WEEK TWELVE Flashcards
pacemaker of the heart
SA node
Electrocardiogram
electrical activity of the heart
Holter Monitoring
records the electrical activity of the heart continuously over 24 hours or longer
- fainting and detect arrhythmias
Stress Testing
assess a patent’s blood and oxygen flow
Heart Rate
time the heart beats per minute
(60-110 bpm)
Heart rhythm
synchronized pumping action of the four heart chambers
Sinus Rhythm
an orderly contraction of the atria and ventricles
Upper heart chambers
atria
AV node
gatekeeper between atria and ventricle
lower heart chambers
ventricles
Heartbeat process
- SA node sends out an electrical impulse
- the upper chambers contract
- AV node sends an impulse into the ventricles
- the lower heart chambers contract or pump
- SA node sends another signal to the atria to contract to start again
12 lead
10 electrodes on body, records activity from 12 angles; monitor 12 leads at once
3 lead
monitors 3 lead at once
single channel
one lead at a time
horizontal axis
time (0.04 secs)
vertical axis
gain or amplitude (0.1 millivolts)
common paper speed
25mm per send
normal set for gain or amplitude
10mm/mv
speed that slows EKG
50mm/sec; waves bunched together due to tachycardia become more clearly visible due to waveform spacing
amplitude set for necessary for large waveforms that exceed the height of the paper
10mm/mv
ECG tracings begin or ends with
calibration maker (upside down u shape)
universal standard calibration measures
5mm wide by 10mm tall represents the standard settings of a 25mm per second paper speed
V1
4th intercostal space, right of the sternum
V2
4th intercostal, left of sternum directly across from V1
V3
midway between V2 and V4
V4
5th intercostal space, midclavicular
V5
5th intercostal space, between V4 and V6, at the anterior axillary line
V6
5th intercostal space, at the midaxillary line
chest leads acronym
Read Your Good Books On a Picnic
RA
white
RL
green
LA
black
LL
red
Lead I
R arm to L arm
Lead II
R arm to L leg
Leg III
L leg to L arm
Right leg
ground
Augmented leads aVR
right arm
Augmented leads aVL
left arm
Augmented leads aVF
left leg
isoelectric (baseline)
flat, no current flowing
P wave
atrial depolarization/contract
QRS complex
ventricular depolarization
T wave
ventricular repolarization/ relaxation
U wave
not always visible
repolarization/relaxation of the bundle of His and Purkinje fibers
PR interval
starts at the beginning of the p wave, ends at the beginning of the Q wave
beginning of AD to beginning of VD
QT interval
Starts at the beginning of the Q wave, ends at the end of the T wave
beginning of VD to end of VR
ST segment
starts at the beginning of the S wave, ends at the beginning of the T wave
VD to beginning of VR
Bipolar Leads
ECG leads I II III
a wave that is not always seen or identified on a normal EKG tracing
U wave
wave that represent ventricular depolarization
QRS complex
ratio of applied leads to recored leads for a standard EKG machine
10:12
atherosclerosis
clogged arteries
ambulatory
patient walking around
telemetry
cardiac rhythm is continually transmitted live to a monitoring station
Spirometry
measures breathing capacity
Spirometer
machine that measure the air taken in and expelled from the lungs
forced vital capacity
the greatest volume of air that can be expelled when a person performed rapid, forced expiration
preparation for spirometry
- wear loose clothing
- no large meals 2 hours before
- no smoking 1 hour before
- discontinue inhalers at least 6 prior
peak flow meter
test to monitor lung function for patients with chronic respiratory diseases(asthma)
forced expiratory volume
volume of airflow out of the lungs
(physician determines peak flow zones)
green zone
good control
yellow zone
large airways are beginning to narrow
red zone
medical emergency
pulse oximetry
measurement of the oxygen saturation in blood
pulse reading 95% or higher
normal
reading less then 95%
low blood oxygen
artifacts
abnormal findings due to:
improper technique
poor conduction
outside interference
AC interference
uniform spikes at the baseline
- cause by electrical devices on or near the patient
Somatic Tremor
erratic spikes at the baseline
- caused by: shivering patients, patients with Parkinsonism& tremor
wandering baseline/loose electrode
caused by: poor skin preparation, hair
interrupted baseline
demonstrated by a tracing that is not continuous
cause by: disconnected or broken lead wire
normal sinus rhythm
- P waves are upward and QRS is narrow
- regular rhythm
- rate 60-100
1500 method
count the number of small boxes between R waves, then divide 1500 by the number
(for regular rhythms)
6 second method
- beginning at the first P or R wave start counting 30 large squares
- count the number of P or R waves
- take the number and multiply it by 10
(used for irregular rhythms)
Sinus Bradycardia
normal ECG tracing with heart rate less than 60 bpm
- originates from SA node
- far distance between QRS complexes
Sinus Arrest
- SA node stops firing, causing a pause in electrical activity
- during the pause, atrial and ventricular contractions do not occur
- not significant unless last longer than 6 seconds
Atrial flutter
“saw tooth’ baseline
- no true P waves(flutter waves)
- atria contacts faster than ventricles
Atrial fibrillation
- no organized contraction of the atria
- atria are in “quivering state”
- blood clots can form due to stagnation of blood in the ventricles
- no clear P waves,, irregular rhythm, narrow QRS
Asystole
heart has stopped and patient is unresponsive (code blue)
Ventricular tachycardia
unstable; notify provider
Ventricular Rhythms
- assess the QRS complex
- notice the changes in the form
- no p waves
- QRS is wideAZ
Ventricular fibrillation
- unorganized electrical activity
- no QRS = no heartbeat
- notify provider immediately (code blue)
