EKG
What is the name of the medical condition that requires a right sided EKG and how should the electrodes be placed (be sure to mention v7, v8 and v9).
dextrocardia
Bipolar leads have two poles. The standard limb leads are bipolar. Which lead records the potential difference between the left arm and left foot?
Lead 3
What does the "p" wave represent on the EKG tracing?
Atrial depolarization
This kind of anemia that is the result of frequent venipunctures?
Iatrogenic anemia
What is the difference between a random urine collection and a clean catch specimen?
Random- No special instructions, minimum of 30 ml
Clean catch- Special cleansing, uses a sterile container, patient will urinate into the toilet, stop the urine stream, next urinate into the sterile cup (minimum 30 ml) then finish voiding into the toilet.
Both- take straight to lab, otherwise refrigerate if it can't be taken to the lab within one hour.
Your patient has breast implants. Where should you place V1 and V2
Place V1 and V2 above the implants.
Which bipolar lead measures that potential difference between the right arm and left arm>
lead 1
What does the QRS complex represent?
Ventricular depolarization
You are preparing to draw blood but do not have a tournequet on hand. What can you do to solve this problem?
Use a blood pressure cuff and inflate it to 40 mm/HG
Specimens that should be protected from light by wrapping in foil.
bilirubin and folate levels
You have been assigned to perform a 12 lead EKG on a patient who is a bilateral arm and leg amputee. Where should you place the electrodes for the limb leads?
Arm amputee: place the electrodes on the upper chest
Leg amputee: place the electrodes on the lower abdomen
Which lead measures the potential difference between the right arm and left foot.
Lead 2
Which wave form represents atrial repolarization?
This is a trick question. You can't see atrial repolarization on the EKG strip because it is obscured by the large QRS complex.
Which hand and finger should be used to palpate a vein ?
Preferred: Index finger of your nondominant hand. The non dominant hand is used
Specimens that should be transported or stored on an ice slurry.
Ammonia, lactic acid, cold agglutinins, 24 hour urine collection for creatinine clearance .
You have an order to perform a 12 lead EKG on a pediatric patient but there is not enough room on the chest for all of the precordial leads. How will you solve this problem?
Place V3 on the right side in the same position and document it as V3R.
Which limb is the "grounding" lead placed?
right foot
Which wave form represents ventricular repolarization?
T wave
What angle is used for a venous puncture from the antecubital area?
15-30 degree angle
When collecting a blood culture 70% isopropyl alcohol alone is not sufficient for cleansing the venipuncture site. What other solutions should be used to cleanse the skin prior to a blood culture draw?
Chlorhexidine, tincture of iodine or a 70% ethyl alcohol and povidone iodine combination should be used. Skin should be cleansed for 30-60 seconds to remove as many pathogens as possible.
Augmented leads are also unipolar. How are they labeled?
AvR, AvL, and AvF
What are signs of "cardiopulmonary" compromise?
1. change in color (pale, dusky, cyanotic)
2. Change in LOC
3. Dyspnea or absent breathing
4. significant change in the EKG
Your patient exhibits signs of cardiopulmonary compromise with a rhythm showing ventricular tachycardia (vtach). What should you prepare for and what will this rhythm likely convert to?
This is likely to convert to ventricular fibrillation (vfib). Get the crash cart and prepare for a code blue.
What angle is used for venous puncture from the hand?
10 degree angle
What are the most common CLIA waved procedures?
Blood glucose, fecal occult blood testing, hematocrit, urine screening and pregnancy tests.