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HGTC NUR 221 EKG Heart Conduction System HGTC NUR 221

artifact EKG waveforms from sources outside the heart
Where is the SA Node located? in the right atrium
The starting point for electrical impulses SA Node (sinoatrial node)
The heart's main pacemaker SA Node (sinoatrial node)
Where is the AV Node located? in the front of the right atrium
The conduction pathway that leads out of the AV node bundle of HIS
True or False: The bundle of His has pacemaker cells FALSE
What is the rate that the bundle of His initiates electrical activity? 40-60 times per minute
Time which impulse travels from the SA node to the atria and downward to the ventricles PR Interval (PRI)
What is the normal PR interval? 0.12-0.20 (3-4 boxes)
Hallmark of atrial flutter sawtooth pattern
What lab value to you check with atrial flutter? electrolytes
What are the hallmarks of sinus rhythm? "P" present, round and upright
Junctional rhythm rhythms that initiated in the area of the AV junction
Who has a shorter QT segment- men or women? Men have a shorter QT segment
What does a long QT segment increase a patient's risk for? death from arrhythmias
In which direction do you read strips? Left to right
How are heart rhythms classified? regular or irregular
The sinoatrial node is located in the____________? right atrium
The AV node is located in the___________? right atrium
The intrinsic firing rate of the SA node is__________ bpm 60-100
The intrinsic firing rate of the AV junction is__________ bpm 40-60
The electrogardiogram is used to: evaluate electrical activity in the heart
The normal conduction pattern of the heart follows the sequence: SA node, Internodal pathways, AV node, bundle of His, Bundle branches, Purkinje fibers
The intrinsic firing rate of the Purkinje network is________ bpm 20-40
The SA node recieves its blood supply mainly from the : SA artery
abnormal heart rhythms are: dysrhythmias
The length of a wave or the distance between 2 waves is defined as an ____________________ interval
Waves may detect__________(above the baseline), or____________(below the baseline) positively, negatively
The first wave on an ECG is a ___wave, and reflects_____________ P wave, atrial contraction
The pacemaker of the heart SA node
The ECG waveform includes a_________, _____________, and___________. baseline, waves, and intervals
atrial contraction is reflected by the______________, normally the 1st wave on an ECG P wave
What indicates that SA node is healthy and the atria are contracting (depolarizing) normally? A single P wave, usually positively deflected
The time it takes for the electrical activity to move through the AV node, the bundle of His, and the left and right bundle branches is reflected in the________________ PR Interval (PRI)
The normal QRS interval is_____to______ seconds 0.06-0.10
There is normally____QRS interval for each P wave 1
A prolonged QRS interval would indicate a ______ or _______ in the path of the electrical impulse block or delay
The T-wave reflects: ventricular relaxation (repolarization)
total absense of electrical activity asystole
The chief chemical transmitter for the sympathetic nervous system is Norepinephrine
Unoxygenated blood travels from the inferior and superior cavae into the: right atrium
One cardiac cycle occurs every _______ seconds 0.8
With the exception of______, all the body's blood vessels have alpha-adrenergic receptors whereas the heart and lungs have beta-adrenergic receptors capillaries
blood travels from the left atrium through the ________ valve into the left ventricle Bicuspid
Blood travels from the right atrium through the_____________ valve and into the right ventricle Tricuspid
Starling's law of the heart is also referred to as: the rubber band theory
Starling's law of the heart is : when the volume of blood in the ventricles is increased, stretching the ventricular myocardial fibers and consequently causing a more forceful contraction
Stroke volume is estimated at approx. ____________ ml per beat 70
The _________ nervous system is responsible for preparation of the body for physical activity (fight or flight) sympathetic
What regulates the calmer (rest and digest) functions of our existence? the parasympathetic nervous system
The____________receives blood from the right atrium and pumps it to the pulmonary system right ventricle
The________ receives oxygenated blood from the left atrium and pumps it to the body system left ventricle
Refers to the volume of blood pumped out of one ventricle of the heart in a single beat or contraction and is estimated at 70 CC per beat stroke volume
