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hemodynamics > Ch.18 Egans > Flashcards

Ch.18 Egans Flashcards

1
Q

The _____ is the most important diagnostic tool that in some settings is obtained by the respiratory therapist

A

ECG

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2
Q

Why is the ECG so popular?

A
  • inexpensive
  • noninvasive
  • easy to obtain
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3
Q

Why is the ECG used?

A

To help evaluate a pt with signs and symptoms of cardiac disease

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4
Q

What can an ECG also be used for?

A

To detect abnormalities that already occur in pts w/ an MI or preoperative screening

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5
Q

The muscle cells of the heart normally are stimulated and pace by the electrical activity of the cardiac______?

A

Impulse conducting system

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6
Q

The cardiac muscle cells generate electrical imbalance across the cell membrane with a ________charge on the outside, and a _______charge on the inside

A

Positive ; negative

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7
Q

What is the resting or polarize state?

A

When there is no electrical activity

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8
Q

Stimulation of _______ cells causes an influx of ______into the interior portion of the cell?

A

Polarized ; Na+

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9
Q

An influx of Na+ into the interior portion of the cell is called what?

A

Depolarization

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10
Q

Depolarization causes the cardiac muscle cells to ________momentarily?

A

Contract

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11
Q

Depolarization is immediately followed by what?

A

Repolarization

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12
Q

What is a repolarization?

A

A rapid return of the cell to the “polarized” position in which an electrical imbalance across the membrane is reestablished

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13
Q

The impulse conduction system has three types of cardiac cells capable of electrical excitation. What are they?

A

• Pacemaker cells
• specialized rapidly conducting tissue
• AV muscle cells

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14
Q

The ability of the cells to depolarize without stimulation is known as_______?

A

Automaticity

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15
Q

The impulse conduction system is responsible for_____ and _______? It also does what?

A

Initiating the heartbeat ; controlling the heart rate ; coordinates the contraction of the heart chambers

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16
Q

A deceptive the impulse conduction system may lead to what?

A

Inadequate cardiac output and decreased tissue perfusion

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17
Q

Where is the SA node located?

A

Upper portion of the right atrium

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18
Q

T or F the SA node has the greatest degree of automaticity and paces the heart

A

True

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19
Q

The AV node is the _______ pacemaker

A

Backup

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20
Q

T or F the AV node has the second greatest degree of automaticity in a healthy heart

A

True

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21
Q

The AV node paces ventricular activity at a lower heart rate of _______?

A

40 to 60 bpm

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22
Q

Once the impulse exits the AV node where does it go?

A

It enters the bundle of His and rapidly moves to the bundle branches

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23
Q

The bundle branches_______ the purkinje fibers

A

Terminates

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24
Q

What is the equipment that is gathered for a 12 lead ECG?

A

• portable ECG unit
• lead wires
• electrodes

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25
Q

The 12 leads are subdivided into two groups:

A

6 extremity (limb) leads
6 chest (percordial) leads

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26
Q

The 12 leads are bipolar which means what?

A

They permit the measurement of electrical activity in two different directions

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27
Q

What are the limb leads called?

A

1,2,3,aVr, aVL, aVf

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28
Q

What are the six chest leads called?

A

V1, V2, V3, V4, V5, V6

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29
Q

Where is the V1 lead located?

A

The fourth intercostal space to the right of the sternum

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30
Q

Where is the V2 lead located?

A

In the fourth intercostal space just to the left of the sternum and ending with a V6

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31
Q

How large is one box on an ECG?

A

0.20 seconds

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32
Q

How large is one small box within one box on the ECG?

A

0.04 seconds

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33
Q

If the QRS complex is longer than three small boxes, what does that mean?

A

There are ventricular problems

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34
Q

The QRS complex on the ECG equals how many small boxes?

A

3 small boxes

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35
Q

What is the number one cause of sinus tachycardia?

A

Hypoxemia

36
Q

What is the treatment for bradycardia?

A

Atropine

37
Q

What are the steps to interpreting an ECG?

A
  1. Identify the atrial and ventricular rates
  2. Measure the PR interval
  3. Evaluate the QRS complex
  4. Evaluate the T-wave
  5. Evaluate the ST segment
  6. Identify the RR interval
  7. Identify the mean QRS axis
38
Q

A normal sinus rhythm has what type of P wave?

A

Upright

39
Q

How long does the PR interval last?

A

0.12 to 0.20 seconds

40
Q

How long does the QRS complexes last?

A

0.12 seconds

41
Q

The ST segment is _____?

A

Flat

42
Q

How long does the PR interval last?

