CVS System: Electrocardiogram (ECG/EKG) – [HESI, Chapter 3]

Flashcard maker : Clarence Louder
The visual representation of the electrical activity of the heart reflected by changes in the electrical potential at the skin surface.
Electrocardiogram (ECG/EKG)
An electrocardiogram (ECG/EKG) is a record of the hearts contractions and electrical events that precede them. T/F
False. An electrocardiogram (ECG/EKG) is NOT a record of the hearts contractions, but is the electrical events that precede them.
An instrument that displays a visual representation of electrical variations of the heart a monitor.
Oscilloscope
The visual representation of an electrocardiogram (ECG/EKG) can be recorded as a tracing on a strip of ________________ ________________ or seen on a oscilloscope.
Graph Paper
What are 5 major complications that can interfere with normal heart functions?
Rate/Rhythm Disturbances
Conductivity Disorders
Enlarged Heart Chambers
Myocardial Infarction (MI)
Fluid & Electrolyte Imbalances
A patients electrocardiogram (ECG/EKG) should contain what information?
Patient Name
Patient Identification Number
Patient Age
Patient Gender
Patient Recordings: Date/Time/Location
Patient Non-cardiac Medications (If Present)
Patient Weight
Patient Blood Pressure (BP)
Patient Diagnosis/Clinical Status
Patient Position During Recording (If Unusual)
Patient Thoracic Deformities (If Present)
Patient Repiratory Distress (If Present)
Patient Muscle Tremors (If Present)
The standard electrocardiogram (ECG/EKG) is a _____________ lead ECG/EKG.
12
What is commonly seen in the clinical setting?
Telemetry
It uses 3 to 5 leads transmitted to an oscilloscope.
Telemetry
Graphic information is printed either on request or at any time the set parameters are transcended. T/F
True
No true P wave.
A-Fib
While wearing a Holter monitor the patient is instructed to keep a diary concerning what 3 things?
Activity: Exercise/Sex/Valsalva Maneuver
Medications: Times/Doses
Chest Pain
Electrocardiograms (ECG/EKG) consists of small squares representing ____________ seconds. _____________ of these small squares represent one large square.
0.04/5
Electrocardiograms (ECG/EKG) consists of large squares representing ____________ seconds. _____________ of these large squares represents 1 second.
0.20/5
What is the six second rule?
A calculation to determine heart rate (HR). Count the number of RR intervals within six seconds, or 30 square blocks, of an electrocardiogram (ECG) and multiply by ten.
What is the normal composition of an electrocardiograms (ECG/EKG)?
What is the normal composition of an electrocardiograms (ECG/EKG)?
P Wave
QRS Complex
T Wave
U Wave
ST Segment
PR Interval
QT Interval
RR Interval
When can the 6 second rule NOT be used?
When the patients heart rate (HR) is irregular.
Represents atrial systole or depolarization of the atrial muscle.
P wave
The normal P wave should be _________________ without _________________ or _________________.
Rounded/Peaking/Notching
Represents ventricular systole, depolarization, or contraction of the ventricular muscles.
QRS Complex
Normally follows the P wave on an electrocardiograms (ECG/EKG).
QRS Complex
The QRS complex is measured from the beginning of the QRS to the end of the QRS normally lasting less than _________________ second/s.
0.12
Represents ventricular diastole or repolarization of the ventricle muscle.
T Wave
It follows the QRS complex on an electrocardiograms (ECG/EKG).
T Wave
The T wave is normally slightly _________________ without _________________ or __________________.
Rounded/Peaking/Notching
It is a critical time within the heart beat where the heart rests and regroups so that the next heart beat can occur.
T Wave
If defibrillation happens during the T wave what problem can occur?
Dysrhythmia
It represents early ventricular repolarization.
ST Segment
It is measured from the end of the S wave to the beginning of the T wave.
ST Segment
It represents the time required for the electrical impulse to travel from the atrioventricular (AV Node) through the entire cardiac conduction system to the ventricles.
PR Interval
It is measured from the beginning of the P wave to the beginning of the QRS complex.
PR Interval
The PR interval represents atrioventricular (AV) node function that is between ________________ and ________________ second/s.
0.12/0.20
It is not always present on an electrocardiograms (ECG/EKG).
U Wave
The U wave is most prevalent or prominent in the presence of _______________________.
Hypokalemia
It represents the time required to completely depolarize and repolarize the ventricles.
QT Interval
It is measured from the beginning of the QRS complex to the end of the T wave.
QT Interval
The normal QT interval is between ________________ and _______________ second/s and varies with gender, age, and heart rate (HR).
0.36/0.44
Normal Sinus Rhythm.
Normal Sinus Rhythm.
Reflects the regularity of the heart rhythm or ventricular rhythm.
RR Interval
It is measured from one QRS to the next QRS.
RR Interval
How does the nurse measure atrial rhythm?
PP Interval
What is the most important data a nurse can collect on a patient with arrhythmia?
Current Rhythm
If the patients electrocardiogram (ECG) shows a severe dysrhythmia, but is sitting quietly, what does the nurse do first?
Check the patients leads to see if they are attached correctly.
Chaotic activity of the AV node.
A-Fib
Cardioversion is used for these two heart disorders.
A-Fib
A-Flut
Saw tooth waveform with regular ventricular rhythm.
A-Flut
Can use radio frequency catheter ablation.
A-Flut
Wide, bizarre QRS.
V-Tach
Can use synchronized cardioversion if pulse is present, if not than treat it like V-Fib.
V-Tach
It is a cardiac emergency.
V-Fib
Irregular undulations of various amplitude with no CO.
V-Fib
Is implanted using a wire threaded into the right ventricle via SVC or an epicardial wire is put in place.
Temporary Pacemaker
Implanted in the abdomen and shoulder and could be single or double chambered.
Permanent Internal Pacemaker
What should the client who has a pacemaker avoid?
Car Engines
Microwave: 5 Feet
MRI
Fixed firing rate.
Asynchronous Pacemaker
On demand firing rate that fires only when the HR falls below a setting on the generator.
Synchronous Pacemaker
Classes of Antidysrhythmics.
Class I: ABC’s
Class 2: Olol’s
Class 3: Inotropics (Amiodarone HCl)
Class 4: Verapamil HCl/Diltiazem
Misc: Atropine, Digoxin, and Epinephrine.
Vasopressors: Norepinephrine
What drugs are contraindicated in clients with cardiac dysrhythmias?
Bronchodilators
What three dysrhythmia’s are always problematic?
Pulseless Ventricular Tachycardia (T-Tach)
Ventricular Fibrillation (V-Fib)
Asystolye

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