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Certified Medical Assistant > Module 13: EKG and Cardiovascular Testing > Flashcards

Module 13: EKG and Cardiovascular Testing Flashcards

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USMLE® Step 1 flashcards
1
Q

CMA role in cardiovascular testing

A
  • preparing pt
  • providing post-procedure assistance
  • accurately and efficiently performing test
  • noting obvious abnormalities
  • maintaining equipment
  • preparing testing materials for provider interpretation
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2
Q

how to prepare pt for EKG

A
  • identify pt
  • explain procedure
  • disrobing, owning, draping
  • clean skin and clip hair if needed
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3
Q

does an EKG shock you with electricity

A
  • no
  • records electrical activity of the heart
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4
Q

how to disrobe/drape/gown pt

A
  • pt undressed from waist up
  • no pantyhose or tights
  • drape with opening in the front
  • provide additional cover after leads are placed
  • remove jewelry and electronic devices
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5
Q

artifacts

A

unwanted external event occurring in an EKG tracing not associated with the heart function

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6
Q

multichannel EKG machine

A
  • monitors all 12 leads at once
  • can record 3, 4, or 6 at a time
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7
Q

three-channel EKG unit

A
  • typically in ambulatory care setting
  • records 3 leads at once
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8
Q

single-channel EKG machine

A
  • records one lead at a time
  • produces running strip
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9
Q

telemetry

A
  • computer-based monitoring
  • conducted in hospital setting
  • pt constantly monitored
  • emergency equipment available
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10
Q

how many electrodes are placed

A

10

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11
Q

how many angles and planes are recorded

A

12

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12
Q

what conducts impulses on electrodes

A

electrolyte gel

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13
Q

vertical axis on EKG

A
  • gain or amplitude
  • small square represents 0.1 mv
  • large squares include 5 small squares and represent 0.5 mv
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14
Q

horizontal axis on EKG

A
  • time
  • small square represents 0.04 seconds
  • large squares include 5 small squares and represent 0.2 seconds
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15
Q

what speed should paper run at

A

25 mm/sec

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16
Q

normal amplitude

A

10 mm or 1 mv

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17
Q

how are waveforms put on paper

A

burned onto paper via heat and pressure-sensitive stylus

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18
Q

how to clean pt skin

A
  • instruct pt to avoid applying any substance to skin
  • clean using alcohol or soap and water
  • clip or shave hair if needed
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19
Q

where should limb electrodes be placed

A
  • fleshy areas
  • within same general vicinity on each limb
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20
Q

where do the first six recorded leads originate from

A

arms and legs

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21
Q

bipolar

A

recording of electrical current involving both a positive and negative pole

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22
Q

unipolar

A
  • recording from one location or one pole
  • must be augmented (assistance in tracing by drawing from other poles)
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23
Q

what would you note on tracing if leads were placed improperly

A

complexes would be negatively deflected

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24
Q

how to position pt if experiencing dyspnea

A

semi-fowler’s

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25
Q

universal standardization mark

A
  • 10 mm high, 1 mv
  • 5 mm wide
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26
Q

what to do if QRS complex is too large and goes off paper

A
  • reduce standardization to 0.5
  • 5 mm high and 5 mm wide
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27
Q

what to do if P waves are absent

A
  • change standardization speed to 50 mm/sec
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28
Q

somatic tremor

A
  • irregular spikes throughout the tracing
  • related to muscle movement (shivering, Parkinson’s disease)
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29
Q

how to eliminate somatic tremor

A
  • decrease pt anxiety
  • provide warmth and comfort as needed
  • pt lay on hands to reduce movement
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30
Q

