BRTP10 Electrocardiograms

Question 1

ECG or EKG

Answer 1

Electrocardiogram- tracing the hearts electrical activity (depolarization and repolarization)

Question 2

When is ECG needed?

Answer 2

Symptoms of heart disease
Chest pain
Shortness of breath
Dyspnea with palpitations
Weakness, lethargy
Syncope
Preoperative screening

Question 3

What does an EKG measure?

Answer 3

Cardiac electrical activity

Depolarization and repolarization of the atria and ventricles

Question 4

Conductivity pathway of the heart

Answer 4

SA Node
AV node 
Bundle of HIS
Bundle branches 
Purkinje fibers

Question 5

HR range of SA NODE

Answer 5

60-100

Question 6

HR range of AV node

Answer 6

40-60

Question 7

HR range of bundle branches

Answer 7

30-40

Question 8

Hr range of purkinje fibers

Answer 8

30-40

Question 9

What happens if sympathetic nervous system is stimulated

Answer 9

HR speeds up

Question 10

What happens if parasympathetic nervous system is stimulated?

Answer 10

Hr slows

Question 11

What does a p wave represent

Answer 11

Atrial depolarization (contraction)

Question 12

What does QRS complex represent?

Answer 12

Ventricular depolarization and atrial Repolarization

Question 13

What does t wave represent?

Answer 13

Ventricular repolarization

Question 14

What is a segment?

Answer 14

A portion of baseline (straight line)

Question 15

What is an interval

Answer 15

Contains at least one WAVE

Question 16

What do 3 leads and 5 leads do?

Answer 16

Monitor heart

Question 17

What does a 12 lead do?

Answer 17

Diagnositics

12 different angles

Question 18

Placement for a 3 lead?

Answer 18

RA white
LA black
LL- red

white on right, smoke over fire

Question 19

5 lead placement

Answer 19

Same as 3 except brown is added on chest and green is added on right lobe

Remember grass is green and low

Question 20

5 step approach to ECGs analysis

Answer 20

Heart rate
Rhythm
P wave
Pr interval 
Qrs complex

Question 21

How many seconds is a small box?

Answer 21

0.04 seconds

Question 22

How many seconds is a large box?

Answer 22

0.2 seconds

Question 23

Normal sinus rhythm (NSR)

Answer 23

Everything is normal

Question 24

Sinus bradycardia

Answer 24

Rhythm is regular, but slow

Question 25

Sinus tachycardia

Answer 25

Regular rhythm, but fast

Question 26

Arrhythmia

Answer 26

An abnromal heart rhythm

Question 27

What is the duration of a PR interval?

Answer 27

0.12-0.2 seconds (3-5 little boxes)

Question 28

Increased heart interval indicates what?

Answer 28

A heart block

Question 29

How long is a QRS interval

Answer 29

0.1 seconds (less than 2.5 little boxes)

Question 30

Tall t waves

Answer 30

Hyperkalemia

Question 31

Flat t waves

Answer 31

Hypokalemia

Question 32

Inverted t waves

Answer 32

Low k, ischemia

Question 33

What is artifact

Answer 33

Interference seen on the monitor or ECG strip

Question 34

4 causes of artifact

Answer 34

Movement Loose electrodes (fuzzy baseline) Improper grounding Faulty ecg apparatus

Question 35

ST depression indicates what

Answer 35

Ischemia

Question 36

ST elevation indicates what?

Answer 36

Heart attack (myocardial infarction)

Question 37

5 components of ecg strip

Answer 37

``` HR Rhythm P wave Pr interval Qrs complex ```

Question 38

How long is a PR interval

Answer 38

0-12-0.2 seconds

Question 39

How long is a QRS complex

Answer 39

0.1 seconds

Question 40

Normal sinus rhythm

Answer 40

Rate 60-100

Question 41

Sinus bradycardia

Answer 41

Rate less than 60 Slow but regular rhythm P, qrs, T wave all normal Causes: physical finess, medications, heart block/ damage

Question 42

Sinus tachycardia

Answer 42

Rate greater than 100, less than 150 Fast but regular rhythm P, qrs, t wave all normal Causes: exercise, smoking, anxiety, fever, acute hypoxia, pain

Question 43

Premature ventricular contraction | PVC

Answer 43

Wide, bizarre, greater rhan .10 seconds No p wave Irritability of ventricles

Question 44

Monomorphic

Answer 44

All PVC look the same and come from same site

Question 45

Polymorphic

Answer 45

Look different, coming from two or more irritable areas in the ventricles

Question 46

Ventricular tachycardia

Answer 46

3 or more consecutive PVCs QRS wide and irregular HR generally 120-200 Life threatening always check pulse **Looks like long fangs**

Question 47

More characteristics of ventricular tachycardia

Answer 47

No pwaves No pr interval Abnormally wide QRS ( greater than .10 secs)

Question 48

Ventricular fibrillation

Answer 48

Quiver Not organized, irregular Chaotic pattern No cardiav output/ no pulse Treat with cpr and defibrillation *think small jagged teeth with no pattern*

Question 49

Asystole

Answer 49

Absence of any cardiac electrical activity Treat with CPR only

Question 50

Pulseless electric activity (PEA)

Answer 50

Pattern on monitor appears organized and regular No pulse or cardiac output CPR only

Question 51

Atrial flutter

Answer 51

Sawtooth Atria rate of 250-300 times/ min P wave flutters and QRS regular

Question 52

Atrial fibrillation

Answer 52

Irregularly, irregular QRS complex will be irregular P wave will have extremely wavy pattern

Question 53

Halter monitoring

Answer 53

Patient wears monitor 24-48 hours Used in cases where has irregular heart rhythm but wont show up on regular EKG

Question 54

When do you use defibrillation?

Answer 54

When patient doesnt have a pulse and is in Ventricular fibrillation or pulseless v tach

Question 55

When to use cpr

Answer 55

V tach without pulse Ventrical fibrillation Asystole Pulseless electrical activity

Question 56

What arrhytmias (dysrhytmias) are associated with acute hypoxia

Answer 56

Tachycardia

Question 57

What arrhytmias (dysrhytmias) are associated with severe hypoxia

Answer 57

Bradycardia