Transcript Review for NHA EKG Exam

Review for NHA EKG Exam
Lynne Clarke, Ed.D., RN
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The ______________ is the primary
pacemaker of the heart.
The ______________ is the primary
pacemaker of the heart.
• Sinoatrial node
The intrinsic rate of the sinoatrial node is:
The intrinsic rate of the sinoatrial node is:
• 60-100 beats per minute (bpm)
Where is the Angle of Louis and why is it
important?
Where is the Angle of Louis and why is it
important?
• It provides a reference for locating the 4th intercostal space
What does the term asymptomatic mean?
What does the term asymptomatic mean?
• Without symptoms
The EKG Technician can administer drugs.
T or F
The EKG Technician can administer drugs.
T or F
• FALSE
What is the correct position of the patient’s
arm when taking blood pressure?
What is the correct position of the patient’s
arm when taking blood pressure?
At the level of the heart supported by a table or arm of chair.
What is the correct name of the dysrhythmia
shown below?
What is the correct name of the dysrhythmia
shown below?
Atrial Flutter
this is considered controlled since the ventricular
rate is <100 bpm
Impulses are conducted to the Perkinje fibers
by the __________________
Impulses are conducted to the Perkinje fibers
by the __________________
• Bundle branches
You are educating a patient about their upcoming
stress test. You should remind them that
You are educating a patient about their upcoming
stress test. You should remind them that
• Do not eat or drink caffeine products (chocolate, soda, tea, coffee or Excedrin®)
for 24 hours before exam. Note: Decaffeinated products contain caffeine.
• Consult your physician about going off beta blockers for 48 hours and calcium
channel blockers 24 hours before your exam.
• Do not eat or drink for 3 hours before your appointment. Drinking water is okay.
• If you are unable to exercise on the treadmill, a medication will be administered
to stress your heart. If you are undergoing this type of an exam, you may take all
your heart and blood pressure medications as instructed by your physician.
If you have diabetes, please speak to your physician prior to this exam to receive
special instructions you may need regarding your medications.
Please bring all your medications or a list of them with doses to your
appointment.
What shape is the p-wave in a junctional
rhythm?
What shape is the p-wave in a junctional
rhythm?
• Inverted
• Normal p wave
What changes in the ST segment indicate a
heart problem?
What changes in the ST segment indicate a
heart problem?
• ST segment depression
• Ischemia
• Left ventricular hypertrophy
• Electrolyte abnormalities
• ST segment elevation
• Ischemia
• Pericarditis
The left atrium receives blood from the
___________
The left atrium receives blood from the
___________
• Pulmonary Vein
Where is the apex of the heart?
Where is the apex of the heart?
It points down and to the left
What is cardiac output?
What is cardiac output?
• The amount of blood pumped by the heart per minute.
Which chamber of the heart has the thickest
myocardium and why?
Which chamber of the heart has the thickest
myocardium and why?
• The left ventricle because it has to pump blood throughout the body.
What is somatic tremor and what type of
patient’s are most likely to show it?
What is somatic tremor and what type of
patient’s are most likely to show it?
• A type of artifact
• Parkinson’s patients
What is an interval?
What is an interval?
• A wave plus a segment
If you patient is short of breath you may have to
place them in the _____________ position to do
an EKG.
If you patient is short of breath you may have to
place them in the _____________ position to do
an EKG.
• Semi-Fowler’s position (45 degree angle)
The target heart range for a stress test is
determined by _____________
The target heart range for a stress test is
determined by _____________
• Subtracting the patient’s age from 220
• Example: a 50 year old would be 170 (220-50)
Which wave represents atrial depolarization?
Which wave represents atrial depolarization?
• P wave
What exchange takes place in the lungs?
What exchange takes place in the lungs?
• Oxygen and carbon dioxide
The vertical axis of the EKG measures
__________ and ______________
The vertical axis of the EKG measures
__________ and ______________
• voltage and amplitude
A prolonged or widened QRS indicates
________ or _________.
A prolonged or widened QRS indicates
________ or _________.
• A ventricular dysrhythmia or a bundle branch block
The artifact called wandering baseline is due
to
The artifact called wandering baseline is due
to
• Dried out electrodes or loose electrodes
What is the standardization button on the
EKG machine used for?
What is the standardization button on the
EKG machine used for?
• To check the calibration of the machine
• Should be 10mm
What is the dysrhythmia shown below?
What is the dysrhythmia shown below?
Atrial fibrillation
What is mitral stenosis?
What is mitral stenosis?
• A narrowing of the mitral valve beteen the left atrium and the left
ventricle
The layer of the heart muscle that produces
contractions is the ____________
The layer of the heart muscle that produces
contractions is the ____________
This type of artifact is called AC Interference
and is caused by ______________.
This type of artifact is called AC Interference
and is caused by ______________.
• Electrical interference – move unnecessary electrical devices away
from the patient and turn them off, especially nonmedical devices
What is the dysrhythmia shown below?
What is the dysrhythmia shown below?
Ventricular fibrillation
What does a red line on the EKG paper
mean?
What does a red line on the EKG paper
mean?
• It is time to change the roll of paper – this is just like what you would
see on a cash register receipt
What is the dysrhythmia shown below?
What is the dysrhythmia shown below?
Ventricular tachycardia
Where is the pericardium?
Where is the pericardium?
• It is the protective sac around the heart
Which electrode is used for grounding?
Which electrode is used for grounding?
• Right leg
The EKG Technician can apply an AED.
T or F
The EKG Technician can apply an AED.
T or F
• True
Where are the leads placed for a 3-leads EKG
to continuously monitor a patient?
Where are the leads placed for a 3-leads EKG
to continuously monitor a patient?
What is the dysrhythmia shown below?
What is the dysrhythmia shown below?
rd
3 degree Heart Block
Where is the j point and what is it’s
significance?
Where is the j point and what is it’s
significance?
The point where the QRS ends and the ST segment begins.
This is where ventricular repolarization begins – abnormalities related
to myocardial infarction occur after this point (during ventricular
repolarization)
How is Target Heart Rate determined?
How is Target Heart Rate determined?
An exercise stress test is performed until 85% of the patient’s target
heart rate is reached (provided that patient can tolerate). The formula
to determine this is:
220 – patient’s age = target heart rate x 85%
Ex. For a 40 year old patient
220 – 40 = 180 x 85% = 153 BPM required for test to be valid