CCMA Exam Domain 3 Leftovers: EKG and CV Testing

P wave

represents atrial depolarization, contraction of atria

QRS wave

Represents ventricular depolarization, contraction of ventricles

T wave

represents ventricular repolarization, relaxation of ventricles

U wave

repolarization of the bundle of His and Purkinje fibers

PR interval

beginning of P wave and ends at beginning of Q wave. Time from beginning of atrial depolarization to beginning of ventricular depolarization

QT interval

starts at the beginning of the Q wave and ends at the end of the T wave. Time from beginning of ventricular depolarization to end of ventricular repolarization

ST segment

starts at end of S wave and ends at beginning of T wave. Time from end of ventricular depolarization to beginning of ventricular repolarization

Ventricular fibrillation

Does not produce a pulse, as the ventricles cannot pump any blood. Patients become unconscious within seconds

Patient preparation for the procedure

Undress and put on gown with opening in the front.

Remove jewelry

Turn off all electronic devices to remove interference

Patients in supine position or semi Fowlers

10 locations for electrodes placed on body

V1, V2, V3, V4, V5, V6, RA, LA, LL, RL

Standard EKG paper speed

25 mm/second

Supplies needed for EKG

electrocardiograph: instrument to produce EKG

electrocardiograph paper: special graph paper

electrodes: ten electrodes or sensors used to record electrical activity

lead wires: wires that carry info

razor: disposable razor may be needed for hair removal on chest

Sinus bradycardia

dysrhythmia of heart rate less than 60/min

Sinus tachycardia

dysrhythmia with a heart rate greater than 100/min and one P wave preceding each QRS complex

Atrial fibrillation

rapid, disorganized firing of multiple sites within the atrial tissue. This results in lots of fibrillatory waves between QRS complexes. It also results in an irregular QRS rhythm. Pts are at higher risk for blood clots

Atrial flutter

a single area within the atrial tissue is firing at a rate faster than the rate the ventricles are responding to

Ambulatory cardiac monitoring besides EKG

stress testing, Holter or ambulatory monitoring

What to check for as the EKG is being recorded

Universal standardization mark (10mm high), R wave in lead I, baseline tracking through the middle, no abnormal spikes, and visible QRS, and T waves

Ventricular arrhythmias

altered conduction in ventricles usually due to ventricular tachycardia and ventricular fibrillation