12-Lead ECG's
The PR interval remains constant has a non-conducted P wave. No lengthening but has a dropped beat.
What is second degree type 2?
You do a 12-lead ECG of a 45 year old female presenting with epigastric discomfort, lethargy and diaphoresis. The ECG shows ST elevation in precordial leads V1 through V6. With this information we know the patient is experiencing this type of injury.
Anterolateral MI.
Left anterior Descending, circumflex
Cardiogenic shock
Vfib, Vtach pulseless
A 48 year old female presents with mild sternal discomfort that only occurs on exertion. The 12-lead shows T-wave inversions in V1-V4. You treat her with Nitro, asa, and oxygen. The repeat ECG is normal and the patient does not have any symptoms. This assessment would diagnosis this condition.
What is stable angina?
Your patient is having an inferior MI. The Dr. orders nitroglycerin infusion. As the primary nurse you talk to the doctor about this order.
Nitro is not given for inferior MI's.
sinus brady through vagal enhancement. Distribution of vagal nerve in the inferior wall.
Your patient in room 3 is in V-Fib. As the medication nurse you prepare this medication to be given.
Epinephrine 1 mg 1:10,000
every 3-5 minutes
Why do we do 12-lead ECG's?
Multiple Reasons: observe electrical conduction through the heart, look for ischemia,injury, infarction, electrolyte imbalance, pericarditis,and because we get them on everyone with heart
You do a 12-lead ECG of a 60 year old female presenting with epigastric discomfort, lethargy and diaphoresis. The ECG shows ST elevation in I, AVL, V5, V6. With this information we know the patient is experiencing this type of injury.
Lateral MI Circumflex artery
Cardiogenic shock, LVHF, pulseless vtach, vfib
A 58 year old male presents with sternal discomfort that occurs at rest. The 12-lead show St depression and T wave inversions in I, AVL, V5, V6. He is treated with nitro, asa, morphine, and oxygen. His symptoms are alleviated. The repeat ECG show the same depression and inversions. The repeat EKG diagnoses this condition.
What is a NSTEMI?
Your patient is having an anterolateral MI. The patient begins to have runs of 12 beat VT followed by multifocal PVC's. What should you do?
Notify the MD. Get help.
Make sure pads are on correctly prepare to defibrillate if necessary.
Assess ABC's, neuro status
Prepare to give amiodarone bolus and infusion
My rate is fast narrow rhythm >150. My nurse is preparing this medication.
SVT
Adenosine 6, 12, and cardiovert
The heart rate on the monitor is 32 there are more P waves than QRS complex. What rhythm is this?
What is third degree.
You do a 12-lead ECG of a 60 year old female presenting with epigastric discomfort, lethargy and diaphoresis. The ECG shows ST elevation in II,III, AVF.
The DR. is requesting another type of EKG
What is right sided EKG?
You do a 12-lead on a 85 year old renal failure patient who missed his last 2 dialysis treatments. You notice tall T waves in all the leads. Tall T waves indicate this condition.
Hyperkalemia
D50,insulin, calcium
You have started your patient on nitro sublingual for chest pain 8/10. After the first dose the patient becomes hypotensive and diaphoretic. What should you do?
Notify the MD.
Assess ABC's make sure IV access is working.
Repeat ECG anticipate ivf order.
Do not give more nitro.
As the medication nurse for the V-Fib arrest I will be preparing this antiarrhythmic.
Amiodarone 300mg IV
second dose 150mg IV
The PR interval is longer than 0.20 seconds. The rate is regular.
What is first degree AV block.
You do a 12-lead ECG of a 65 year old male presenting with jaw pain radiation to the left shoulder and arm. On assessment you note an elevated JVD, normal lung sounds, and hypotension. The ECG shows ST elevation in II, III, AVF. With this type of ECG finding we know the patient is experiencing this type of injury.
Inferior MI right ventricle
Right coronary artery
complications hypotension, atrial arrythmias, preload dependent.
A 72 year old female recently diagnosed with CHF and was started on lasix 2 weeks ago. She complains of dizziness and funny heart beats. The 12 lead shows frequent PVC's. As a nurse you are concerned and look at her electrolytes for this condition.
Hypokalemia secondary to the loop diuretic.
Your patient is having a anterolateral MI. Vitals are stable when leaving the ED. On your way to the elevator you notice your patient becomes unresponsive and the monitor shows Vfib. What do you do?
Check for unresponsiveness, check pads, follow ACLS protocol and shock the patient. Bag the patient and begin CPR.
The patient is in cardiac arrest and suspected tricyclic antidepressant overdose. As a nurse in the critical care assignment I will be expected to prepare this medication.
Bicarb 50mg iv
The five step procedure for ECG analysis.
What is rate, rhythm, P waves, PR, QRS, and QT intervals?
You do a 12-lead ECG of a 45 year old male presenting with severe sternal chest pressure for 3 hours. The ECG shows ST elevation in the inferior leads. Assessing the ST segment elevation by this marker.
Find the isoelectric line and measure across.
A 35 year old baseball player recently traveled to South America to play a tournament. He felt like he had the flu-like symptoms. He presents with lethargy and fatigue. Complains of sternal burning. The 12-lead shows ST elevation in all the leads. As a nurse you suspect this condition.
Pericarditis
Anti-inflammatories colchicine
complications: tamponade, myocarditis
Your patient has been diagnosed with hyperkalemia. The orders call for insulin, D50, and calcium. As a nurse you know this drug is given first.
What is calcium? Helps the heart to beat normally by binding to the troponin complex to make the heart cell squeeze together.
Following ACLS guidelines during an PEA cardiac arrest. The team ruled out hypovolemia, hypoxia, and acidosis. But one more H is needed.
Hypovolemia, hypothermia, hypoxia, hydrogen ion (acidosis),
tension pneumo
cardiac tamponade, toxins, thrombosis pulmonary/coronary