Chapter 6: Basic EKG Procedures

Question 1

Describe how a patient should be identified before any care is provided

Answer 1

Full name and date of birth
This information is then checked against the provider’s order

Question 2

What are the two key pieces of information an EKG technician should check on a patient’s wristband?

Answer 2

• Full name
• Date of birth

This information is essential for accurate patient identification before any care is provided.

Question 3

What could happen if a patient is not correctly identified?

Answer 3

• Link to the wrong medical record
• Duplicate medical record created

Incorrect identification can lead to serious medical errors.

Question 4

What information should be entered into the EKG machine?

Answer 4

• Full name
• Date of birth
• Gender
• Race
• Medical record number
• Name of provider who ordered the test
• Medications patient is taking
• Symptoms at the time of the test
• Special considerations

This information is crucial for accurate EKG testing and patient care.

Question 5

True or false: EKG technicians should be alert to changes in the patient’s state of consciousness, vital signs, or signs of pain.

Answer 5

TRUE

These changes can indicate a developing cardiac emergency.

Question 6

What should an EKG technician do if a patient does not speak English?

Answer 6

Use an interpreter or interpretation service

This should be done according to facility policy.

Question 7

Before an EKG, patients should know that the procedure is _______ and over quickly.

Answer 7

painless

This helps to alleviate patient anxiety about the test.

Question 8

Before an EKG, patients should know:

Answer 8

Nothing goes into the body
It is painless and over quickly
Chest hair may need to be clipped for electrodes to stick
It gives the provider important information about heart rate and rhythm

Question 9

After a clear EKG tracing has been achieved, you should check for:

Answer 9

Lethal dysrhythmia and any ST segment before proceeding

Question 10

Telemetry pack

Answer 10

device attached to a patient to monitor heart rate and rhythm on an ongoing basis
Also called a telemetry unit.

Question 11

A telemetry pack is worn in a:

Answer 11

gown pocket or in a pouch around the patient’s neck

Question 12

Technicians monitor signals from telemetry units at a:

Answer 12

central monitoring station

Question 13

When a patient wears a telemetry pack, they should tell the EKG technician or nurse if the electrodes:

Answer 13

come loose

Question 14

Stress test

Answer 14

Measures how the heart functions under controlled stress
Used to assess heart function and predict future heart problems
Can be helpful in planning more invasive heart procedures

Question 15

The stress test procedure lasts:

Answer 15

2-4 hours

Question 16

What is the most common type of stress test?

Answer 16

Exercise on a treadmill or stationary bicycle

This method assesses how the heart functions under controlled stress.

Question 17

What should patients avoid for 24 hours before a stress test?

Answer 17

• Caffeine
• Certain headache medications
• Some medications that need to be stopped temporarily
  Patients with diabetes should consult their doctors a instructions may be different for them

These restrictions help ensure accurate test results.

Question 18

For a stress test, patients should wear:

Answer 18

Comfortable, loose clothes and rubber-soled shoes or athletic shoes

Question 19

Patients who have had heart surgery usually have a stress test:

Answer 19

Once a year to monitor heart function

Question 20

Stress tests may be used as a screening tool for:

Answer 20

Patients that are 35 years of age and older, especially those with a family history of heart disease

Question 21

A stress test should be stopped if the patient has any of the following:

Answer 21

Dizziness
Chest pain
Shortness of breath
A sudden increase or decrease in systolic or diastolic blood pressure
Systolic BP>250 mm Hg
Diastolic BP>115 mm Hg
Leg cramps
Severe fatigue
Severe diaphoresis
ST segment changes
Worsening or possibly dangerous dysrhythmias
If the patient wants to stop
Heart rate does not rise above 120 BPM

Question 22

What is the age-predicted maximal heart rate formula?

Answer 22

220 - patient’s age
85% of this number is the target rate for stress testing

This calculation helps determine the target heart rate for stress testing.

Question 23

What should be done if a patient experiences dizziness during a stress test?

Answer 23

Stop the stress test

Other symptoms indicating the test should be stopped include chest pain and shortness of breath.

Question 24

What is a nuclear stress test?

Answer 24

Variation of stress test with a harmless radioactive substance injected into the patient’s bloodstream

It provides detailed information about possible blockages in coronary arteries.

Question 25

A nuclear stress test may be used to give doctors:

Answer 25

more detailed information about possible blockages in the coronary arteries

Question 26

Crash cart

Answer 26

cart containing supplies needed immediately in the case of a medical emergency.

Question 27

How many **electrodes** are typically used by most ambulatory monitors?

Answer 27

5 electrodes ## Footnote Proper placement is crucial for accurate monitoring over extended periods.

Question 28

Stress testing can be used to:

Answer 28

Assess heart function (as a screening tool or for patients who have had surgery) Predict future heart problems Assist in planning more invasive heart procedures

Question 29

Ambulatory monitoring may be ordered for these reasons:

Answer 29

To check rhythm issues a patient is describing (e.g., irregular beats) that is not seen on a resting EKG To evaluate cardiac activity over a longer time and with varying activity levels

Question 30

What is the purpose of a **stress loop** in ambulatory monitoring?

Answer 30

Reduces tension on the electrodes caused by patient movements A loop in the lead wires close to the electrodes ## Footnote This helps maintain electrode contact during regular activities.

Question 31

If you can't use a regular stress loop, you can make one using:

Answer 31

tape

Question 32

Electrodes must be placed securely for ambulatory monitoring because:

Answer 32

Patients will be wearing the monitor for 24 hours or more and will continue regular activities

Question 33

Amount of electrodes used by most ambulatory monitors:

Answer 33

5 electrodes

Question 34

For the ambulatory monitor, sometimes a patient is given this item for replacement alongside instructions:

Answer 34

Extra batteries

Question 35

What does **HIPAA** stand for?

Answer 35

Health Insurance Portability and Accountability Act ## Footnote This act protects patient privacy and imposes penalties for mishandling personal health information.

Question 36

Under HIPAA, healthcare workers can be:

Answer 36

fined, lose certification, and be sentenced to prison for mishandling patients’ PHI

Question 37

HITECH Act

Answer 37

The Health Information Technology for Economic Clinical Health Act Increased penalties established by HIPAA and encouraged providers to adopt EHR in place of paper records

Question 38

Systems review

Answer 38

A provider's assessment of the patient

Question 39

Release form

Answer 39

If signed by a patient, can give others the right to receive their health information

Question 40

What is the role of EHR (Electronic Health Records) in patient record-keeping?

Answer 40

Completed EKGs are often uploaded here ## Footnote EHR systems facilitate the sharing and analysis of patient information.

Question 41

What should an EKG technician do with a **completed EKG**?

Answer 41

Upload it to the electronic health record ## Footnote This ensures it becomes part of the patient's medical history for analysis.