W2 D1 - Cardiac Monitoring

Question 1

What is different about the brown lead/electrode?

Answer 1

You can use it to monitor any portion of the heart. ex. V1,2,3,4,5,

Question 2

What do the cardiac leads show you?

Answer 2

1. Different views of the heart
   2.

Question 3

Discuss the different lead-views of the heart and their electrical charges

Answer 3

Standard limb leads
* Lead I - view of left lateral wall, negative right arm positive left arm
* Lead II - view of inferior wall, from apex. Negative right arm, positive left leg
* Lead III - view of inferior wall, directly from the bottom, negative from left arm, positive left leg

Chest leads V1-V6
* V1-2, 4th intercostal space, R/L
* V4-5, 5th intercostal space, left midclavicular + axillary

Question 4

What does the vertical and horizontal portion of the ECG measure?

Answer 4

Amplitude is vertical
* voltage in millivolts, 1 mm

Duration is horizontal
* 1 mm = 0.04 seconds

Question 5

How tall is a normal T wave? How do you describe it?

Answer 5

T wave
less than 5 mm
inverted, hyperacute, flattened

Question 6

How do you breakdown ECGs? What is normal?

Answer 6

P wave
* one P for every QRS
* abnormal: fewer or more

PR interval
* 0.12-0.2 seconds
* longer = lengthened

QRS complex
* less than 0.10 seconds
* longer than = wide

ST segment
* within 1 mm of isoelectric line
* abnormal: elevated or depressed by more than 1mm

T-wave
* bigger than P wave but no measurement
* abnormal can be peaked (above 5 mm), inverted, flattened

• QT interval
• less than half of the R-R interval
• prolonged or shortened

Question 7

What is the J point?

Answer 7

Junction between S and T waves
should be on isometric line

Question 8

What is the U wave?

Answer 8

Rare
small, upright wave found after T wave
Possibly hyperkalemia

Question 9

How do you calculate HR with regular and irregular rhythms?

Answer 9

Regular
1500 / small boxes between R waves

Irregular
Count the Rs in the six second strip and times by 10