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Cardio Assess Unit 4

SPC Cardiopulmonary Assessment Unit 4 Exam 2

Small square 1mm = what? .04 Seconds
Large Square 5mm = what? 0.2 Seconds
ECG paper runs at what pace? 25mm/sec
Time interval on what axis? Horizontal
Amplitude interval (voltage) on what axis? Vertical
1mV =? 10 small squares (10mm) or 2 Large Squares
Define Bipolar? 2 opposite polarity leads (+, -)
Define Unipolar? A positive lead on a limb (+) Also called augmented lead because they must be amplified.
Define Positive Deflection? Upward spike, current flow is toward the (+) electrode.
Define Negative Deflection? Downward spike, current flow is away from the (+) electrode.
Define Lead Axis? Refers to the average direction of current flow in the heart
Define Mean Cardiac Vector? A vector relates both current direction & intensity or magnitude. Relates to where the current flow is the most intense. Current flow follows tissue mass.
Bipolar Leads 1? 1. (-) Right Arm/(+) Left Arm 2. View heart in a vertical or frontal plane as do the unipolar leads. Collectively known as limb leads
Bipolar Leads 2? 1. (-) Right Arm/(+) Left Leg 2. QRS is most prominent as current flow parallels normal depolarization.
Bipolar Leads 3? 1. (-) Left Arm/(+) Left Leg
Unipolar Lead aVR (+) Right Arm
Unipolar Lead aVL (+) Left Arm
Unipolar Lead aVF (+) Left Foot
Define Precordial Leads? On horizontal plane and called chest leads since they are placed on the chest.
With Pericordial Leads where is V1 & V2? 4th Intercostal space next to sternum
With Pericordial Leads where is V3-V6? 5th Intercostal space from just medial of midclavicular line to midaxillary line.
Pericordial leads V1 & V2 view what? Right Ventricle
Pericordial leads V3 & V4 view what? Interventricular Septum
Pericordial leads V5 & V6 view what? Left Ventricle
The normal quadrant is between what? 0 & 90 degrees
Lead 1 & aVF are used to locate what? The Mean Cardiac Vector in on of the four 90 degree quadrants
What is axis deviation? Occurs when the MCV shifts out of the normal quadrant.
When MVC shifts out of a normal quadrant? 1. Muscle Mass changes (Hypertrophy) 2. Polarity shifts (Bundle Branch Block) 3. Tissue dies (Infarct) 4. Position Changes (Obesity)
Right Axis Deviation Shift right side of the heart 1. Cor pulmonale 2. Left ventricular infarction 3. Acute pulmonary embolism
Left Axis deviation Shift to left side of the heart 1. Right ventricular Infarction 2. Left Ventricular Hypertrophy 3. Obesity
Isoelectric Baseline Flat line just before the P wave or right after the T wave. Used to zero voltage reference point.
ECG Segment Time line between two waves
ECG Interval The A wave plus the time line to the next wave
PR Interval The P wave plus the time line to the QRS complex
Normal PR Interval is? .12-.20 sec (1 large square) or >.20 sec = 1 Heart Block
QRS Interval Time from the Q to S deflections.
Normal QRS Interval is? <.12 (3 small squares)
ST segment End of the QRS complex to the T wave It is isoelectric, meaning no electrical activity
Elevated or Depressed ST Segment indicates what? 1. Myocardial Infarction 2. Left bundle branch block 3. Pericarditis
If RR is regular you count what? Number of squares between two QRS complexes divided into 300
If RR is irregular you count what? Number of QRS complexes between 3 sec time lines @ the top or bottom of the strip x20
Sinus Tachycardia 1. P wave is present 2. RR interval is regular 3. Rate > 100/min 4. Hypoxemia is a common cause 5. Xanthines & Beta 1 adrenergics associated with sinus tach
Ventricular Tachycardia 1. No P waves 2. Wide, Bizarre QRS complexes >.12 sec 3. Defined as a run of >3 PVC 4. RR interval is regular 5. Rate 150-250/min
Ventricular Fibrillation 1. Ventricles are showing minimal activity 2. QRS waves rarely over 1 mV
What is the treatment for Ventricular fibrillation? Defibrillation
Atrial Flutter 1. Sawtooth 2. P waves between normal QRS complexes 3. Atrial Rate 200-300/min 4. RR interval is normal 5. Common w/ pulmonary disease
Atrial Fibrillation 1. No true P waves 2. Atrial Rate 350-600/min 3. RR interval is irregular
What is the treatment for Atrial Fibrillation? Synchronized Cardioversion
PVC 1. Ectopic beat from a ventricle 2. Wide, bizarre ORS complexes >.12 sec 3. RR Interval is disrupted 4. Myocardial Ischemia is the most common cause
What is the Treatment of PVC Lidocaine
Define Couplet 2 PVC's in a row
Define Salvo Run of 3 or > PVC's Runs ?30sec = V. Tachycardia
Untreated Ventricular Tachycardia goes to what? Ventricular Fibrillation
Treatment of Ventricular Tachycardia? Lidocaine & Synchronized Cardioversion
Define Bigeminy A pattern of two heart beats, commonly involving a PVC. "Normal Beat - PVC pause....Normal Beat - PVC pause"
Define Trigeminy A pattern of three heart beats, commonly involving a PVC. "Classic" PVC pattern where every 3rd beat is a PVC preceded by 2 normal beats.
What is AV Blocks? Indicate an impulse transmission problem between the atria and ventricles. All due to damage to the nodal pathway due to ischemia or infarction. The degree increases as damage progresses.
Significant of 1st Degree Heart Block? 1. P wave normal 2. PR Interval >.20sec 3. QRS is normal 4. RR Interval is normal 5. P to QRS relation is normal 6. No Treatment
Significant of 2nd Degree Heart Block? Mobitz Type 1 1. PR interval progressively increases until a P is not conducted to the ventricles (no QRS follows) 2. RR interval is regular w/ a pause following dropped QRS
Significant of 2nd Degree Heart Block? Mobitz Type 2 1. Series of non-conduceted P waves followed by a conducted P w/ normal PR interval 2. Fixed Ratio 2:1 or 3:1
Treatment for 2nd Degree Heart Block? Atropine or Isoproterenol to maintain ventricular rate or pacemaker
Significant of 3rd Degree Heart Block? 1. Complete AV Dissociation 2. P is unrelated to QRS 3. QRS may become wide/bizzare 4. RR interval is regular 5. Ventricular rate <60/min 6. Treatment: Pacemaker
Created by: Langhout1418