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Certified Medical Assistant > Module 13: EKG and Cardiovascular Testing > Flashcards

Module 13: EKG and Cardiovascular Testing Flashcards

1
Q

CMA role in cardiovascular testing

A
  • preparing pt
  • providing post-procedure assistance
  • accurately and efficiently performing test
  • noting obvious abnormalities
  • maintaining equipment
  • preparing testing materials for provider interpretation
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2
Q

how to prepare pt for EKG

A
  • identify pt
  • explain procedure
  • disrobing, owning, draping
  • clean skin and clip hair if needed
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3
Q

does an EKG shock you with electricity

A
  • no
  • records electrical activity of the heart
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4
Q

how to disrobe/drape/gown pt

A
  • pt undressed from waist up
  • no pantyhose or tights
  • drape with opening in the front
  • provide additional cover after leads are placed
  • remove jewelry and electronic devices
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5
Q

artifacts

A

unwanted external event occurring in an EKG tracing not associated with the heart function

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6
Q

multichannel EKG machine

A
  • monitors all 12 leads at once
  • can record 3, 4, or 6 at a time
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7
Q

three-channel EKG unit

A
  • typically in ambulatory care setting
  • records 3 leads at once
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8
Q

single-channel EKG machine

A
  • records one lead at a time
  • produces running strip
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9
Q

telemetry

A
  • computer-based monitoring
  • conducted in hospital setting
  • pt constantly monitored
  • emergency equipment available
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10
Q

how many electrodes are placed

A

10

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11
Q

how many angles and planes are recorded

A

12

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12
Q

what conducts impulses on electrodes

A

electrolyte gel

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13
Q

vertical axis on EKG

A
  • gain or amplitude
  • small square represents 0.1 mv
  • large squares include 5 small squares and represent 0.5 mv
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14
Q

horizontal axis on EKG

A
  • time
  • small square represents 0.04 seconds
  • large squares include 5 small squares and represent 0.2 seconds
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15
Q

what speed should paper run at

A

25 mm/sec

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16
Q

normal amplitude

A

10 mm or 1 mv

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17
Q

how are waveforms put on paper

A

burned onto paper via heat and pressure-sensitive stylus

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18
Q

how to clean pt skin

A
  • instruct pt to avoid applying any substance to skin
  • clean using alcohol or soap and water
  • clip or shave hair if needed
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19
Q

where should limb electrodes be placed

A
  • fleshy areas
  • within same general vicinity on each limb
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20
Q

where do the first six recorded leads originate from

A

arms and legs

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21
Q

bipolar

A

recording of electrical current involving both a positive and negative pole

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22
Q

unipolar

A
  • recording from one location or one pole
  • must be augmented (assistance in tracing by drawing from other poles)
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23
Q

what would you note on tracing if leads were placed improperly

A

complexes would be negatively deflected

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24
Q

how to position pt if experiencing dyspnea

A

semi-fowler’s

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25
universal standardization mark
- 10 mm high, 1 mv - 5 mm wide
26
what to do if QRS complex is too large and goes off paper
- reduce standardization to 0.5 - 5 mm high and 5 mm wide
27
what to do if P waves are absent
- change standardization speed to 50 mm/sec
28
somatic tremor
- irregular spikes throughout the tracing - related to muscle movement (shivering, Parkinson's disease)
29
how to eliminate somatic tremor
- decrease pt anxiety - provide warmth and comfort as needed - pt lay on hands to reduce movement
30
AC interference
- aka 60-cycle interference - regular spikes in the tracing - poor grounding or electrical activity (lights, computers, crossed lead wires)
31
how to eliminate AC interference
- proper grounding of machine - three-prong plug - avoid crossed wires - move bed away from wall - turn off unnecessary electronics
32
wandering baseline
- baseline wanders from the center of the paper - poor electrode connection (lotions/oils/powders on skin)
33
how to eliminate wandering baseline
- clean skin prior to attaching electrodes - instruct pt to avoid creams and lotions
34
interrupted baseline
- obvious break in tracing - disconnected or broken lead wire
35
sinus bradycardia
- heart rate less than 60bpm
36
sinus tachycardia
- heart rate greater than 100bpm
37
sinus dysrhythmia
- slight irregularity in rhythm - associated with normal breathing patterns
38
sinus arrest
- break in normal EKG - SA node failed to fire - not significant unless arrest lasts longer than 6 seconds
39
atrial flutter
- atria contracting at a rapid rate, faster than ventricles
40
atrial fibrillation
- no organized contraction of atria, quivering - blood clot formation due to stagnation of blood in ventricles is possible
41
ventricular fibrillation
- ventricles not contracting, quivering - no discernable waves throughout the tracing
42
asystole
- heart stops - patient has no rhythm noted
43
P wave negative deflection
- junctional dysrhythmia - typical impulse pathway from SA node to AV node is not occurring - initial impulse originating in AV junction, AV node, or ectopic source
44
premature ventricular contraction
- wide and bizarre QRS - PVC is most common ventricular arrhythmia - can be insignificant but provider should be notified
45
P wave
- atrial depolarization
46
QRS wave
- ventricular depolarization - atrial repolarization not visible but occurs during this phase
47
T wave
- ventricular repolarization
48
U wave
- repolarization of bundle of His and Purkinje fibers - not always visible
49
PR interval
- time from beginning of atrial depolarization to beginning of ventricular depolarization - beginning of P wave to beginning of QRS wave
50
QT interval
- time from beginning of ventricular depolarization to end of ventricular repolarization - beginning of QRS wave to end of T wave
51
ST segment
- time from end of ventricular depolarization to beginning of ventricular repolarization - end of QRS wave to beginning of T wave
52
V1
- red - right side of sternum, 4th ICS
53
V2
- yellow - left side of sternum, 4th ICS
54
V3
- green - left side of chest, between V2 and V4
55
V4
- blue - left side of chest, 5th ICS, midclavicular line
56
V5
- orange - left side of chest, 5th ICS, anterior axillary line
57
V6
- purple - left side of chest, 5th ICS, midaxillary line
58
right arm
- white
59
left arm
-black
60
right leg
- green
61
left leg
- red
62
lead I
- bipolar - impulses between left and right arms
63
lead II
- bipolar - impulses between right arm and left leg
64
lead III
- bipolar - impulses between left arm and left leg
65
lead AVL
- unipolar - left leg and right arm assist with the left arm tracing
66
lead AVR
- unipolar - left arm and left leg assist with the right arm tracing
67
lead AVF
- unipolar - right and left arms assist with the left leg tracing
68
transmitting single-channel EKG
- may need to mount tracing prior to delivering to provider
69
is an EKG part of pt medical record
yes
70
where is stress testing typically done
- hospital setting - emergency equipment available
71
greatest risk of stress testing
cardiac arrest
72
stress testing procedure
- pt attached to heart monitor - exercise on treadmill or stationary bike to see how heart handles stress - may receive thallium dye to provide info on blood flow
73
CMA role in stress testing
- attaching leads - monitor vitals - pt education
74
CMA role in holter monitoring
- attaching electrodes to pt trunk - pt education
75
holter monitoring procedure
- pt assumes normal activities - keep diary of activities - press event monitor if experiencing cardiac or neurological symptoms - pt should not move electrodes - avoid showers and metal detectors

Certified Medical Assistant (40 decks)

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