Week 3 EKG Lead Placement

Question 1

what does an EKG do?

Answer 1

provides info about electrical system of the heart from 12 different views using 10 electrodes

Question 2

what node is responsible for the automatic beating of the heart

Answer 2

SA node

Question 3

what are indication for EKG? 4

Answer 3

diagnose abnormal conduction, arrythmias, pre-op assesments, abnormalities resulting from genetic factors

Question 4

what are some contraindications to performing an EKG? 2

Answer 4

severe trauma to chest, uncooperative patient

Question 5

what are the complications to doing and EKG?

Answer 5

none

Question 6

to what extent should a patient be clothed for an EKG?

Answer 6

removed clothing from waste up

Question 7

what is the standard patient position?

Answer 7

supine(face up on back)

Question 8

what is the max angle the head can be for EKG

Answer 8

45 deg

Question 9

what happens if a patient cannot lie flat w/ head under 45 deg?

Answer 9

document altered EKG position (this can impact tracing)

Question 10

what step must you do before placing leads and after positioning the patient?

Answer 10

skin prep (gives best electrical conduction)

Question 11

what is involved in skin prep?

Answer 11

de-fat skin with alcohol wipe and then abrade skin with gauze pad

Question 12

if skin is oily what do you do before alcohol and gauze?

Answer 12

wash with soap

Question 13

what if the chest is hairy?q

Answer 13

separate hair or clip them

Question 14

if skin is diaphoretic (sweaty) what steps do you do before alcohol wipe and gauze pad to clean it?

Answer 14

rub with gauze pad to dry

Question 15

to place chest electrodes you will have to ____ and use ___

Answer 15

palpate and use landmarks

Question 16

what if electrodes cannot be placed accurately?

Answer 16

clearly document the actual location of the electrode

Question 17

where does electrode V1 go?

Answer 17

4th intercostal space, right sternal border

Question 18

V2?

Answer 18

4th ICS, left sternal border

Question 19

V3?

Answer 19

equadistant between V2 and V4

Question 20

V4?

Answer 20

5th ICS at midclavicular line

Question 21

V5?

Answer 21

horizontal to V4 at the anterior axillary line

Question 22

V6?

Answer 22

horizontal to V4 at the midaxillary line

Question 23

limb electrodes should be placed…

Answer 23

on fleshy areas of wrists and ankles avoiding bony prominence, on the same spot on each limb

Question 24

what are the three main problems in a EKG?

Answer 24

electrical interference, wandering baseline, muscle tremor

Question 25

how do you troubleshoot electrical interference?

Answer 25

alter electrical activity of the room

Question 26

what is a wandering baseline?

Answer 26

wave form moves up and down over course of tracing

Question 27

what casues wandering baseline?

Answer 27

poor lead connection

Question 28

what does a muscle tremor look like on an EKG?

Answer 28

lines close together and spiking. not as long as the electical interference

Question 29

how do you fix muscle tremors?

Answer 29

quiet the movements of the patient

Question 30

before removing electrodes what do you do?

Answer 30

take recording to physician

Question 31

electrode vs lead

Answer 31

electrode: sticky part
lead: alligator clips