EKG Chapter 6-10 Exam

Sinus Rhythm

originates from SA node/primary pacemaker

Criteria for Classification

Rhythm, Rate, P wave, PR Interval, QRS

Normal Rhythm

regular pattern

Normal Rate

60-100 bpm

Normal P wave

upright and uniform, in front of QRS

Normal PR Interval

.12 to .20 seconds

Normal QRS

.06 to .10 seconds, no variation

P wave

atrial depolarization

QRS segment

ventricular depolarization

P-P

atrial heart rate

R-R

ventricular heart rate

normal EKG strip length

10 seconds

small box length

.04 seconds

large box length

.20 seconds

small box height

.1 mV

large box height

.5 mVE

EKG normal speed

25mm/second

EKG tachycardia speed

50mm/second

Gain normal setting

10mm/mV

Gain adjusted setting (taller)

5 mV

Artifact filter normal setting

140-150 Hz

tachycardia

more than 100bpm

Normal heart rate

60 - 100 bpm

T wave

ventricular repolarization

U wave

purkinje fiber repolarization

U wave is visible

electrolyte imbalance

PR interval

start of atrial depolarization to start of ventricular depolarization

QT interval

start of ventricular depolarization to start of ventricular repolarization

ST segment

end ventricular depolarization to start of ventricular repolarization

Ischemia

sudden loss or reduction of blood to a heart regionc

Cardiac output

volume of blood pumped per minute

stroke volume

volume pumped by left ventricle

cardiac output calculation

stroke volume x heart rate

low cardiac output symptoms

lightheaded, confusion, hypotension, difficulty breathing

low cardiac output

heart not pumping enough blood to the body

Sinus bradychardia

regular heartbeat less than 60 bpm

Sinus tachycardia

regular heartbeat 100-150 bpm

sinus dysrhythmia

irregular heartbeat within 60-100 bpm, follows breathing pattern

sinus arrest

regular rate with pauses under 6 seconds

Abnormal sinus rhythm

impulse from SA node, rhythm or rate abnormal

Atrial Dysrhythmia

ectopic atrial impulse, p wave abnormal

Premature Atrial Complex (PAC)

early impulse causes abnormal p wave, irregular rhythm

Wandering Atrial Pacemaker (WAP)

3 different p waves in one lead, normal rate

Multifocal Atrial Tachycardia

3 different p waves, 100-150 bpm

Atrial Flutter (AF)

P wave hidden, flutter wave, 250-350 bpm

Atrial Fibrillation (A Fib)

no p wave, chaotic wave, 375-700 bpm

Polarization

resting state, inside negative charge, outside positive charge

depolarization

electrical activation

action potential

change in polarization, contraction

repolarization

relaxation

vagal tone

when stimulation of the vagus nerve causes changes in heart rate

asystole

no electrical current through cardiac conduction system

sinus exit block

SA impulse is blocked from atrium

ectopic impulse

impulse outside the SA node that overrides the SA impulse

Somatic tremor error

body tremors cause small erratic spikes

somatic tremor solution

place hands under butt

wandering baseline error

improper application causes wavy baseline

wandering baseline solution

reapply electrodes

alternating current interference

lead wires crossed or intercepted

alternating current solution

move patients bed, reposition wires

interrupted baseline error

damaged or dirty equipment

interrupted baseline solution

replace or clean equipment

patient is pale and breathing fast, but heart rate normal

report to physician

sinus dysrhythmia cause

stimulated vagus nerve follows breathing

Classical Heart Block aka

Mobitz 2

Premature Junctional Complex (PJC)

inverted p wave, premature irregular rhythm, shorter PR, less than 4-6 instances per minute

Junctional Escape Rhythm

inverted p wave, regular rhythm, shorter PR, bpm 40-60

Accelerated Junctional Rhythm

inverted p wave,regular rhythm, shorter PR, bpm 60-100

Junctional Tachycardia

p wave inverted, regular rhythm, shorter PR, bpm 100-180,

Junctional Dysrhythmia

electrical impulse from AV Junction, inverted, late, or hidden p wave, PR shorter

Supraventricular Tachycardia

regular rhythm, no p wave or late p wave, bpm 150-250

Wolfe Parkinson White syndrome (WPW)

regular rhythm, PR shorter, longer QRS, bpm 150-250

Coronary artery

first branch of aorta

coronary artery branches

posterior descending, marginal, circumflex, left anterior descending, diagonal

widowmaker

when anterior descending artery is obstructed, the left ventricle is not supplied with blood

coronary artery walls

tunica intima, tunica media, tunica adventitia

Inferior left ventricle leads

I, III, aVF

inferior left ventricle arteries

right coronary, marginal

Example of ethics as a healthcare professional

maintaining confidentiality and patient health information

who signs the consent form for illiterate patients?

family member or witness

PPE

personal protective equipment

an EKG records

electrical activity of the heart

Electrocardiograph

machine used to record electrical activity of the heartel

electrocardiogram

recording of the hearts electrical activity

heart valves

bicuspid, tricuspid, pulmonary, aortic

atrioventricular heart valves

bicuspid and tricuspid/mitral

semilunar heart valves

pulmonary and aortic

largest veins

vena cava

largest artery

aorta

first vessels branched from aorta

coronary arteries

automaticity

ability to initiate an electrical impulse without stimulation

bundle branch function

conduct impulses from AV Bundle to ventricles

Unipolar leads

augmented and chest leadsb

bipolar leads

standard/limb leads

12 lead EKG

3 standard, 3 augmented, 6 chest

preferred electrode for hospital/acute care

silver

most accurate method for calculating regular heart rhythm

1500 method

most accurate method for calculating irregular heart rhythm

6 second method

first requirement for an EKG

physician’s order

if patient asks why the curtain is closed during an EKG

explain that its for privacy