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health science foundations > unit 4 big test > Flashcards

unit 4 big test Flashcards

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Biology 101 flashcards
1
Q

what starts the pumping of the heart muscle

A

electrical activity

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2
Q

what causes the electrical current in the heart muscle

A

chemical changes in the cells of the heart

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3
Q

what is the state of a resting cell

A

negative charge

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4
Q

what is the mechanical response to depolarization (cell turns positive)

A

systole

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5
Q

why type of electrode is only used for a short time

A

resting

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6
Q

when would you chose monitoring electrodes over resting electrodes

A

when the electrodes must stay on the patient longer

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7
Q

what is telemetry used for

A

ongoing mobile monitoring in a hospital setting

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8
Q

how many leads are used in telemetry

A

5

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9
Q

what is a holter monitor used for

A

ongoing mobile monitoring outside of an inpatient setting

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10
Q

what is continuous monitoring used for

A

ER, ICU, or bedside monitoring without movement

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11
Q

how many leads are viewed in continuous monitoring

A

3-5

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12
Q

what is a 12 lead EKG used for

A

evaluating heart rhythm and signs of heart diease

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13
Q

what is a stress test used for

A

evaluating for heart disease when heart rate is increased

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14
Q

how many leads are used in a stress test

A

12

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15
Q

which electrode is positive and negative in lead 1

A

LT arm positive, RT arm negative

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16
Q

which electrode is positive and negative in lead 2

A

LT leg positive, right arm negative

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17
Q

which electrode is positive and negative in lead 3

A

left leg, left arm

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18
Q

what is positive and negative in the augmented leads

A

in each lead a different limb is positive, the negative is always the central terminal

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19
Q

what are the positive electrodes in aVR, aVL, and aVF

A

right arm, left arm, and the leg left

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20
Q

what are the precordial leads

A

v1-v9

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21
Q

what is the negative in the precordial leads

A

the central terminal

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22
Q

which leads look at the inferior wall of the heart (right coronary artery)

A

lead 2, lead 3, and aVF

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23
Q

which leads look at the anterior wall of the heart (left anterior descending)

A

v1, v2, v3, v4

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24
Q

which leads look at the left lateral wall (circumflex)

A

lead 1, aVL, v5 and v6

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25
Q

what is the default speed of EKG paper

A

25 mm/sec

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26
Q

what is the default gain (sensitivity) of EKG

A

10 mm/minivolt

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27
Q

what happens if you speed up the tracing of EKG paper. when you you do so?

A

the waves spread out. this is used for fast rhythms.

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28
Q

what happens if you increase the gain of EKG tracing? when would you do so?

A

the waves become taller. when waves are hard to identify

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29
Q

when would you decrease the gain (make waves shorter)

A

if they are overlapping vertically

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30
Q

what are the colors of lead 1, 2, and 3

A

white, red, and black (white on right, smoke over fire)

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31
Q

what color is v1 and the one below it (RL)?

A

brown and green (dirt over grass below the clouds)

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32
Q

how should a patient be positioned for an EKG

A

laying down (supine or semi-fowlers)

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33
Q

what do you need to examine tracing for when an EKG is complete

A

clear tracing and fix issues before removing wires. check for signs of dangerous arrhythmias

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34
Q

who removes wires from patient? who removes electrodes?

A

the EKG tech, the patient

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35
Q

If the patient needs multiple EKGs can you leave the electrodes in place?

A

check the package, it will tell you if they can be reused

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36
Q

what equipment is necessary for applying telemetry?

A

a pack with batteries, lead wires, electrodes (monitoring style), towel, clippers, instructions

37
Q

how are the steps for applying a telemetry pack similar and different from applying a 12 lead EKG?

A

they use the same skin prep and placement of leads on the torso. they are different in the amount of wires used, the patient must carry a transmitter with telemetry, the amount of time they are used for, and telemetry requires patient teaching

38
Q

what are stress tests used for

A

checking heart function, future heart problems, planning for a heart procedure, routine screenings, family history, and heart surgery follow-ups

39
Q

how is stress induced during a stress test

A

exercise or injection of medication that increases HR

40
Q

how is a nuclear stress test special

A

it is done in addition to a normal stress test and it provides brain imaging to see where blood is not flowing

41
Q

how is the patient positioned during a nuclear stress test?

A

they are laying down with arms above head

42
Q

when is the imaging for a nuclear stress test done

A

before and after the plain stress test

43
Q

how many hours before a stress test must a patient avoid caffine?

A

24, potentially 48

44
Q

how long before a stress test should a patient be NPO

A

3 hours

45
Q

what must patients bring with them to the test

A

all of their medications

46
Q

what should patients avoid before a stress test

A

beta blockers

47
Q

how long do stress tests normally last?

