notes lol!
most of the time it is supine position
for some people it can be semi-fowler position
The technician should place a healthy adult patient in the supine position for an EKG.
https://www.brainscape.com/flashcards/nha-4-12265097/packs/21033550#:~:text=An%20EKG%20technician%20is%20performing%20an%20exercise%20stress%20test%20when,a%20shock%20to%20the%20patient.
telemetry -
Lead 1 - left to right arm
lead 2 - right arm to left leg
lead 3 - left arm and left leg
temporary telemetry - holter
continuous telemetry - bedside
sternal angle - angle of louis
anterior axillary - v5
deflection - above the baseline positive
negative deflection - lower than the baseline
The technician should assist the patient to apply a simple face mask before transporting the patient through the facility. This will prevent the spread of infection.
If my baseline is not straight it is wandering
interrupted baseline - broken lead wire
60 cycle/AC interference - electrical interference/phones ex
somatic tremor - movement
Formula for target heart rate- 220 - age 85%
You should stop the stress test when they are dizzy, lightheaded, nausea, severe shortness of breath tingling sensations, numbness, chest pain, or extreme fatigue
The technician should wipe the lead wires and clips with disinfectant before storage to prevent transmission of microorganisms.
For a patient who has dextrocardia, the location of the electrode for lead V1 should be mirrored to its standard placement for a 12-lead EKG.
30 - 49/min expected range for a healthy newborn patient
The left leg is involved in recording electrical activity in leads II and III. Therefore, the technician should check the left leg electrode to correct this error.
Sinus rhythm is characterized by upright P waves, narrow QRS complexes, and a ventricular rate between 60 and 100/min.
A single set of disposable electrodes has enough adhesive gel to allow for two tracings.
The technician should place a patient who is pregnant slightly on her left side with a small pillow supporting the right hip to promote comfort during an EKG tracing.
The technician should have the patient sit quietly for at least 5 min before taking the patient's blood pressure.
The technician should place the lower left extremity lead on the groin of a patient who has a below-the-knee amputation.
The technician should have the patient sit quietly for at least 5 min before taking the patient's blood pressure.
The technician should not touch the patient while allowing the AED to analyze the patient's cardiac rhythm. This is the next action the technician should take.
The expected reference range for a healthy adult patient is 36.5° to 37.2° C (97.7° to 99.0° F).
The EKG tracing shows a somatic tremor. The technician should ask the patient to place their hands under the buttocks with the palms facing down.
The technician should recognize that hand-delivering the records to the provider is one way of protecting the patient's privacy.
The PR interval is a direct reflection of AV node conduction. The PR interval signifies the distance the electrical impulse travels from the start of atrial depolarization to the start of ventricular depolarization.
Loss of capture occurs when pacemaker spikes appear on the patient's EKG tracing but are not followed by the appropriate waveforms. In this case, the pacemaker is providing AV pacing, but there are several pacemaker spikes that are not followed by the appropriate QRS complex. This indicates that, in those instances, the heart is not responding to the pacemaker's electrical impulses.
Surgical tape will help to keep the electrodes from tugging and pulling away from the skin. The technician should send surgical tape home with the patient to use as needed.
The technician should use the radial artery to measure the patient's heart rate because it is the easiest to access and most palpable for an adult patient.
The technician should ensure placement of the V6 electrode exactly on the left midaxillary line when performing an EKG for a child who is over 8 years old.
This is the correct measurement for the QRS complex. Beggining of the Q wave to the end of the S wave
Irregular R-R intervals are commonly seen on pediatric EKGs. Irregular R-R intervals are commonly seen on pediatric EKGs
The electrodes should remain equidistant from one another. If the technician moved the left-leg electrode to the lower left abdomen, the right-leg electrode should be moved to the lower right abdomen.
The technician should apply silver electrodes to a client who is scheduled to receive a series of EKG readings because these electrodes can be left in place and only need to be checked daily.
The patient's symptoms are life threatening and should be addressed immediately. The technician should have someone nearby call emergency services while the technician remains on the call with the patient.
