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HGTC EKG 1
HGTC NUR 221 EKG Heart Conduction System HGTC NUR 221
| Question | Answer |
|---|---|
| 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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