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Module 1 > Basic ECG > Flashcards

Basic ECG Flashcards

1
Q

What is the inherent pacemaker of the heart?

A

SA node.
At a rate of 60-100

Any cell in the heart an initiate an impulse.

The fastest pacer will always control the pace of the heart.

SA node may be working fine, but it may not be the fastest.

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2
Q

What does the P wave indicate?

All P waves must be?

A 
Atrial depolarization 
(does not tell about contraction)

Identical in size, shape, and position (this is what distinguishes from a U wave)

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3
Q

What does the QRS wave indicate?

A

Ventricular depolarization

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4
Q

What does the T wave indicate?

A

Ventricular repolarization

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5
Q

What is the appropriate time measurement for the PR interval?

A

.12 - .2 sec.

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6
Q

What is the appropriate time measurement for the QRS interval?

A

less than .12 seconds

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7
Q

What is the time measurement for one SMALL box on the EKG paper?

A

.04 sec

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8
Q

What is the time measurement of one LARGE box on the EKG paper?

A

.20 sec

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9
Q

How do you calculate heart rate?

A

Take a pulse
Rapid rate calculation
Precise rate calculation

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10
Q

What are the RULES for Normal Sinus Rhythm?

A 
Determine the regularity of R waves
Calculate the heart rate
Identify and examine P waves
Measure the PR Interval
Measure the QRS complex
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11
Q

Important Measurements

A

PR interval - .12 - .20 sec.
QRS complex – less than .10 seconds
P – P – Regular
R – R - Regular

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12
Q

Analyzing a Rhythm StripStep – by - step

A 
Determine the regularity of R waves
Calculate the heart rate
Identify and examine P waves
Measure the PR Interval
Measure the QRS complex
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13
Q

Calculate the heart rate

A

Rapid rate calculation-
Count the number of R waves in a 6 sec strip
Multiply by 10
Do not include premature beats in calculating

Precise rate calculation-
Count the number of small squares between two consecutive R waves
Divide the number of small squares into 1500 or use a conversion chart
Only accurate for REGULAR RHYTHMS

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14
Q

Identify and Examine P waves

A

One P wave preceding each QRS
All P waves identical in shape, size, and position
P to P interval should be regular

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15
Q

Examine the ST Segment

Normal ST segment is:

Elevation or depression measuring ____ above or below is abnormal

Elevation =

Depression =

A

flat and at the isoelectric line

1mm

acute myocardial injury

myocardial ischemia, hypokalemia, digitalis

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16
Q

Assess the patient

Is there a PULSE with that Rhythm???!!!

False high alarms-
False low alarms (Turn up the amplitude, change lead positions)
- FOR BOTH, DO NOT TREAT THE MACHINE, TREAT THE PATIENT

Artifact- movement, hair, poor connection, electrical razor

A
17
Q

Normal Sinus Rhythm

A 
Rhythm:   	   Regular
Rate:        	   60 – 100
P waves:   	   1 P wave before each QRS	
	                  Normal in appearance
PR:           	  .12 - .20 seconds
QRS:         	  < .12 seconds

There is only one normal sinus rhythm.
Sinus tachycardia and Sinus bradycardia are not normal sinus rhythms even if their cause is not pathologic (such as with climbing the stairs causing tachycardia, or a well conditioned athlete causing bradycardia)

18
Q

Sinus Tachycardia

Causes:

A 
Rhythm:   	Regular
Rate:   		100 - 160
P waves:	     	1 P wave before each QRS
				Normal in appearance	
PR:		.12 seconds - .20 seconds
QRS:		< .12 seconds

Pain, volume deficiency, pump problem/perfusion (these are pathologic causes that need to be treated)

19
Q

Sinus Bradycardia

A 
Rhythm:   	Regular
Rate:   		40 - 60
P waves:	     	1 P wave before each QRS
			Normal in appearance	
PR:		.12 seconds - .20 seconds
QRS:		< .10 seconds
20
Q

Sinus Arrhythmia

A 
Rhythm:		Irregular
Rate:		60 - 100
P waves:		1 P wave for each QRS
				Normal in appearance
PR:		.12 seconds - .20 seconds
QRS:		< .10 seconds
21
Q

Monitoring in leads 1, 2, and 3 - p wave is ____

A

upright

22
Q

U waves indicate:

A

repolarization issues

23
Q

Irregular rhythms are normal with:

A

children

24
Q

Always check to see if there is a pulse with a rhythm because?

A

You can have a rhythm with no pulse

25
Q

A heart rate less than 40 means:

A

that it is not sinus

26
Q

Just because it is Sinus does not mean that you don’t treat it

A
27
Q

If STEMI occurs with patient, what do you do?

A 
O2
Morphine
large bore IV
Troponin levels (higher than 0.4 indicate MI)
BMP (potassium and sodium)

Module 1 (11 decks)

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