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Nursing Test One > Telemetry > Flashcards

Telemetry Flashcards

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1
Q

Vertical axis 1 small square

A

1mm

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2
Q

Vertical axis 1 large square

A

5mm

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3
Q

Vertical axis 2 large squares

A

1 mV

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4
Q

Horizontal axis 1 small square

A

.04 seconds

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5
Q

Horizontal axis 1 large square

A

0.2 seconds

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6
Q

Horizontal axis 5 large squares

A

1 second

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7
Q

12 leads where are they

A

has 10 electrodes, 6 on chest, 4 on limbs, arm leads placed between shoulders and wrists away from bony prominences, leg leads placed between hips and ankles away from bony areas. If placed on trunk, note this

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8
Q

What is the most common monitoring lead?

A

Lead 2

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9
Q

What does the P wave represent?

A

atrial depolarization

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10
Q

How long should P wave last?

A

0.10

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11
Q

PR interval normal duration

A

0.12-0.20 seconds, over 0.20 means a 1st degree block

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12
Q

What is the PR interval?

A

The time it takes for the electrical impulse to leave the SA node and travel through the atria to the AV node, bundle branches and purkinje network

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13
Q

PR interval >0.20 indicates

A

1st degree block

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14
Q

What is the QRS complex?

A

depolarization of the ventricles

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15
Q

How long does the QRS last?

A

0.60-0.12 seconds

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16
Q

What does a QRS interval greater than 0.12 indicate?

A

A bundle branch block

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17
Q

What does a Q wave 0.04 seconds or wider or 1/4 size of R wave indicate?

A

MI

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18
Q

What is the T wave?

A

repolarization of the ventricles-resting

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19
Q

What do peaked T waves indicate?

A

hyperkalemia

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20
Q

What is a normal sinus rhythm?

A
  1. Rhythm is regular
  2. Rate 60-100 bpm
  3. P wave 1:1
  4. PR interval: 0.12-0.20 sec
  5. QRS interval:
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21
Q

What is normal R to R

A

0.04 seconds

22
Q

What are causes/symptoms of sinus bradycardia?

A
23
Q

Atrial Flutter causes

A

heart disease, PE, valvular heart disease, hyperthyroidism, lung disease

24
Q

Atrial Flutter symptoms

A

palpitations, chest pain, shortness of air, dizzy, nausea, nervous, feeling of impending doom

25
Q

Atrial Flutter treatment

A

digoxin, calcium channel blocker, adenosine, cartoid sinus massage-slow vent. rate, electrical cardioversion

26
Q

Hallmark of A Fib

A

No P wave, very fast rhythm 350-600 bpm

27
Q

Hallmark of A Flutter

A

Sawtooth-Woodchips fluttering in the wind

28
Q

A-Fib Causes

A

MI, lung disease, after open heart surgery-common cause of strokes r/t clots shooting out

29
Q

A-Fib heart rate

A

350-700 bpm, no p wave

30
Q

A-Fib s/s

A

Palpitations, chest discomfort, short of air, resp distress, hypotension, light headed, loss of consciousness
Peripheral edema, jugular vein distension, pulmonary edema

31
Q

Holiday Heart Syndrome

A

A-Fib from alcohol, clears up in 24 hours

32
Q

Sinus Bradycardia treatment

A

None unless symptomatic, for symptomatic-dopamine & epinephrine when atropine is ineffective

33
Q

Sinus Tachycardia rate

A

101-160

34
Q

Sinus Tachycardia causes

A

atropine, PE, MI, HF, fever, inhibition of vagus nerve, hyperthyroidism, hypoxia

35
Q

Sinus Tachycardia s/s

A

palpitations, pounding heart, dizziness, chest pain-can be sharp, chest pressure, fatigue, short of breath, activity intolerance

36
Q

Sinus Tachycardia treatment

A

treat underlying cause, oxygen, tylenol for fever. Persistent tachycardia-beta blockers to slow HR

37
Q

A-fib treatment

A

digoxin, calcium channel blockers, beta blockers, amiodarone, cardioversion, oxygen

38
Q

A-fib treatment > 48 hrs

A

coumadin, heparin therapy until transesophageal echocardiogram is performed to rule out clot in atrium

39
Q

What is cardioversion?

A

Controlled shock to put heart back in normal sinus rhythm

40
Q

Atrial rhythm notes

A

Originate in one or more irritable foci in atia,
called an ECTOPIC rhythm when pacemaker site is outside of SA node
Sites in the atrium usurp the SA NOde as pacemaker, TX: conversion

41
Q

AV Block notes

A

Sinus fires as usual with a partial or complete disruption to ventricles
site of block is either the AV node or at the bundle branches
Underlying rhythm is sinus
HR can be normal or slow
Tx goal-increase heart rate and improve AV conduction

42
Q

AV block criteria

A

PR interval prolonged >0.20, some Ps not followed by a QRS, P-P irregular

43
Q

First degree block hallmark

A

PR interval is prolonged, it is > 0.20, everything else is normal

44
Q

Causes & treatment of first degree block

A

AV node ischemia, digitalis toxicity, side effect of beta blockers or calcium channel blockers
Tx: remove cause

45
Q

Third degree block hallmark

A

P waves not associated with QRS, might be 3 P waves before a QRS

46
Q

Causes of third degree block

A

MI, conduction system lesion, med side effects, hypoxia

47
Q

Symptoms of third degree block

A

chest pain, palpitations, shortness of breath, diaphoresis, fatigue, faintness– Symptoms worsen on exertion!!!

48
Q

Third degree heart block treatment

A

temporary pacemaker, then a permanent pacemaker, atropine, epinephrine, dopamine until pacemaker inserted, oxygen

49
Q

Ventricular rhythm notes

A

Rhythm originates in ventricular tissue
Impulse is conducted slowly through ventricle producing a wide QRS complex that measures >0.12 seconds
Impulse can travel backward to depolarize atria & P wave is lost
Conduction systems last attempt at pacemaker

50
Q

Ventricular rhythm criteria

A

Wide QRS > 0.12 seconds w/o preceding P wave
No QRS at all
Premature, wide QRS beat without preceding P wave, interrupting other rhythm

Nursing Test One (11 decks)

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