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Specialized Nursing > UNIT 1 - ECG interpretation & Treatment > Flashcards

UNIT 1 - ECG interpretation & Treatment Flashcards

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1
Q

RA Electrode Placement

A

Right forearm or wrist

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2
Q

LA Electrode Placement

A

Left forearm or wrist

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3
Q

LL Electrode Placement

A

Left lower leg, proximal to ankle

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4
Q

RL Electrode Placement

A

Right lower leg, proximal to ankle

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5
Q

V1 Electrode Placement

A

4th intercostal space, right sternal edge

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6
Q

V2 Electrode Placement

A

4th intercostal space, left sternal edge

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7
Q

V3 Electrode Placement

A

Midway between V2 and V4

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8
Q

V4 Electrode Placement

A

5th intercostal space, mid-clavicular line

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9
Q

V5 Electrode Placement

A

Anterior axillary line

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10
Q

V6 Electrode Placement

A

Mid-axillary line

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11
Q

The H causes of cardiac arrest

A

Hypovolemia
Hypoxia
Hypothermia
Hypo/hyperkalemia
Hypoglycemia
H+ acidosis

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12
Q

The T causes of cardiac arrest

A

Tension pneumothorax
Tamponade
Toxins
Trauma
Thrombosis

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13
Q

A patient comes into the emergency room with shortness of breath and epigastric pain. The doctor is querying an MI, what enzymes would be tested?

A

Creatine-Kinase (Ck-MB)
Troponin T

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14
Q

How long do heart enzymes increase after pain of an MI has started?

A

3 - 6 hours

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15
Q

How long do heart enzymes remain elevated for?

A

14 - 21 days

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16
Q

How long does Troponin I levels rise after an Acute MI?

A

7 - 14 hours

17
Q

What is the treatment for STEMI?

A

Aspirin 300 mg
O2 therapy
IV Nitroglycerin
Streptokinase
Tissue-type plasminogen activator (t-PA)

18
Q

Josh’s ECG shows electrical activity but when feeling for a pulse, none is absent. What is your next course of action?

A

Commence CPR
Treat H’s and T’s
Give Epinephrine 1 mg

Patient has pulseless electrical activity

19
Q

Your patient experiences a flat line (code blue/asystole), what is your next course of action?

A

Commence CPR
1 mg Epinephrine
Treat H’s and T’s

20
Q

On your patient’s ECG, there is an irregular rhythm, atrial rate 400 bpm, ventricular rate 160 - 180 bpm and absent P wave. What is this rhythm and what is your next course of action>

A

A fib

Use a biphasic defibrillator for electrical conversion or use chemical conversions such as Amiodarone, procainamide or diltiazem.

Provide Heparin to prevent atrial thrombus

21
Q

Brian has a HR 100-250 bpm and expresses that they are experiencing feelings of impending death. His ECG shows absent P waves and QRS complex > 0.12 seconds. What is this rhythm and what is your next course of action?

A

V tach

Amiodarone 150 mg IV slow bolus over 10 minutes

Repeat 150 mg IV (over 10 minutes) every 10 - 15 minutes.

22
Q

What do you do for pulseless VT?

A

Defibrillation 200
Chest compressions
1 mg Epinephrine q 5 mins
Amiodarone 300mg IV push

23
Q

What is an alternate infusion of Amiodarone for VT?

A

360 mg over 6 hours then 540 mg over the remaining 18 hours.

1mg/min over 6 hours - 0.5 mg/min

24
Q

The ECG of Katyln reveals regular narrow QRS complexes with a HR 150 - 250 bpm. What is this rhythm and what do you give?

A

PSVT
Adenosine 6 - 12 mg IV

25
Q

This rhythm has a regular r-r interval, HR 125 bpm and a PR interval 0.16 sec. What is this?

A

Sinus Tachycardia

26
Q

Lian is experiencing SOB, altered LOC, pulmonary edema and her ECG shows a PR interval <0.2. What is this rhythm?

A

Sinus Bradycardia

27
Q

Explain the protocol for a client experiencing symptomatic bradycardia?

A

Assess signs & symptoms.

IDENTIFY & TREAT UNDERLYING CAUSES
Maintain patent airway
Administer O2
Cardiac monitoring to identify rhythm, monitor BP and SPO2
IV access
Assess 12 lead ECG

If it is present and causes hypotension, altered LOC, signs of shock, chest pain and acute CHF then administer atropine 1mg bolus then q 3 - 5 minutes to 3mg max dose

28
Q

If atropine doesn’t work for bradyarrhythmia, what can you do?

A

Dopamine 2 - 50mcg/kg per min
Epinephrine 2 - 10 mcg per min
Transcutaneous pacing

29
Q

How do you ventilate a patient with bradycardia?

A

Start @ 10 - 12 breaths/min until partial pressure of end tidal CO2 is 35 - 40 mmHg

30
Q

Normal PR interval

A

0.12 - 0.20 sec

31
Q

Normal QRS complex

A

0.06 - 0.12

32
Q

Big box method

A

Number of big boxes between two R waves then divide it into 300

33
Q

Atrial contraction/depolarization

A

P wave

34
Q

Time it takes for the impulse to spread from the atria to the ventricles

A

PR interval

35
Q

Ventricular contraction/depolarization

A

QRS complex

36
Q

Electrical systole

A

QT interval

37
Q

Ventricular depolarization is complete and repolarization about to begin.

A

ST segment

38
Q

Repolarization of the ventricles

A

T wave

39
Q

How does the conduction of the heart go?

A

Sinoatrial node (60 - 100 bpm) -> Atrioventricular node (40 - 60 bpm)-> Bundle of His (40 - 60 bpm)-> Left and right bundle branch (20 - 40 bpm) -> Perkinjie fibers (20 - 40 bpm)

Specialized Nursing (8 decks)

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