EKG Exam 1 Review Flashcards

Assault

Threatening or attempting to harm someone physically, which causes the victim to fear immediate bodily harm.

Battery

Intentionally and unlawfully touching another person without their consent, resulting in harmful or offensive contact.

Slander

Making false spoken statements about someone

Libel

Making false written/published statements about someone

HIPAA

Health Insurance Portability and Accountability Act; keep patient info private

Standard precautions

basic precautions applied to all patients;

PPE Required:

• Gloves

• Hand Hygiene

Contact Precautions

Precautions used when a patient has a contagious disease spread via contact

PPE:

• Gloves

• Gown

• Hand Hygiene

Airborne Precautions

Precautions taken when a patient has a disease spread via airborne particles

Patient is placed in a negative pressure room

PPE:

• N95 Mask

• Gloves

• Eye Protection

• Hand Hygiene

Normal Temp for adults/children

97°F-99°F (36.1°C-37.2°C)

Best place to obtain a temperature on adult

orally

Best place to obtain a temperature on infant (0-3months)

Rectally

Best place to obtain a temperature on child

orally or tympanic (ear)

Normal Pulse Ox range

95-100%

Normal heart rate for adults

60-100 bpm

Normal heart rate for children

70-120 bpm

Normal heart rate for infants

100-160 bpm

Best place to take pulse on adults?

Radial pulse (wrist)

Best place to take pulse on infant?

apical pulse

What is the normal/most commonly used paper speed?

25 mm/s

An EKG tech is preparing to perform a standard 12-lead EKG on a patient who has a heart rate of 150/min. Which of the following speed controls should the EKG tech select?

50 mm/s

What is gain?

Gain is the amplification of the electrical signals produced by the heart.

What does adjusting gain do?

Increasing gain will make rhythm look bigger; decreasing gain will make rhythm look smaller

Lead l and aVL

High Lateral

Lead ll, lll and aVF

inferior wall

V1 and V2

septal wall view

V3 and V4

anterior wall

V5 and V6

low lateral wall

aVR

no view, because it is a ground lead

Resting tab electrodes

electrodes that are meant to be used when the patient is resting; These electrodes will not conduct accurately after two EKG tracings.

How to position patient during EKG

Supine (lying on their back)

How to position a pregnant patient during an EKG

Semi-Fowler’s position

Which of the following should you check if multiple artifacts appear in Lead 1 and 2?

Right Arm

If the arm limb electrodes are reversed, what EKG tracings will change?

Lead 1 and avR

Ventricular pacemaker cells are found in the ________

Purkinje Fibers

What should the EKG tech do if one of the leads shows a flat line?

Check if all wires are attached to electrodes

Widened QRS complexes and ST segment depression with T-wave inversion indicates:

bundle branch block

Lead 2 shows the tracing between which limbs?

Right arm and Left leg

Blood pressure should be taken how often during a stress test?

2.5 minutes

If RA and LA are switched, what lead will it show a downward deflection in?

Lead 1

Where is V7 placed?

Left posterior axillary line; same horizontal plane as V6

Where is V8 placed?

Tip of left scapula; same horizontal plane as V6

Where is V9 placed?

Left paraspinal region; same horizontal plane as V6

Common symptoms of atrial arrhythmias

Palpitations, SOB, fatigue, dizziness, chest pain, weakness, fainting

Common symptoms of ventricles arrhythmias

Palpitations, SOB, fatigue, dizziness, chest pain, weakness, fainting, sudden cardiac arrest

First-degree heart block

prolonged PR interval (>0.20)

Second-degree heart block type 1

progressive lengthening of the PR interval until a beat is dropped (Wenkebach)

Second-degree heart block type 2

intermittent failure of impulses being sent to the ventricles WITHOUT progressive lengthening PR intervals

Third-degree heart block

atria and ventricles beat independently of each other; no communication at all; CAN LEAD TO CARDIAC ARREST

What should the EKG tech do if a patient has a idioventricular rhythm?

assess the patient, call the doctor/nurse, monitor the patient

[Cardiac cycle] p wave corresponds to?

Atrial systole (contraction)

[Cardiac cycle] QRS to T-Wave corresponds to?

Ventricular systole (contraction)

[Cardiac cycle] What happens between QRS to start of P wave

Atrial diastole (relaxation)

[Cardiac cycle] What happens between end of T-wave to start of QRS wave

Ventricular diastole (relaxation)

Wandering Baseline

Gradual shifting of the baseline on an EKG tracing, often due to patient movement or improper electrode placement.

Artifact

Unwanted signals or disturbances on an EKG tracing that are not related to the heart's electrical activity

Wandering Baseline

shifting of the baseline on an EKG tracing, due to patient movement or improper electrode placement.

Indications of a past MI in an EKG strip:

• Abnormal Q-waves

• Persistent ST-segment elevation or depression

• T-wave inversion

What differentiates accelerated idioventricular rhythms from junctional rhythms?

accelerated idioventricular rhythms have prolonged QRS complexes (>0.20), while junctional rhythms have shorter QRS complexes (<0.12)

Stress test uses:

Assessing cardiovascular function during physical exertion; diagnosing CAD; assessing effectiveness of medicine; evaluating symptoms such as chest pain/SOB

Stress test patient education:

• Instruct patient to wear comfortable clothing and shoes for exercise

• Tell patient to not drink caffeine or eat heavy meals before test

Stress test electrode placement

V1-V6 placed normally, limb electrodes are placed on torso

Stress test target heart rate formula:

220 - patient age = target HR

When is a stress test stopped?

When the patient experiences chest pain, significant EKG changes, severe change in BP (increase or decrease), extreme fatigue or SOB

What to report to doctor after stress test:

significant changes in EKG, symptoms of patient, and changes in vital signs

What to do if a patient starts hyperventilating during a stress test:

reassure them and tell them to take slow, deep breaths; give them a paper bag; watch patient closely for worsening symptoms

Holter monitor uses:

continuous monitoring of the heart over a 24-48 hr time period

Patient instructions for Holter monitor:

• Continue normal activities during the monitoring period

• Keep diary of symptoms/events that occur

  • Avoid getting monitor wet

Patient preparation for Holter monitor:

• Abrade skin with alcohol pads for good stick

• Attach electrodes to chest (5 lead placement)

• Use tape to secure the electrodes

  • Connect electrodes to holter monitor

When is a Holter monitor recommended?

• Your heartbeat is too fast or too slow.

• You experience symptoms like low blood pressure, dizziness, or shortness of breath.

  • An electrocardiogram (EKG) didn’t reveal the cause of your symptoms.

• You’ve been diagnosed with a heart condition.

Event monitor

Activated by patient when they are experiencing symptoms; Doesn’t monitor continuously