w6 electrocardiogram tracing

Question 1

when performing an ecg when should you wear gloves

Answer 1

lessions or breaks in the skin where sensors are going to be applied.
-trauma patient, where there is blood on or near the patient.

Question 2

reverse isolation

Answer 2

protect patient from microorganisms from the environment, these may be burn patients or immunosuppressed patients who are susceptible to infections with low0grade pathogens – sterile environment.
-disinfect and wash everything before entering the room.

Question 3

MLAs job with ecg

Answer 3

MLA must distinguish artifact from abnormal waveforms initiated by the heart of the patient. if the area in question is artifact a repeat ecg will be performed to obtain an artifact free tracing. if there is an abnormal wave form the tracing showing this wave form should be submitted for further interpretation.

Question 4

what to do if abnormality present

Answer 4

the operator needs to be able to RECOGNIZE and DESCRIBE what abnormality is present and contact physician.-do not diagnose findings

Question 5

what are the tracing analysis guidelines (7 general)

Answer 5

1. ID of patient
2. smooth baseline.
3. calibration mark.
4. einthovens law
5. AVR is a negative downward deflection
6. R wave progression
7. lead 2 is positive

Question 6

2.baseline tracing smooth

Answer 6

or flat throughout -this is the line between beats. if its jagged the patient may have been moving and a second one may need to be run.

Question 7

what is the calibration mark?

Answer 7

rectangular mark at beginning of ecg and it is 10 squares high when millivolts are set to 10.0mm/mv

Question 8

what is Einthoven’s law on a tracing

Answer 8

the height of r wave 2 should be equal to the sum of r waves 1 and 3

Question 9

Rhythm strips

Answer 9

It is the length for each lead and is determined by length that fits the mounting card or a pre-set length is determined by automatic instruments

Question 10

what to do if heart rate is below 40bpm

Answer 10

this gives on beat per lead in most cases and it is not enough to evaluate an arrhythmia so you may need to make a longer strip

Question 11

what is cause of unusual wave forms, what to do for a better tracing?

Answer 11

premature ventricular contractions per say. A longer strip is required to determine how frequently they appear and whether there are sequences a serious of PVCS can lead to ventricular tachycardia and life threatening arrhythmia

Question 12

what needed for a better tracing and why if patient not in sinus rhythm

Answer 12

a longer test strip is required to identify type of arrhythmia

Question 13

how to get a longer test strip

Answer 13

manual-letting the required lead run for a longer period.

automatic- instrument set to manual control to extend time for recording

Question 14

increasing speed for rhythm strips

Answer 14

normal speed is 25mm per second. if heart rate fast above 100 bpm some ways may not be detected, increasing the paper speed to 50 mm per second willl spread the waves further on the paper and this will reveal wave forms not previously seen. just mark this on tracing.

Question 15

changing sensitivity or gain, and when would you need to change it?

Answer 15

normal sensitivity is 1mV = 1cm. Sensitivity can be increased to 1mV= 2cm or decreased to 1mV=0.5cm

• if the QRS complexes give a very small deflection making it hard to identify waves or if p wave is hard to locate the sensitivity would be increased
• the QRS complex extends beyond the ruled area of paper you will need to decrease so they dont overlap.

Question 16

what is the normal sinus rhythm

Answer 16

the normal rhythm of the heart

-SA node serves as pacemaker firing at 60-100 bpm

Question 17

normal ecg findings

Answer 17

regularity:regular rhythm or interval between beats
Rate:60-100 bppm
P wave: uniform shape, on eP wave in front of every QRS complex
QRS complex: one QRS complex following each p wave
t wave: one t wave following QRS