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nha study guide
pre test prep
| Question | Answer |
|---|---|
| convert .04 seconds to milliseconds | 40 milliseconds |
| if you increase the speed of paper what will it do | it will make it appear slow- all that were bunched up will become clear- example- normal speed 25 - if increase to 50 will become more clear |
| what is the standard amplitude per calibration box | 10 mm per 1 mV - should measure 10 mm tal by 5 mm wide so amplitude of 25 mm/sec and 10 mm/mV |
| lead 1 - name limb and posititve/negative | right arm negative left arm positive and left foot positive |
| lead 2- name limb and positive/negative | right arm negative left foot positive |
| lead 3 - name limb and positive/negative | left arm negative left foot positive |
| Einthoven's triangle which limb is always positive | left foot |
| 1500 method is best for what rhythms | fast rythms |
| 300 method is good for all rhythms but what one | irregular rhythms |
| 6 second rule is good for what rhythm | all |
| 3 lead white | right shoulder or clavicle area |
| 3 lead black | left shoulder or clavicle area |
| 3 lead red | left lower abdominal area |
| 3 lead green (in 5 lead with a brown lead | right lower abdominal area -brown just to the right of the bottom of the sternum- similuar to lead V1 |
| why is 3 lead used | used to contiuously monitor the patient's heart rythm |
| why is 5 lead used | holter monitor |
| 5 lead white | right stermum/ clavicle area |
| 5 lead black | left sternum/clavicle area |
| 5 lead red | left lower thoracic area |
| 5 lead green | right lower thoracic area |
| 5 lead brown | just below and to the right of the bottom of the sternum |
| V1 left side placement | 4th intercostal space, right of sternum |
| V2 left side placement | 4th intercostal space, left of sternum |
| V4 left side placement | 5th intercostal space, midclavicular |
| V6 left side placement | 5th intercostal space, midaxillary |
| who would need a right sided 12 lead | 8 years of age and younger-however another part of book says typically just to age 2 but 2-8 can use right side |
| PR interval | the interval is measured from the beginning of the P wave to the beginning of the QRS |
| ST segmant importance | looking for patterns of Ischemia |
| J point | where ventricular depolarization stops & ventricular repolarization starts |
| QT inverval | one complete ventricular cycle- measured fromt he beginning of Q wave to the end of T wave |
| P wave for normal should be for duration | less than 110 milliseconds (0.11 seconds) |
| common for Junctional rhythm | missing P wave and rate is 40-60/min- if less than 40 then junctional bradycardia |
| accelerated Juntional rhythm | missing P wave (or inverted)- will see long period with multiple very small waves with a hill with small waves |
| idioventricular rhythm | no P wave- QRS greater than 0.12 and inverted |
| polymorphic ventricular tachycardia | no P waves looks like just irregular wide R waves (QRS but cant really see the q or s- looks like just one mountain after another and different amplitudes |
| ventricular tachycardia (monomorphic) | no P waves , all same amplitude but look like a mountain then a ledge attached |
| ventricular fibrillation | no P waves-looks like irregular shapes and durations of waves |
| premature ventricular complex (PAC) | absent Pwave preceding the early QRS, wide QRS, a QRS that looks diff than the other QRS's, the direction of QRS opposite T wave |
| Ischemia wave form | ST segment depression and/or T wave inversion- deeply interted T waves are a frequently encountered presentation fo ischemia |
| Injury wave form - STEMI | ST segment elevation in tow or more contiguous leads- greater than 1 mm in limb leads and greater than 2 mm in precoridal leads |
| Infarction wave form | two main changes can be observed days to weeks after- complete resolution of and normalization of the tracing or developement of a pathological Q wave |
| ischemia, injury or infarction lead involment for Inferior wall | lead II, III, aVF |
| ischemia, injury or infarction lead involvment of Septum | V1, V2 |
| ischemia, injury or infarction lead involvment of Anterior wall | V3, V4 or V1 to V4 |
| ischemia, injury or infarction lead involvment of Lateral wall- high | Leads I, aVL |
| ischemia, injury or infarction lead involvment of Lateral wall - low | Leads V5, V6 |
| ischemia, injury or infarction lead involvment of Posterior wall | V7 to V9 |
| ischemia, injury or infarction lead involvment of right ventricle | Lead V4R |
| Reciprocal leads (one sees elevation the other sees depression ) for ischemic/injury events - part 1 of 2 | Leads II, III, aVF- reciprocal to leads I, aVL |
| Reciprocal leads (one sees elevation the other sees depression ) for ischemic/injury events - part 2 of 2 | Leads V1 to V3- reciprocal to leads II, III, aVF |
| signs of Ventricular fibrillation (VF) | dizziness, impending doom, chest discomfort and shrtnss of breath |
| diff of VF and VT | VF is disorganized and chaotic, VT is organinzed, drop of blood pressure and level of consciousness- low pulse |
| common cause of asystole | large pulmonary embolism, large myocardial infarction, respiratory arrest (hypoxia) and overdose- check another lead |
| calibration marker measurement | 5mm wide by 10 mm tall - gain is ofter printed near bottom 1X , 2X (twice size- etc) |
| difference of Paced Ventricular Rhythm (ventricular pacer) and Atrial-Ventricular Paced Rhythm (AV Sequential Paced) | AV has p wave- both inverted- both have wide QRS |
| how many leads on holter monitor | 5 lead |
| how many leads on for stress testing | 12 lead but put the limb leads on the torso |
| how many leads on telemetry | 3 or 5 lead |
| when is lead V7, V8, V9 USED | when an inferior wall infarction- leads are Posterior wall |
| what is tachypneic | respiratory rate greater that 20/min |
| respiratory rate at rest | adult 12-20/min...//.child 6-12 18-30/// child 1-5 24-34///infant 30-60/min |
| sign of cardiovascular distress | cyanosis is a sign- where headache, nausea, shortness of breath are "symptons" |
| what are some symptons that you would stop a stress test | dizziness and nausea- may be symptons of acute coronary syndrome |
| common side effect of the beta-blockermetoprol for hypertesion | hypotension - beta-blockers cause a decrease in blood pressure |
| sinus tachycardia characteristics | heart reate 100-150 , has p waves, narrow QRS |
| what may be considered a "positive" Holster test | sinus rhythm with ST segment elevation (medical emergency) |
| 60 cycle | too many plugged into outlet |
| broken recordings | wires frayed or elctrode pads are loose |
| interrupted baseline | electrode pads are loose |
| wandering baseline | too much lotion or sweat |
| somatic | tremor |
Created by:
angelshari
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