ekg-quizla

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ekg-quizla
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2011-11-16 16:01:06
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medic12 ekg-quizla
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  1. The activity on an EKG represents _____ of the myocardium.
    electrical activity
  2. When the myocardium is stimulated the muscle _____.
    contracts
  3. In the resting state the myocardial cells are _____.
    polarized
  4. In the resting state the interior of the myocardial cells are _____ charged.
    negatively
  5. During depolarization the interior of the cell becomes _____ charged and the muscles _____.
    positively, contract
  6. The dominant pacemaker site in the heart is the _____.
    SA node
  7. The SA node is able to pace the heart through the process of _____.
    automaticity
  8. The P wave represents the depolarization of the _____.
    atria
  9. Ventricular repolarization occurs during the _____.
    T wave
  10. A big box on EKG paper has _____ small sqaures inside.
    5
  11. The time frame represented by one big box is
    0.20 seconds
  12. The leads placed on the right and left arm are called _____.
    limb leads
  13. Lead one shoots from _____.
    left to right, straight across
  14. Measurements on ekg paper are calibrated in _____.
    millimeters
  15. Deflections on the ekg paper are actually a measurement of _____.
    voltage
  16. How will an EKG tell you if you have a high potasium level?
    spiked T wave
  17. Lead 1
    lateral
  18. Lead 2
    inferior
  19. Lead 3
    inferior
  20. Lead aVL
    lateral
  21. Lead aVF
    inferior
  22. Lead V1
    septal
  23. Lead V2
    septal
  24. Lead V3
    anterior
  25. Lead V4
    anterior
  26. Lead V5
    lateral
  27. Lead V6
    lateral
  28. Normal Axis
    • Lead 1: up
    • Lead 2: up
    • Lead 3: up
    • Note:
  29. Physiological Left Axis
    • Lead 1: up
    • Lead 2: up or up down
    • Lead 3: down
    • Note:
  30. Pathological Left Axis
    • Lead 1: up
    • Lead 2: down
    • Lead 3: down
    • Note: anterior hemiblock
  31. Right Axis
    • Lead 1: down
    • Lead 2: up
    • Lead 3: up
    • Note: posterior hemiblock
  32. Extreme Right Axis
    • Lead 1: down
    • Lead 2: down
    • Lead 3: down
    • Note: ventricular in orion?
  33. Normal Sinus Rhythm
    • Rate: 60 to 100 (atrial = ventricular)
    • Rhythm: R-R intervals constant; regular
    • P Wave: uniform. 1 P Wave in front of every QRS
    • PRI: 0.12 - 0.20 seconds & constant
    • QRS: < 0.12 seconds
    • S-T Segment: neither elevated or depressed
    • T Waves: usually slightly rounded and asymmetrical: T wave is less than 1/2 the height of the QRS
  34. Sinus Arrhythmia
    • Rate: usually 60 to 100, can be slower (atrial = ventricular)
    • Rhythm: R-R intervals vary; slightly irregular
    • P Wave: uniform. 1 P Wave in front of every QRS
    • PRI: 0.12 - 0.20 seconds & constant
    • QRS: < 0.12 seconds
    • S-T Segment: neither elevated or depressed
    • T Waves: usually slightly rounded and asymmetrical: T wave is less than 1/2 the height of the QRS
  35. Wandering Atrial Pacemaker
    • Rate: usually 60 to 100, can be slower (atrial = ventricular)
    • Rhythm: R-R intervals vary as the pacemaker site changes; can be slightly irregular
    • P Wave: morphology of P waves changes as the pacemaker site changes. 1 P wave in front of every QRS complex. some P waves may be difficult to see, depending on the pacemaker site.
    • PRI: PRI measurement will vary slightly as the pacemaker site changed. should be 0.12 - 0.20 seconds. some may be < 0.12.
    • QRS: < 0.12 seconds
    • S-T Segment: neither elevated or depressed
    • T Waves: usually slightly rounded and asymmetrical: T wave is less than 1/2 the height of the QRS
  36. CBC Rule of 5's
    • Red Blood Count (RBC) = 5
    • Hemoglobin (HBg) = 15
    • Hematocrit (Hematocrit) = 45
  37. H&H
    • ...............HBg....................
    • WBC >------------<Platlets
    • ................Hct.....................
  38. Hemoglobin
    • Amount of hemoglobin in a standardized sample of uncoagulated blood.
