreased amplitude

A

children

62
Q

the calibration marker will change in ___ when the speed is altered

A

width

63
Q

the calibration marker will change in _____ based on the amplitude

A

height

64
Q

how can pt’s arms be positioned if they are nervous/have Parkinson’s

A

palms downward under the glutes or crossed on the abdomen

65
Q

how can late stage pregnant pts be positioned

A

slightly on left side with pillow supporting back

66
Q

what should a pt do if they experience itching, swelling, or redness at the site of electrode placement during a telemetry monitoring

A

call provider’s office

67
Q

if you cannot place electrodes on the arms of a pt, where should they be placed

A

close as possible to point of shoulder attachment

68
Q

what are the 12 leads on a 12 lead EKG

A
  • Leads I, II, III
  • avF, avR, avL
  • V1-6
69
Q

what does avR stand for

A

augmented vector right

70
Q

what does aVL stand for

A

left wrist

71
Q

what does aVf stand for

A

augmented vector foot

72
Q

lead I records impulses inbetween

A

left and right arm

73
Q

lead II records impulses between

A

right arm and left leg

74
Q

lead III records impulses between

A

left arm and left leg

75
Q

what is the leg used for leads I, II, III and AV leads

A

left

76
Q

the AVL involves the

A

left leg and right arm

77
Q

the AVR involves the

A

left arm and left leg

78
Q

the AVF involves the

A

right and left arms

79
Q

define ANGLE OF LOUIS

A

sternal angle

80
Q

the color of the right arm lead is

A

white

81
Q

the color of the left arm lead is

A

black

82
Q

the color of the left leg lead is

A

red

83
Q

the color of the right leg lead is

A

green

84
Q

V1 is typically

A

red

85
Q

V2 is typically

A

yellow

86
Q

V3 is typically

A

green

87
Q

V4 is typically

A

blue

88
Q

V5 is typically

A

orange

89
Q

V6 is typically

A

purple

90
Q

holter monitors are commonly

A

5 leads

91
Q

for a 12 lead, should electrodes be placed over bone

A

no

92
Q

should electrodes for 5 lead ekgs be put on bone

A

yes

93
Q

for a 5 lead, the white lead can be placed

A

right sternal border first rib OR right chest about 2 inches below clavicle

94
Q

in a 5 lead, the red lead can be placed

A

right sternal border third rib OR left chest lower rib cage

95
Q

in a 5 lead, the black lead can be placed

A

left side anterior axillar line fifth rib OR left chest opposite white lead

96
Q

in a 5 lead, the brown lead can be placed

A

left sternal border first rib directly opposite white lead OR right chest fourth rib

97
Q

in a 5 lead, the green lead is placed

A

right lower thoracic area anywhere on rib cage OR right lower chest over a rib

98
Q

in a 3 lead, the white lead is placed

A

right shoulder just below clavicle

99
Q

in a 3 lead, the black lead is placed

A

left shoulder just below clavicle

100
Q

in a 3 lead, the red lead is placed

A

below left pectoral muscle at apex of the heart

101
Q

which pts may need a right sided 12 lead ekg

A
  • pts younger than 8
  • pts with inferior wall ST segment elevation, myocardial infarction, dextrocardia,
102
Q

what instance may require a posterior ekg

A

inferior wall infarction

103
Q

where do V7, V8, and V9 go

A

underneath left scapula

104
Q

define POSITIVE DEFLECTION

A

portion of waveforms above isoelectric line

105
Q

positive deflection indicate that the leads are

A

appropriately attached

106
Q

define NEGATIVE DEFLECTION

A

downward presentation of waveforms below isoelectric line

107
Q

negative deflections indicate

A

improper attachment of leads

108
Q

positive and negative deflection appears in

A

lead I

109
Q

how does limb lead reversal appear as on the ekg

A
  • lead I inverted
  • leads II and III switch places
  • AVR and AVL switch places
110
Q

the baseline represents

A

repolarization

111
Q

define REPOLARIZATION

A

relaxation

112
Q

movement of the cables/leads, pt movement, loose or dry electrodes, pt’s labored breathing, and improper skin preparation are causes of this artifact

A

wandering baseline

113
Q

what are ways to eliminate wandering baseline

A
  • clean attachment sites prior
  • educate pt on how to breathe and when to not talk
  • reposition limb leads on fleshy areas
114
Q

aka AC interference

A

60 cycle interference

115
Q

how does AC interference manifest

A

uniform sharp spikes throughout tracing

116
Q

what are potential causes of AC interference

A
  • table moved away from wall
  • ekg plug is tight and snug into outlet
  • cell phone
  • metal
  • medical devices like insulin pumps
117
Q

how does an interrupted baseline manifest

A

break in baseline or fully nonrecorded lead

118
Q

cause of interrupted baseline

A

broken lead wires or disconnected leads

119
Q

how do you calculate target heart rate for a stress test

A

(220-age) x 0.85

120
Q

how does a stress test work

A

increasing speed and incline of a treadmill every 3 min until reach target heart rate

121
Q

how often is BP measured during a stress test

A

incremental readings within first 3 min and before every transition

122
Q

how long should pts be monitored after a stress test

A

every 3-5 min for 10-15 min

123
Q

the target heart rate is generally

A

60-85% of maximum heart rate

124
Q

what are signs of pt distress during a stress test

A

dizziness, lightheadedness, nausea, severe SOB, tingling sensations, numbness, chest pain, extreme fatigue

125
Q

what should you do if a pt experiences signs of distress during a stress test

A

stop the test and notify the provider

126
Q

complications of stress testing include

A

excessive tachycardia, hypotension, arrhythmias

127
Q

what should be done if a pt has hypotension after a stress test

A

notify provider and have pt lie supine with legs elevated

128
Q

define DEXTROCARDIA

A

heart positioned on right side of chest

129
Q

the calibration mark is 10 mm high and 10 mm wide, the machine must have used which of the following settings
A) 25 MM/SEC
B) 2 MM/MV
C) 50 MM/SEC
D) 0.5 MM/MV

A

c) 50 mm/sec

130
Q

which of the following changes to settings of EKG will double height of tracing
A) 10 MM/MV
B) 25 MM/SEC
C) 20 MM/MV
D) 50 MM/SEC

A

c) 20 mm/mV

131
Q

where does the ground lead for 5 lead on holter monitor go

A

right lower abdomen

132
Q

where does V5 go on a pt with dextrocardia when doing a 12 lead

A

right anterior axillary line, fifth intercostal space

133
Q
A

CET (6 decks)

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