A

2-4 hours

48
Q

when is the first 12 lead EKG done during a stress test

A

3 EKGS are done before the exercise portion. one laying, one standing, and one hyperventilating

49
Q

how often are vital signs recorded during a stress test

A

following Bruce’s protocol, every 2-3 minutes, and always prior to an increase in incline or speed

50
Q

what is a requirement for the the stress test to be valid

A

patient’s HR must reach 85% of their maximum heart rate zone

51
Q

what training besides an EKG cert is required to perform a stress test?

A

CPR certification

52
Q

what equipment is necessary to have in a stress testing facility

A

a crash cart, electrodes, clippers, towel, BP cuff, pulse ox monitor, oxygen

53
Q

what symptoms require you to stop a stress test

A

dizziness, SOB, chest pain, increase in systole BP greater than 10 mmHg, decrease in systolic BP greater than 10 mmHg, systolic BP greater than 250 mmHg, diastolic BP greater than 115 mmHg, leg cramps, severe diaphoresis, worsening arrhythmias, patient asks to stop, rate does not go above 120

54
Q

when can an EKG tech stop monitoring a patient after a stress test is complete

A

vitals are checked every 5 minutes until the 15 minute mark. tech can stop monitoring when vital signs return to baseline

55
Q

how long does a holter monitor record activity for

A

24-48 hours

56
Q

how must you prepare the skin for holter monitoring

A

clean with soap and water, abrade

57
Q

what should be sent home with a patient that is having holter monitoring

A

monitoring equipment with batteries, medical tape, a journal

58
Q

what should a patient do if their electrode becomes loose or falls off

A

notify their office and retape

59
Q

what must a patient document when they are using a holter monitor

A

anything that might change HR< medications, activities, symptoms

60
Q

when would patients push the event button

A

when they feel concerning symptoms

61
Q

why would a physician order an event monitor

A

to log activity for longer than a holter monitor. EMs can track for 1-2 weeks.

62
Q

how are looping event monitors different from nonlooping

A

looping event monitors constantly record, while nonlooping do not record anything leading up to an event

63
Q

what is the purpose of a stress loop

A

to give slack to the wire so the electrode can withstand more tug

64
Q

where is a nonlooping event monitor placed when patients have symptoms

A

directly over the heart

65
Q

which laws protect the privacy of protected health information

A

HIPAA, and HITECH

66
Q

how should you position a patient with orthpnea

A

semi-fowlers or high-fowlers

67
Q

what cant a pregnant women be positioned laying down

A

we must keep pressure off the vessels tracing to the fetus

68
Q

how should you position a woman who is 6+ months pregnant during an EKG

A

semi-fowlers, propped on the left side

69
Q

if you can not place the electrodes on the correct spots on the chest, where should you place them

A

as close to their normal location as possible

70
Q

what are the locations of v7, v8, and v9

A

left posterior MAL, middle of left scapula, left vertebral border

71
Q

why would a posterior lead EKG be done

A

to view the back of the heart or to view the right atrium

72
Q

why are pediatric electrodes moved

A

the heart is tilted to the right in ages 2-12

73
Q

if a person has an injury, large breasts, or implanted devices where electrodes should be placed, how should you place them

A

move to the closest location that is not impacted by these.

74
Q

what types of artifact are always caused by environment

A

broken recording an electrical interference

75
Q

what can you do to reduce electrical interference

A

remove devices from proximity, unplug unnecessary equipment, do not use extension cords,

76
Q

what is dextrocardia

A

when the heart points to the right rather than the left

77
Q

what might cause artifact

A

temperature, faulty equipment, the patient

78
Q

what types of artifact are caused by muscle action

A

somatic tremor and wandering baseline

79
Q

choppy distortion throughout tracing indicates which artifact

A

somatic tremor

80
Q

how can you reduce artifact from tremors

A

place hands under butt, move leads to torso, increase temp or room/give blanket, encourage deep and slow breathing (if patient is nervous)

81
Q

what is a normal activity that may cause wandering baseline

A

breathing

82
Q

how can you adjust electrodes if breathing is causing artifact

A

place the leads on the limbs rather than the chest

83
Q

what can cause wandering baseline

A

bad contact with skin, breathing, patient moved

84
Q

what causes broken recording artifact

A

wires or electrodes are loose, broken wires

85
Q

how do you treat broken recording artifact

A

check the electrodes in leads that you are seeing the pattern, replace

86
Q

what is the pre stage of hypertension

A

elevated bp, 120-120 systolic and less than 80

87
Q

what is the first stage of hypertension

A

stage 1 130-139 systolic or diastolic 80-89

88
Q

what is the the second stage of hypertension

A

systolic greater than 140 or diastolic greater than 90

89
Q

what is a hypertensive crisis

A

systolic over 180, diastolic over 120

health science foundations (13 decks)

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