The first action the technician should take is to check the patient and verify asystole in two leads. If the patient is conscious, the technician should then check the electrodes and leads. If the patient is unconscious, the technician should call for help and contact the provider.
https://www.studystack.com/flashcard-3332822
5 leads for a holter monitor
The EKG technician should calibrate the machine to ensure it is working properly.
The technician should place the electrodes for a 3-lead ambulatory monitor on the patient's right shoulder, left shoulder, and lower left abdomen.
The technician should have the patient repeat the instructions back to determine if the patient understands. The technician should also have the patient make the first entry into the diary.
The technician should store the electrodes in the original, foil-lined packaging to prevent the electrode gel from drying out.
The technician should recognize that crossed lead wires will result in electrical interference.
The technician should provide an interpreter to translate for the patient. This will reduce the possibility of miscommunication between the technician and the patient.
The technician should use an alcohol pad, soap and water, or an electrolyte pad to cleanse the patient's skin at the site of electrode placement.
A transtelephonic monitor with loop memory creates a recording of the electrical activity of the heart for the segment of time before, during, and after an episode when the patient presses the record button.
Although it is not an invasive procedure, a stress test requires informed consent. It cannot be performed with implied consent because risk factors are involved.
The technician should instruct the patient to apply the card over the middle to the lower part of the sternum to activate the monitor.
The technician should place the electrodes on the patient's back if the patient cannot move from the fetal position.
The EKG tracing for a patient who has ventricular hypertrophy will display an increased amplitude of the QRS complex. A patient who has ventricular hypertrophy has overdeveloped cardiac muscles, which causes a higher amplitude of the QRS complex.
The technician should recognize that the resting tab electrode gel will not provide accurate results after two consecutive EKG tracings.
The classic presentation of myocardial ischemia includes ST segment depression and T wave inversion.
The technician should place the RL electrode on the patient's right side on the lower abdomen. This location enables the patient to move without interference during the exercise stress test.
The technician should allow the child to touch the equipment before the procedure. The child can place the electrodes on a doll or a parent to show that the procedure does not hurt.
The technician should prepare the site with antiperspirant or tincture of benzoin when applying electrodes to a patient whose skin is diaphoretic, or sweaty.
The carotid pulse is most frequently used to check an adult patient's pulse during CPR. This pulse is located on the front and to the side of the neck.
Improper grounding, crossed lead wires, and electrical interference can produce AC interference, which appears as uniform, small spikes on an EKG tracing.
This is an accurate method for the technician to use while obtaining a respiratory rate. - Place a hand on the middle of the patient’s back to count respirations
The technician should increase the paper speed to 50 mm/second to spread out the tracing. A faster paper speed spreads out the waveforms and makes the tracing easier to read.
The anticipated QRS complex would include positive and negative amplitude pulls to and away from the baseline.
Somatic tremor is caused by body movement, which can occur when a patient is experiencing a seizure.
After attaching the telemetry lead wires to electrodes, the technician should refer to the manufacturer's instructions and check the wire colors to ensure attachment to the correct electrodes.
Pathologic Q waves are typically greater than or equal to one-third the height of the R wave and indicate a previous myocardial infarction.
The technician should clip or shave the patient’s hair to increase electrode adherence to the patient's skin.
The most commonly used speed for an EKG tracing is 25 mm/second. If the technician changes the speed, this information must be noted on the tracing and the provider should be notified.
During a nuclear stress test, the patient should be in a supine position with the arms above the head so the camera can rotate around the patient to produce a multidimensional image.
AN EKG is called to the emergency department to perform a standard 12-lead EKG on a patient. When the technician arrives, the patient is attached to a 5-lead monitor. Which of the following actions should the technician take? - Remove the electrodes for the 5-lead monitor before attaching the electrodes for the 12-lead EKG
The technician should recognize that the expected reference range for a child who is 1 to 2 years of age is a pulse rate of 80 to 140/min.
The technician should explain to the patient that the purpose of an EKG as a part of the physical examination is to allow the provider to compare previous EKG result with the new results to identify any potential changes that occurred.