Module 9 - EKG And Cardiovascular Testing

Question 1

P wave

Answer 1

Represents atrial depolarization, contraction of the atria.

Question 2

QRS wave

Answer 2

Represents ventricular depolarization, contraction of the ventricles

Question 3

T wave

Answer 3

Represents ventricular repolarization, relaxation of the ventricles

Question 4

U wave

Answer 4

Not always visible but represents a repolarization of the bundle of His and Purkinje fibers.

Question 5

PR interval

Answer 5

• Starts at the beginning of the P wave and ends at the beginning of the Q wave.
• Represents the time from the beginning of atrial depolarization to the beginning of ventricular depolarization.

Question 6

QT interval

Answer 6

• Starts at the beginning of the Q wave and ends at the end of the T wave.
• Represents the time from the beginning of ventricular depolarization to the end of ventricular repolarization.

Question 7

ST segment

Answer 7

• Starts at the end of the S wave and ends at the beginning of the T wave.
• Represents the time from the end of ventricular depolarization to the beginning of ventricular repolarization.

Question 8

Sinus rhythms

Answer 8

Normal rhythms that originate from the firing of the sinoatrial (SA) node and are characterized by the presence of one P wave for each QRS interval on the EKG

Question 9

Sinus dysrhythmias, also known as arrhythmias, can arise when…

Answer 9

the SA node fires too slowly or too quickly.

Question 10

Sinus bradycardia is a dysrhythmia characterized by what

Answer 10

a heart rate less than 60/min

Question 11

Sinus tachycardia is a dysrhythmia by what

Answer 11

a heart rate greater than 100/min and one P wave preceding each QRS complex.

Question 12

What is a break in the normal EKG

Answer 12

sinus arrest

Question 13

Abnormal atrial rhythms are characterized by what?

Answer 13

the absence of P waves on the EKG

Question 14

Commonly encountered atrial rhythms include

Answer 14

atrial flutter, atrial fibrillation, and premature atrial contractions (PACs).

Question 15

What happens during an atrial flutter?

Answer 15

• a single area within the atrial tissue is firing at a rate faster than the rate the ventricles are responding to.
• results in multiple flutter waves for each QRS complex on the EKG

Question 16

What happens during atrial fibrillation

Answer 16

• rapid, disorganized firing of multiple sites within the atrial tissue
• results in lots of fibrillatory waves between QRS complexes and an irregular QRS rhythm

Question 17

What are the risks of atrial fibrillation

Answer 17

developing blood clots and a stroke

Question 18

When do premature contractions occur

Answer 18

when the atria are triggered to contract earlier than they should, resulting in a premature contraction

Question 19

Ventricular arrhythmias typically need immediate intervention and include

Answer 19

ventricular tachycardia, ventricular fibrillation, and asystole.

Question 20

Ventricular tachycardia (V-tach) is a regular, fast rhythm characterized by what

Answer 20

large, irregular, wide QRS complexes on the EKG.

• P waves are absent, not visible, or occur randomly throughout the tracing

Question 21

What is Ventricular fibrillation

Answer 21

ventricles twitch or quiver, not pumping blood to the rest of the body

Question 22

What happens to the pulse of a pt if they have a ventricular fibrillation

Answer 22

• no pulse, as the ventricles cannot pump any blood,
• patients typically become unconscious within seconds.

Question 23

What is asystole

Answer 23

he complete absence of any waves on the EKG tracing

Question 24

Somatic tremor

Answer 24

characterized by irregular spikes throughout the tracing and is related to muscle movement.

Question 25

shivering can occur when the patient is cold, causing an irregular tracin. This is an example of what

Answer 25

somatic tremor

Question 26

Medical conditions such as Parkinson’s disease can result in

Answer 26

somatic tremors * have them lay their hands palms-down under their buttocks to reduce somatic interference.

Question 27

How to decrease somatic tremors

Answer 27

by decreasing patient anxiety and providing warmth and comfort as needed.