    • Evaluates:
    • 1. anemia
    • 2. blood loss
    • 3. volume replacement
  39. Hematocrit
    • The percentage of red blood cells in circulation.
    • Evaluates:
    • 1. anemia
    • 2. hydration
    • 3. fluid balances/loss/replacement
  40. Red Blood Count
    Number of red blood cells per microliter.
  41. Erythropoietin (EPO)
    hormone produced by the kidneys that promotes the formation of red blood cells in the bone marrow
  42. White Blood Count (WBC)
    • determines the number of leukocytes per microliter
    • Normal Values 4,000 to 10,000 cells/mcl
    • Evaluates:
    • 1. infection
    • 2. inflammatory response
  43. Precordial Leads
    • V1 - right of sternum, 4th intercostal space
    • V2 - left of sternum, 4th intercostal space
    • V3 - 5th rib, between V2 & V4
    • V4 - 5th intercostal space, midclavicular
    • V5 - 5th intercostal space, anterior axillary
    • V6 - 5th intercostal space, midaxillary
    • V4R - 5th intercostal space, midclavicular Right Side
  44. You want to give PANCURONIUM when and why? What is the pedi dose (with route)?
    Also know as Pavulon, a nondepolaring neuromuscular blocker. It is used to facilitate endotracheal intubation. The pedi dose is the same as the adult dose, 0.04 to 0.1 mg/kg IV.
  45. Transcutaneous Cardiac Pacing
    • Use if pharma has no effect & pt is hypotensive of hypoperfusing. Consider an analgesic prior or during.
    • 1. initiate IV, O2 & ECG
    • 2. place pt suppine
    • 3. confirm symptomatic bradycardia & confirm medical direction order for TCP
    • 4. apply pacing electrodes
    • 5. connect electrodes
    • 6. set desired heart rate on pacemaker (typically 60/60)
    • [adhock]
  46. Symptomatic Bradycardia Drugs
    • 1) ATROPINE 0.50 mg IV q 3-5 min, max 3mg
    • 2) DOPAMINE 5-20 mcg/kg/min
    • 3) EPINIPHRINE 2-10 mcg/min
  47. Tachycardia: Narrow Complex Drugs
    • 1) ADENOSINE 6/12/12 rapid w/ flush
    • other considerations...
    • 1) AMIODARONE 150 mg slow IV (15mg/min)
    • 2) PROCAINAMIDE 20-30 mg/min/IV
    • 3) DILTIAZEM 0.25 mg/kg slow IV or VERAPAMIL 2.5 mg slow IV if NO WPW/Hypotension
  48. Hs (Hs & Ts)
    • 1) hypovolemia
    • 2) hypoxia
    • 3) hydrogen ion
    • 4) hyper/hypo-kalemia
    • 5) hypothermia
    • 6) hypo/hyper-glycemia
  49. Ts (Hs & Ts)
    • 1) tablets/toxins
    • 2) cardiac tamponade
    • 3) tension pneumo
    • 4) tamponade (AMI)
    • 5) thromboembolism
    • 6) trauma
  50. 3rd Degree Heart Block
    • 1) RATE: atrial normal, ventrical Brady
    • 2) RHYTHM: Regular P-P and R-R since firing independently
    • 3) P WAVE: more P than QRS
    • 4) PRI: varies. no association P to QRS
    • 5) S-T: neither elevated or depressed
    • 6) T WAVE: normal - usually slightly rounded & assymetrical; < 1/2 the height of the QRS
  51. Depolarization of the ventricles is represented on the EKG strip by the...
    T wave.
  52. Normal QRS Complex
    < .012 seconds
  53. Normal PRI
    between 0.12 & 0.20 seconds & constant
  54. AVR, AVL & AVF are known as ________ leads.
    augmented or unipolar
  55. AVL looks at...
    high lateral wall.
  56. What are the coronary ateries for each lead?
    All of the leads are supplied by the LCA except for those that look at the Inferior wall ( 2, 3 & AVF) & they are supplied by the RCA.
  57. How can you tell if you have a Trycyclic OD?
    AVR will will have large R waves.
  58. some Neurotransmitters
    • 1. GABA
    • 2. Dopamine
    • 3. Norepinephrine
    • 4. Epinephrine
    • 5. Histamine
    • 6. Serotonin
    • 7. Acetylcholine
    • 8. Adenosine
  59. How can you identify Pericarditis on an EKG?
    ST elevation will be present in almost every lead

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