The amount of blood pumped by the left ventricle in 1 minute Cardiac output
The______________ regulates functions of the body that are involuntary or not under conscious control autonomic nervous system
What bodily functions are regulated by the autonomic nervous system? Heart rate and blood pressure
Cardiac output (CO) is calculated by multiplying_________x__________ stroke volume (SV) x heart rate (HR)
A CO of 5600cc per minute is how many liters per minute? 5.6
Inadequate cardiac output may be indicated by what symptoms? shortness of breath, dizziness, decreased blood pressure, chest pains, cool and clammy skin
The resistance against which the heart must pump is__________ afterload
The pressure in the ventricles at the end of diastole is___________ preload
Normal Adult CO (Cardiac Output) is_________ 4-8 L/min
About what percentage of total CO flows passively from the atria to the ventricles? 70%
The right ventricle pumps blood into the…… Pulmonary Artery
How many impulses per minute are normally generated by the SA node? 60-100
What does the P wave represent? atrial depolarization
What is the normal duration of the QRS complex? 0.06 to 0.10 seconds
What does the T wave represent? ventricular repolarization
How long is a normal PR interval? 0.12 to 0.20 seconds
Which part of the ECG varies with heart rate? QT interval
What does each small box on the vertical axis of ECG paper represent? 1mm
An inverted P wave most likely indicates that….. the impulse originates in the AV junction.
Signs or symptoms of decreased CO due to SVT include…… confusion
Which is the first I.V. drug used to treat most forms of stable narrow-complex SVT? Adenosine
Diltiazem is classified as a(n)………………. calcium channel blocker
Which intervention is appropriate for a patient in VF? CPR
Which intervention is appropriate for VT in a hemodynamically stable patient? I.V. amiodarone
The I.V. drug of choice for most patients with symptomatic bradycardia is…………… atropine
Which statement is correct about AV dissociation? P waves have no consistent relationship with QRS complexes.
When caring for a patient with a dysrhythmia, remember to always treat the ______________, not the_______________ patient, monitor
When caring for a patient with a dysrhythmia, administer____________ as indicated, ensure patent______________, obtain______________, and notify the patient's healthcare provider. supplemental oxygen, IV access, a 12-Lead ECG
Depolarization is a(n)__________________ event electrical
Electrical impulses are generated by the exchange of which ions? primarily potassium, sodium, chloride, and calcium
myocardial contraction or systole is a(n) mechanical event
Diastole is the ____________ phase of the cardiac cycle resting
The horizontal axis on ECG represents___________, and one small box equals___________, and a large one (representing 5 small boxes) equals________________ time, 0.04, 0.20
The vertical axis on an ECG measures amplitude or ______________. Each small box represents __________, each large box represents______________ voltage, 1mm, 5mm
Normal Sinus rhythm: HR between 60-100 bpm with regular atrial and ventricular rhythms and P waves that are uniform, round and upright
The absence of P waves means ____________ has been lost atrial kick
SVT: regular rhythm that originates above the ventricles and has a rate greater than 150/bpm
What drug usually terminates SVT? adenosine
How do you give adenosine? by rapid IV push due to its short half-life
A fast, ugly, irregular rhythm is most likely to be_____________________ uncontrolled atrial fibrillation (AF) not to be confused with Atrial Flutter!
Hallmarks of AF: isn't always fast, just irregular with no identifiable P waves and a generally normal QRS complex
One concern with AF Clots likely- often seen in patients on blood thinners
Rapid AF is often treated with_____________ to control the ventricular rate. diltiazem
diltiazem is classified as a _______________ that causes peripheral vasodilation, so it can worsen the______________ that may be associated with AF calcium channel blocker, hypotension - Monitor the patients BP closely!
Ventricular Tachycardia (VT) occurs when the____________ take over as the hearts pacemaker ventricles
The most common cause of VT is………… coronary artery disease
Causes of sinus bradycardia include: increased vagal tone associated with myocardial infarction, adverse drug reactions, electrolyte inbalances, hypoxemia, hypoglycemia, hypothyroidism
For symptomatic bradycardia, the drug of choice is______________________ IV atropine
Created by: Laurie2000
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