453: Test 2 EKG

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Flashcards on 453: Test 2 EKG , created by brittny beauford on 14/02/2017.
brittny beauford
Flashcards by brittny beauford, updated more than 1 year ago
brittny beauford
Created by brittny beauford about 7 years ago
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Question Answer
The heart is the engine of the body, it is_________ and___________. electrical mechanical
Cardiac cells are electrically negative at rest. ____IN and_____OUT K+ Na++
Movement of sodium and potassium in and out of the cells cause changes that can be picked up on the ______ by electrodes and translated to the ECG printout. skin
When the cell is stimulated by an electrical impulse,________ rushes into the cell and____________ leaks out. This causes cell to become positively charged, this is referred to as_________! Contraction follows. sodium potassium DEPOLARIZATION
During cell recovery, the sodium-potassium pump returns cell to it’s negative charge. This is____________! Muscle relaxation follows. REPOLARIZATION
#1 SA Node=___-__ beats per minute 60-80
#2 _____=40-60 BMP AV node
#3____,_____, & _______=20-40 BPM HIS, Bundle Branches & Purkinje
Cardiac Intervals One small box=_____ seconds One large box=_____ seconds 5 large boxes=_____ seconds 0.04 seconds .20 seconds 1 second
reference for counting
PR interval – time for electrical impulse to get from _______ to the _________, <0.20 seconds (5 small or 1 large boxes) atria ventricles
_____ interval – measures the time it takes to depolarize the ventricles, < 0.12 seconds (3 small boxes) QRS interval <0.12 seconds is mentioned twice in the powerpoint and .04-.10 seconds is mentioned once
QT interval – measures depolarization and repolarization time of the ventricles. Measured from the beginning of the QRS to the end of the T-wave. Should be less than one half the R – R interval. If prolonged can lead to ____________. Usually 0.36 - 0.44 seconds (9 – 11 little boxes) Lead 2 or V5 – 6 best place to measure. lethal dysrhythmias
Indicates atrial depolarization, or contraction of the atrium. The P wave can have any shape, up, down, or biphasic, as long as it is consistent P wave
Indicates AV node conduction time Duration time is 0.12 to 0.20 seconds PR segment
Indicates ventricular depolarization, or contraction of the ventricles. Interval is .04-.10 seconds or <0.12 seconds QRS interval <0.12 seconds is mentioned twice in the powerpoint and .04-.10 seconds is mentioned once
Indicated ventricular repolarization. Or the ventricles at rest Rounded and asymmetrical T wave
Questions to consider with an EKG Is it regular or irregular? Is there a P wave? Is there a P wave for every QRS? What is the rate ? Is the QRS wide or normal ?
Sinus tachycardia (100 and above)
Sinus rhythm (60-99)
Sinus brady (59 and below )
supraventricular tachycardia (don't need to know) *In class we pretend this is sinus tach even though there is no P wave and it breaks all there rules grrrrr
Atrial fibrilaiton (irregularly irregular with no discernible P wave) If rate is irregular, must calculate by range Ex. this pt is 55-90 (shorts and longest range)
atrial flutter (sawtooth or shark tooth)
Rate control: just because its upside down doesn't mean it doesn't count *cool story bro
3 treatments of A-Fib PREVENTINO OF BLOOD CLOTS: ASA, Warfarin. NOACS-Pradaxa, Xarelto, Eliquis HEART RATE CONTROL: Beta Blockers HEART RHYTHM CONTROL: Sodium Channel Blockers (Flecanide, Quinidine) Potassium Channel Blockers (Amiodarone, Sotalol)
Rest period before heart get ready to beat again Depolarization
Premature atrial contraction (don't need to know) *in class we pretend this is sinus rhythm with a rate even though its not regular once again grrrr
PVC (an ecotype we don't need to know)
PVC (an ecotype we don't need to know)
A sinus rhythm must be/have what? A QRS wave and regular
(lethal ventricular rhythms)
Ventricular tachycardia (lethal ventricular rhythms)
torsades de pointe
ventricular fibrillation (lethal ventricular rhythms)
Treatment of VT or V-Fib Assess patient NOT monitor. Pulse? LOC? VS? CPR, O2, IV, defib/pacer pads Cardioversion: Stable Defibrillate: Symptomatic Rx: Epi, vasopressin, amiodarone, (Lidocaine, old school)
Torsades can occur when magnesium is depeleated
Long QT syndrome Risk factors? Torsades de Pointes Risk factors: Medications, women 2x > men, >65 y/o, Heart Dx, Diuretics, Renal or Hepatic dysfunction, Electrolytes abnorms, Bradycardia,
Treatment Collaborative Care for Torsades STOP CAUSATIVE MEDS Synchronized Cardioversion IV Magnesium (for who?), Potassium, Amiodarone IAD
Education Collaborative Care for Torsades Medications to avoid and those to take Seek care immediately for syncope BLS training for family, consider AED (enter defibrilatior)
Benefits of multiple leads
What is this? Point is sometimes you need more then one lead
What is this? ?
TEST QUESITON Cardioversion and defribilation BOTH SHOCK Defibrilaiton-push button pads go, it will go no matter what when you push button cardioversion synchronized- goes specifically when a pattern is recognized. *Used during Vtach if conscious and unsymtomatic
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