A

0.12 seconds between QRS complexes

43
Q

What is the normal adult heart rate?

A

60-100bpm

44
Q

What is sinus arrhythmia?

A

It’s recognized by the irregular spacing between QRS complexes

45
Q

How long does the RR interval last during a sinus arrhythmia?

A

More than 0.12 seconds

46
Q

Sinus arrhythmia may occur with affects of breathing on the heart, or as a side effects of medication, such as______?

A

Digoxin

47
Q

Most cases of sinus arrhythmia are______ and do not need treatment?

A

Benign

48
Q

What is first-degree heart block?

A

The PR interval is longer than 0.20 seconds

49
Q

What is another name for second-degree heart block?

A

Type 1(Wenckebach or Mobitz type 1)

50
Q

What is third-degree heart block?

A

It indicates that the singnal between the atria and the ventricles is completely block

51
Q

The atria and ventricles are paced by _____ sources?

A

Independent

52
Q

In 3rd degree block the P-P and R-R intervals are _____ but have no correlation with each other

A

Regular

53
Q

What is atrial flutter?

A

The rapid depolarization of the atria resulting from an ectopic focus that depolarizes at a rate of 250 to 350 times per minute

54
Q

What kind of pattern will you see in atrial flutter?

A

Sawtooth baseline pattern

55
Q

What kind of conditions can produce atrial flutter?

A

Rheumatic heart disease, coronary heart disease, pulmonary embolism, stress, renal failure, and hypoxemia

56
Q

What is the treatment for atrial flutter?

A

Digoxin, beta blockers, calcium channel blockers

57
Q

What is atrial fibrillation?

A

The atrial muscle quivers in an irregular pattern

58
Q

The ventricular rate is often very______ in atrial flutter

A

Irregular

59
Q

What is ventricular tachycardia?

A

A run of three or more PVCs

60
Q

What do the waves look like on ventricular tachycardia?

A

A series of wide bizarre QRS complexes that have no preceding P wave

61
Q

What is the ventricular rate for ventricular tachycardia?

A

100 to 250 bpm

62
Q

What is ventricular fibrillation?

A

Erratic quivering of the ventricular muscle mass it causes the cardiac output to drop to zero

63
Q

What is the most life-threatening arrhythmia?

A

Ventricular fibrillation

64
Q

What kind of shape will you see in ventricular fibrillation?

A

Irregular fluctuations with a zigzag pattern

65
Q

How do you fix ventricular fibrillation?

A

• Rapid defibrillation
• cardiopulmonary resuscitation
• administration of O2
• anti-arrhythmic medications

66
Q

A V-tach is left untreated what could it progress to?

A

V-fib

67
Q

What are some meds for V fib?

A

Amiodarone or adenosine

68
Q

What is some medication for PVCs?

A

Lidocaine

69
Q

What is PEA?

A

A serious condition characterized by a disassociation between the electrical and mechanical activity of the heart

70
Q

What happens during PEA?

A

The heart generates an electrical signal that produces an ECG pattern on the monitor but the heart does not mechanically generate a pulse

71
Q

PEA is relatively_______?

A

Rare

72
Q

What kind of conditions will you see with PEA?

A

• Pneumothorax
• MI
• Drug overdose
• Severe electrolyte or acid base disturbance

73
Q

What are the Hs? 7 total

A

• Hypovolemia
• hypoxia
• hyperkalemia
• hypokalemia
• hyperthermia
• hypoglycemia
• acidotic state too much H+ ions

74
Q

What are your Ts? 6 total

A

• Trauma
• Tension pneumothorax
• Toxins (poison)
• Tamponade (cardiac)
• Thrombosis (coronary)
• Thrombosis (pulmonary)

75
Q

Name this arrhythmia?

A

Normal sinus rhythm

76
Q

Name this arrhythmia?

A

Sinus tachycardia

77
Q

Name this arrhythmia?

A

Sinus bradycardia

78
Q

Name this arrhythmia?

A

Sinus arrhythmia

79
Q

Name this arrhythmia?

A

First-degree heart block

80
Q

Name this arrhythmia?

A

Second-degree heart block type 2

81
Q

Name this arrhythmia?

A

Third-degree heart block

82
Q

Name this arrhythmia?

A

Atrial flutter

83
Q

Name this arrhythmia?

A

Atrial fibrillation

84
Q

Name this arrhythmia?

A

PVC

85
Q

Name this arrhythmia?

A

Ventricular tachycardia

86
Q

Name this arrhythmia?

A

Ventricular fibrillation

hemodynamics (14 decks)

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