AC interference

A
  • aka 60-cycle interference
  • regular spikes in the tracing
  • poor grounding or electrical activity (lights, computers, crossed lead wires)
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31
Q

how to eliminate AC interference

A
  • proper grounding of machine
  • three-prong plug
  • avoid crossed wires
  • move bed away from wall
  • turn off unnecessary electronics
32
Q

wandering baseline

A
  • baseline wanders from the center of the paper
  • poor electrode connection (lotions/oils/powders on skin)
33
Q

how to eliminate wandering baseline

A
  • clean skin prior to attaching electrodes
  • instruct pt to avoid creams and lotions
34
Q

interrupted baseline

A
  • obvious break in tracing
  • disconnected or broken lead wire
35
Q

sinus bradycardia

A
  • heart rate less than 60bpm
36
Q

sinus tachycardia

A
  • heart rate greater than 100bpm
37
Q

sinus dysrhythmia

A
  • slight irregularity in rhythm
  • associated with normal breathing patterns
38
Q

sinus arrest

A
  • break in normal EKG
  • SA node failed to fire
  • not significant unless arrest lasts longer than 6 seconds
39
Q

atrial flutter

A
  • atria contracting at a rapid rate, faster than ventricles
40
Q

atrial fibrillation

A
  • no organized contraction of atria, quivering
  • blood clot formation due to stagnation of blood in ventricles is possible
41
Q

ventricular fibrillation

A
  • ventricles not contracting, quivering
  • no discernable waves throughout the tracing
42
Q

asystole

A
  • heart stops
  • patient has no rhythm noted
43
Q

P wave negative deflection

A
  • junctional dysrhythmia
  • typical impulse pathway from SA node to AV node is not occurring
  • initial impulse originating in AV junction, AV node, or ectopic source
44
Q

premature ventricular contraction

A
  • wide and bizarre QRS
  • PVC is most common ventricular arrhythmia
  • can be insignificant but provider should be notified
45
Q

P wave

A
  • atrial depolarization
46
Q

QRS wave

A
  • ventricular depolarization
  • atrial repolarization not visible but occurs during this phase
47
Q

T wave

A
  • ventricular repolarization
48
Q

U wave

A
  • repolarization of bundle of His and Purkinje fibers
  • not always visible
49
Q

PR interval

A
  • time from beginning of atrial depolarization to beginning of ventricular depolarization
  • beginning of P wave to beginning of QRS wave
50
Q

QT interval

A
  • time from beginning of ventricular depolarization to end of ventricular repolarization
  • beginning of QRS wave to end of T wave
51
Q

ST segment

A
  • time from end of ventricular depolarization to beginning of ventricular repolarization
  • end of QRS wave to beginning of T wave
52
Q

V1

A
  • red
  • right side of sternum, 4th ICS
53
Q

V2

A
  • yellow
  • left side of sternum, 4th ICS
54
Q

V3

A
  • green
  • left side of chest, between V2 and V4
55
Q

V4

A
  • blue
  • left side of chest, 5th ICS, midclavicular line
56
Q

V5

A
  • orange
  • left side of chest, 5th ICS, anterior axillary line
57
Q

V6

A
  • purple
  • left side of chest, 5th ICS, midaxillary line
58
Q

right arm

A
  • white
59
Q

left arm

A

-black

60
Q

right leg

A
  • green
61
Q

left leg

A
  • red
62
Q

lead I

A
  • bipolar
  • impulses between left and right arms
63
Q

lead II

A
  • bipolar
  • impulses between right arm and left leg
64
Q

lead III

A
  • bipolar
  • impulses between left arm and left leg
65
Q

lead AVL

A
  • unipolar
  • left leg and right arm assist with the left arm tracing
66
Q

lead AVR

A
  • unipolar
  • left arm and left leg assist with the right arm tracing
67
Q

lead AVF

A
  • unipolar
  • right and left arms assist with the left leg tracing
68
Q

transmitting single-channel EKG

A
  • may need to mount tracing prior to delivering to provider
69
Q

is an EKG part of pt medical record

A

yes

70
Q

where is stress testing typically done

A
  • hospital setting
  • emergency equipment available
71
Q

greatest risk of stress testing

A

cardiac arrest

72
Q

stress testing procedure

A
  • pt attached to heart monitor
  • exercise on treadmill or stationary bike to see how heart handles stress
  • may receive thallium dye to provide info on blood flow
73
Q

CMA role in stress testing

A
  • attaching leads
  • monitor vitals
  • pt education
74
Q

CMA role in holter monitoring

A
  • attaching electrodes to pt trunk
  • pt education
75
Q

holter monitoring procedure

A
  • pt assumes normal activities
  • keep diary of activities
  • press event monitor if experiencing cardiac or neurological symptoms
  • pt should not move electrodes
  • avoid showers and metal detectors

Certified Medical Assistant (40 decks)

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