Question 28

AC interference, or 60-cycle interference

Answer 28

* characterized by regular spikes in the EKG tracing * related to poor grounding or external electricity interfering with the tracing

Question 29

What are some electrical equipments that can cause an AC interference

Answer 29

lights, computers, and other items plugged into wall sockets

Question 30

How to avoid an AC interference

Answer 30

Ensure proper grounding of the machine by using a three-prong plug, avoiding crossed lead wires, moving the bed away from the wall, and turning off unnecessary electronic devices.

Question 31

A wandering baseline results from what

Answer 31

movement associated with breathing or poor electrode connection

Question 32

What will happen to the baseline during a wanering baseline result

Answer 32

The baseline will wander away from the center of the paper, causing difficulty in tracing interpretation

Question 33

How will a EKG tracing appear In an interrupted baseline

Answer 33

a flat, horizontal line will print on the EKG tracing

Question 34

How to avoid an artifact

Answer 34

* Turn off all electronic devices, such as cell phones, and remove them from the patient * Poor-quality or expired electrodes or gel

Question 35

Electrodes are placed on 10 areas of the body to record heart activity from ___angles and planes

Answer 35

12

Question 36

Each small horizontal square represents ___ seconds

Answer 36

0.04

Question 37

What is the usual speed and amplitude of an EKG machine

Answer 37

* s: 25 mm/second. * amplitude is 10 mm or 1 mv.

Question 38

What is the time period captured by one large square containing five small boxes on the EKG?

Answer 38

0.20 seconds

Question 39

Leads I, II, and III are bipolar and record impulses that travel from where

Answer 39

a negative to a positive pole at specific positions in the heart

Question 40

Lead I records impulses between what

Answer 40

right and left arms

Question 41

Lead II records impulses between

Answer 41

the right arm and left leg

Question 42

Lead III records impulses between

Answer 42

the left arm and left leg.

Question 43

In aVL, the left leg and right arm assist with

Answer 43

the left arm tracing

Question 44

In aVR, the left arm and left leg assist with

Answer 44

the right arm tracing

Question 45

In aVF, the right and left arms assist with

Answer 45

with the left leg tracing.

Question 46

White wire

Answer 46

right arm

Question 47

black wire

Answer 47

left arm

Question 48

red wire

Answer 48

left leg

Question 49

green wire

Answer 49

right leg

Question 50

V1 wire colour and area of placement

Answer 50

red; right side of the sternum at the fourth intercostal space

Question 51

v2 wire colour and placement

Answer 51

yellow; left side of the sternum, directly across from V1 at the fourth intercostal space

Question 52

v3 wire colour and placement

Answer 52

green; left side of the chest, midway between V2 and V4*

Question 53

v4 wire colour and placement

Answer 53

blue; left side of the chest, fifth intercostal space, midclavicular line

Question 54

v5 wire colour and placement

Answer 54

orange; left side of the chest, fifth intercostal space, anterior axillary line

Question 55

v6 wire colour and placement

Answer 55

purple; left side of the chest, fifth intercostal space, midaxillary line

Question 56

V4 is placed before which wire

Answer 56

V3

Question 57

A medical assistant is placing electrodes for an EKG on a patient’s left upper arm due to a left below-the-elbow amputation. Where should the MA place the right arm lead?

Answer 57

Right upper arm

Question 58

After the EKG has been recorded, you must check the printout to ensure what

Answer 58

* Make sure the standardization mark is 10 mm high. * Check the direction of the R wave in lead I. The R wave on lead I should have a positive deflection. If it has a negative deflection, the limb leads are not attached correctly. Reattach leads and run the EKG again. * Observe and check for artifacts.

Question 59

Proper positioning of the electrocardiograph machine reduces which artifacts.

Answer 59

60-cycle interference artifacts.

Question 60

The calibration box should measure ___mm tall by __ mm wide at the standard setting.

Answer 60

10 5

Question 61

What is thallium

Answer 61

a dye that provides additional information on blood flow within the heart

Question 62

Holter monitor

Answer 62

A portable device for cardiac monitoring that is worn for 24 hours-72 hours.

Question 63

When should Patients press the "event" button on the holter monitor

Answer 63

if they experience any cardiac symptoms (such as palpitations) or neurological symptoms (such as syncope) and record a description of the activity surrounding the symptoms.