ECG

Question 1

what is the pacemaker pace of the SA node?

Answer 1

60-100bpm

Question 2

what is the pace of the AV node?

Answer 2

40-60

Question 3

what is the pace of the ventricle cells?

Answer 3

20-40bpm

Question 4

what is preload?

Answer 4

The amount of stretch on the right ventricle from blood returning to the heart
More stretch = more forceful contraction….up to a point!

Question 5

what is after load?

Answer 5

The force against which the left ventricle must pump

systemic vascular resistance – SVR

Question 6

how many electrodes are you putting on your patient for a 12 lead?

Answer 6

10. 6 chest leads and 4 limb leads

Question 7

what are leads?

Answer 7

leads refer to the tracing of the voltage between the electrodes on the ECG printout

Question 8

(idk if we need to know this) which leads are the interior leads?

Answer 8

leads II, III, and aVF. Look at electrical activity from the vantage point of theinferiorsurface (diaphragmatic surface of heart)

Question 9

(idk if we need to know this) what leads are the lateral leads?

Answer 9

(I, aVL, V5and V6 ) Look at the electrical activity from the vantage point of thelateralwall of leftventricle

Question 10

(idk if we need to know this) what leads are the septal leads?

Answer 10

(V1and V2) Look at electrical activity from the vantage point of theseptalsurface of the heart (interventricular septum)

Question 11

(idk if we need to know this) what leads are the anterior leads?

Answer 11

(V3and V4) Look at electrical activity from the vantage point of theanteriorwall of the right and left ventricles (Sternocostal surface of heart)

Question 12

what does a positive waveform mean?

Answer 12

electrical current moves towards the positive electrode

Question 13

if the current moves away from the positive electrode what does the wave look like?

Answer 13

inverted waveform

Question 14

how are the leads placed for a 5 lead? remember the saying think she used

Answer 14

RA white (white to the upper right), RL green (clouds over grass), LL (left leg red- smoke over fire), V1 smoke over fire, LA left arm (black)

Question 15

what does the P wave mean?

Answer 15

atrial depolarization

Question 16

what does QRS mean?

Answer 16

ventricular depolarization

Question 17

what does T wave?

Answer 17

ventricular repolarizatin

Question 18

how many seconds is one small box?

Answer 18

0.04 s

Question 19

how many seconds is one large box?

Answer 19

0.2 s

Question 20

what is the amplitude of one large box?

Answer 20

0.5mV or 5mm

Question 21

what are the normal features of the P wave: height, seconds duration, placement?

Answer 21

Precedes the QRS
2 – 3mm high
0.6 – 0.12 seconds duration
Rounded, smooth, and upright in lead II

Question 22

what is important to evaluate when looking at the PR interval? what is happening during this time?

Answer 22

duration. tracks the atrial impulse from the atria through the AV node, bundle of his and r and l bundle branches

Question 23

what is the duration of the PR interval?

Answer 23

0.12-0.2 seconds

Question 24

what do changes in the PR interval indicate?

Answer 24

an altered impulse formation or a conduction delay, as seen in AV block

Question 25

what do you pay special attention to when evaluating the QRS complex?

Answer 25

duration and configuration

Question 26

characteristics of QRS complex? location, duration, height, what does it consist of?

Answer 26

follows PR interval. 5 to 30 mm high but differs for each lead used 0.06 to 0.10 second, or half of the PR interval consists of the Q wave (the first negative deflection after the P wave), the R wave (the first positive deflection after the P wave or the Q wave), and the S wave (the first negative deflection after the R wave

Question 27

where does the PR interval start and end?

Answer 27

starts at the BEGINNING of the p wave and the BEGINNING of QRS

Question 28

what do you pay attention to for the St segment?

Answer 28

pay attention to deflection

Question 29

where is the ST segment?

Answer 29

extends from the S wave to the beginning of the T wave

Question 30

is the ST segment positive or negative?

Answer 30

usually isometric (neither positive or neg)

Question 31

the point that marks the end of the QRS complex and the beginning of the ST segment is known as the

Answer 31

J point

Question 32

what does a change in the ST segment indicate?

Answer 32

myocardial damage. might be elevated or depressed

Question 33

what do you evaluate when looking at a T wave?

Answer 33

amplitude, configuration and deflection

Question 34

what is the height of the T wave? duration?

Answer 34

.5mm and duration is not measured

Question 35

what do you look at for the Qt wave? where is it?

Answer 35

the duration. | beginning of QRS and end of T wave

Question 36

what does the WT interval measure? when does it vary?

Answer 36

vernacular depolarization AND repolarization. varies according to heart rate

Question 37

prolonged Qt intervals indicate what?

Answer 37

relative refractory perid is longer. it is a congenital conduction- system defect in families

Question 38

short QT intervals may result from what?

Answer 38

dignoxin toxicity or hypercalcemia

Question 39

is the U wave always present? where is it? what does it look like?

Answer 39

no. after T wave. rounded and upright

Question 40

what is the U wave?

Answer 40

represents the recovery period of the Purkinje or ventricular conduction fibers

Question 41

a prominent U wave may be due to what?

Answer 41

hypercalcemia, hypokalemia or digoxin toxicity

Question 42

what are the 8 steps for an 8 step interpretation?

Answer 42

1. determine the rhythm 2. determine the rate 3. eval the P wave 4. measure the PR interval 5. measure the QRS 6. eval the T wave 7. measure the QT interval 8. note any abormalities and conclude your analysis

Question 43

how do you determine the rhythm?

Answer 43

measure from P-P and R-R | are they regular ? using caliper or paper

Question 44

how do you determine the rhythm?

Answer 44

Count the small squares between two consecutive P waves and then divide 1,500 by that number to get the atrial rate. To obtain the ventricular rate, use the same method with two consecutive R waves. ie: 1500/20 = 75 BPM or print a 6 second strip and count number of P waves and multiply by 10 and repeat for R waves every 3 sec is marked

Question 45

what do you ask yourself when evaluating the P wave?

Answer 45

How do they look? Normal? Upright? Rounded? Are they all a similar size and shape? Is there one P wave per QRS complex?

Question 46

how do you measure the PR interval?

Answer 46

count small squares between the P and beginning of QRS and multiply by 0.04

Question 47

how do you measure the QRS?

Answer 47

Measure from the end of the PR interval to the end of the S wave Count the number of small squares and multiply by 0.04

Question 48

what do you ask yourself when evaluating the t wave?

Answer 48

Are there T waves? Are they upright in lead II? Are they all the same shape? Does each T wave follow a QRS complex?

Question 49

how od you measure the QT interval?

Answer 49

Count the number of small squares between the beginning of the QRS complex and the end of the T wave, where the T wave returns to the baseline and multiply by 0.04

Question 50

does the QT interval increase or decrease when the heart increases?

Answer 50

decreases

Question 51

what do you ask yourself for abnormalities ?

Answer 51

Are there any ectopic beats? Anything else unusual? Is the ST segment isoelectric? Elevated? Depressed? Record and document your findings

Question 52

how do you document your analysis?

Answer 52

name your strip based on: The origin of the rate (sinus node, atria, AV node, or ventricles) The rate (bradycardic, tachycardic) Rhythm abnormalities (flutter, fibrillation, heart block, escape rhythm, or other arrhythmias)