Patient verification & equipment
True or False: Natural skin oils, moisturizers, and perspiration can contribute to artifact on the EKG tracing?
What is: true.
Why do you close the door or pull a curtain while prepping the patient for an EKG?
What is the medical name for "breast bone"
What is: the sternum
Where are the (alternative) leads placed for the upper extremities
what is: upper arms near the shoulders
You must always check the machine to ensure the ____________ is full before starting an ECG/EKG.
What is: paper
To verify a patients for an ECG, you must first check the?
What is: Physician's order
What do you do if a patient refuses to have their EKG?
What is: 1st determine the cause of the refusal
(ex: fear)
then report it to your supervisor and notify the ordering physician.
Where is the midclavicular line?
Where are the (alternative) lower extremity leads placed
What is: the abdomen
If a patient has an amputated right leg, where would you apply the lower extremity leads?
What is: the lower abdomen
To verify the patient, you must ask for the patients
__________ and ________.
What is: name and dob
If a patient asks for the EKG reading, what do you do
What is: refer them to the ordering physician
Where is the midaxillary line?
What is: an imaginary line that starts at the middle of the axilla (armpit) and extends down the side of the chest.
The original placement for the upper and lower extremities are
what is: forearms and ankles
the alternative sites are the upper arms (near shoulders and lower abdomen)
Explain patient preparation before an EKG.
What is: Use alcohol to remove any lotions, perfumes, or oils. Shave hair if necessary.
When documenting the ECG, you must enter their
__________ and _________.
What side of the patient should you work from?
What is: patients left side
Where is the anterior axillary line?
What is: an imaginary vertical line that starts in front of the axilla (armpit) and extends down the left side of the chest.
V1 lead is placed in this location
What is: 4th intercostal space, right sternal border
What are the causes somatic tremors?
Body movement: involuntary or voluntary muscle movement. (Parkinsons, shivering, pain, fear)
It is important to document if the patient is on any
what is: cardiac medications
How do you explain the EKG procedure to a pediatric patient?
What is: "I am going to apply these stickers (leads) to your chest" "It will not cause any pain"
you could let them touch the stickers (leads) or apply them to their doll or teddy bear
Where is the suprasternal notch located?
What is: the dip you feel at the anterior base of the neck.
V2 is placed in this location
4th intercostal space, left sternal border
What is the medical term for flat line?
What is Asystole
It is extremely important to document what _______
the patient was in for the ECG.
What is: position
ex: posterior
How do you explain the EKG procedure to an adult patient
What is: "I am going to perform an electrocardiogram on you today." "I am going to apply leads (stickers) to your chest, it is non-invasive & will permit the EKG to obtain "pictures" of your heart".
Where is an "intercostal space"(ICS) located?
V3 is placed in this location
halfway between V2 and V4
What does the term "diaphoretic" mean
What is: excessive sweating
Make sure the ECG/EKG machine is set to the standard paper speed. What is that speed?
What is: 25mm/sec
If your patient (inpatient in the hospital) is placed on a precaution, where will the information and PPE be placed?
What is: at the patient's door
How many ribs do most humans have?
What is: 24 (12 on each side)
V4 is placed in this location
Fill in the blanks:
__________ over _______________
__________ over _______________
What is: clouds over grass
smoke over fire
Marks on the ECG tracing caused by another source of activity are
What is: artifact
In pediatric patients, sometimes V3 must be moved to the right side. Why?
What is: pediatric chest size can be too small to accommodate all of the leads. V3 is moved.
How many floating ribs do most humans have?
*floating means: not attached to the sternum*
What is: 4
V5 is placed in this location
at the anterior axillary line on the same horizontal
level as V4
Clouds over grass and smoke over fire are placed where?
Clouds: Right arm
Grass: Right leg
Smoke: Left arm
Fire: Left leg
What are the causes of AC interference?
What is: improper grounding, other electrical equipment, or the wires are crossed
Where would you place the lower limb leads on a pregnant patient?
What is: on the thighs...NOT the abdomen
Where is the "angle of Louis" located?
What is: a ridge about an inch or so below the suprasternal notch
V6 is located at this position
what is: at the midaxillary line (on the same horizontal level/line as V4 and V5)
What are the causes of a "wandering baseline"
What is: too loose or incorrect electrode application, tension or pulling on the lead wires, too little electrode gel or solution or oil, lotion, dirt or hair under the electrodes