Electrocardiograms

Question 1

Describe the 5 lead placement.

Answer 1

WHITE on right, snow over GRASS. SMOKE over FIRE. Brown on RT side.

Question 2

Sinus bradycardia

Answer 2

<60bpm regular rhythm
Tx: atropine, pacemaker

Question 3

Sinus arrhythmia

Answer 3

varies with respiration. Slows during exhalation, quickens during inhalation.

Question 4

Premature atrial contraction

Answer 4

regular rate and rhythm until the early P wave occurs. Contains noncompensatory pause.

Question 5

Atrial flutter

Answer 5

d/t lack of conduction btwn atria and ventricles and rapid depolarization of SA node
rate 250-350
sawtooth pattern
No P waves
irregular radial pulse
Tx: amiodarone, cardioversion

Question 6

Ventricular tachycardia

Answer 6

irregular rate 125
wide QRS
No P waves
Tx: w/ pulse: lidocaine, cardioversion
w/o pulse defibrillation; CPR

Question 7

Atrial fibrillation

Answer 7

irregular rate
350-660
squiggly lines w/ small P-waves
irregular QRS rate
Tx: amiodarone, digoxin

Question 8

Ventricular fibrillation

Question 9

A nurse is caring for a client with heart failure whose telemetry reading shows flattened T waves. What laboratory results should the nurse anticipate as the cause of this ECG change?

Answer 9

hypokalemia - flat T wave or prominent U wave.

Question 10

A nurse is caring for a client with heart failure whose telemetry reading shows AV block. What laboratory results should the nurse anticipate as the cause of this ECG change?

Answer 10

digoxin toxicity (>0.5-0.8 ng/mL)

Question 11

A nurse is caring for a client with heart failure whose telemetry reading shows a prolonged ST and QT interval. What laboratory results should the nurse anticipate as the cause of this ECG change?

Answer 11

hypocalcemia

Question 12

Premature ventricular contraction

Answer 12

higher & wider QRS complexes
opposite QRS polarity
compensatory pause present

Question 13

A nurse is monitoring a client’s ECG monitor and notes the client’s rhythm has changed from NSR to SVT. The nurse should prepare what type of intervention?

Answer 13

1. vagal stimulation - may cause bradydysrhythmia, ventricular dysrhythmia, asystole
2. cardioversion
3. defibrillator if pulseless
4. resuscitation equipment

Question 14

Atropine

Answer 14

used to treat bradycardia and bradydysrhythmias

Question 15

Amiodarone

Answer 15

used to treat atrial fibrillation, SVT, ventricular tachycardia

Question 16

Epinephrine

Answer 16

used to treat bradycardia unresponsive to atropine, ventricular tachycardia w/o pulse

Question 17

vagal stimulation

Answer 17

used to decrease heart rate, increases right ventricular contraction, interrupts seizures