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Nursing Test One > Telemetry > Flashcards

Telemetry Flashcards

1
Q

Vertical axis 1 small square

A

1mm

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2
Q

Vertical axis 1 large square

A

5mm

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3
Q

Vertical axis 2 large squares

A

1 mV

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4
Q

Horizontal axis 1 small square

A

.04 seconds

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5
Q

Horizontal axis 1 large square

A

0.2 seconds

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6
Q

Horizontal axis 5 large squares

A

1 second

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7
Q

12 leads where are they

A

has 10 electrodes, 6 on chest, 4 on limbs, arm leads placed between shoulders and wrists away from bony prominences, leg leads placed between hips and ankles away from bony areas. If placed on trunk, note this

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8
Q

What is the most common monitoring lead?

A

Lead 2

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9
Q

What does the P wave represent?

A

atrial depolarization

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10
Q

How long should P wave last?

A

0.10

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11
Q

PR interval normal duration

A

0.12-0.20 seconds, over 0.20 means a 1st degree block

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12
Q

What is the PR interval?

A

The time it takes for the electrical impulse to leave the SA node and travel through the atria to the AV node, bundle branches and purkinje network

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13
Q

PR interval >0.20 indicates

A

1st degree block

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14
Q

What is the QRS complex?

A

depolarization of the ventricles

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15
Q

How long does the QRS last?

A

0.60-0.12 seconds

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16
Q

What does a QRS interval greater than 0.12 indicate?

A

A bundle branch block

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17
Q

What does a Q wave 0.04 seconds or wider or 1/4 size of R wave indicate?

A

MI

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18
Q

What is the T wave?

A

repolarization of the ventricles-resting

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19
Q

What do peaked T waves indicate?

A

hyperkalemia

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20
Q

What is a normal sinus rhythm?

A
  1. Rhythm is regular
  2. Rate 60-100 bpm
  3. P wave 1:1
  4. PR interval: 0.12-0.20 sec
  5. QRS interval:
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21
Q

What is normal R to R

A

0.04 seconds

22
Q

What are causes/symptoms of sinus bradycardia?

23
Q

Atrial Flutter causes

A

heart disease, PE, valvular heart disease, hyperthyroidism, lung disease

24
Q

Atrial Flutter symptoms

A

palpitations, chest pain, shortness of air, dizzy, nausea, nervous, feeling of impending doom

25
Atrial Flutter treatment
digoxin, calcium channel blocker, adenosine, cartoid sinus massage-slow vent. rate, electrical cardioversion
26
Hallmark of A Fib
No P wave, very fast rhythm 350-600 bpm
27
Hallmark of A Flutter
Sawtooth-Woodchips fluttering in the wind
28
A-Fib Causes
MI, lung disease, after open heart surgery-common cause of strokes r/t clots shooting out
29
A-Fib heart rate
350-700 bpm, no p wave
30
A-Fib s/s
Palpitations, chest discomfort, short of air, resp distress, hypotension, light headed, loss of consciousness Peripheral edema, jugular vein distension, pulmonary edema
31
Holiday Heart Syndrome
A-Fib from alcohol, clears up in 24 hours
32
Sinus Bradycardia treatment
None unless symptomatic, for symptomatic-dopamine & epinephrine when atropine is ineffective
33
Sinus Tachycardia rate
101-160
34
Sinus Tachycardia causes
atropine, PE, MI, HF, fever, inhibition of vagus nerve, hyperthyroidism, hypoxia
35
Sinus Tachycardia s/s
palpitations, pounding heart, dizziness, chest pain-can be sharp, chest pressure, fatigue, short of breath, activity intolerance
36
Sinus Tachycardia treatment
treat underlying cause, oxygen, tylenol for fever. Persistent tachycardia-beta blockers to slow HR
37
A-fib treatment
digoxin, calcium channel blockers, beta blockers, amiodarone, cardioversion, oxygen
38
A-fib treatment > 48 hrs
coumadin, heparin therapy until transesophageal echocardiogram is performed to rule out clot in atrium
39
What is cardioversion?
Controlled shock to put heart back in normal sinus rhythm
40
Atrial rhythm notes
Originate in one or more irritable foci in atia, called an ECTOPIC rhythm when pacemaker site is outside of SA node Sites in the atrium usurp the SA NOde as pacemaker, TX: conversion
41
AV Block notes
Sinus fires as usual with a partial or complete disruption to ventricles site of block is either the AV node or at the bundle branches Underlying rhythm is sinus HR can be normal or slow Tx goal-increase heart rate and improve AV conduction
42
AV block criteria
PR interval prolonged >0.20, some Ps not followed by a QRS, P-P irregular
43
First degree block hallmark
PR interval is prolonged, it is > 0.20, everything else is normal
44
Causes & treatment of first degree block
AV node ischemia, digitalis toxicity, side effect of beta blockers or calcium channel blockers Tx: remove cause
45
Third degree block hallmark
P waves not associated with QRS, might be 3 P waves before a QRS
46
Causes of third degree block
MI, conduction system lesion, med side effects, hypoxia
47
Symptoms of third degree block
chest pain, palpitations, shortness of breath, diaphoresis, fatigue, faintness-- Symptoms worsen on exertion!!!
48
Third degree heart block treatment
temporary pacemaker, then a permanent pacemaker, atropine, epinephrine, dopamine until pacemaker inserted, oxygen
49
Ventricular rhythm notes
Rhythm originates in ventricular tissue Impulse is conducted slowly through ventricle producing a wide QRS complex that measures >0.12 seconds Impulse can travel backward to depolarize atria & P wave is lost Conduction systems last attempt at pacemaker
50
Ventricular rhythm criteria
Wide QRS > 0.12 seconds w/o preceding P wave No QRS at all Premature, wide QRS beat without preceding P wave, interrupting other rhythm

Nursing Test One (11 decks)

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