EKG
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In order to get a clear EKG tracing the patient must be lying:

  • In the Sims position
  • Quietly in the prone position
  • In the Trendelenburg position
  • In the supine position (correct)

    • Where will the electrodes be placed to record the augmented leads of the 12 lead EKG?

  • Chest
  • Arms and legs (correct)
  • Head
  • Abdomen

    • Which of the following describes how the EKG machine works?

  • Records the electrical activity of the heart (correct)
  • Makes a picture of the heart
  • Makes a tracing of the heart and lung activity
  • Records the impulse from the brain

    • The EKG machine can pick up interference from which of the following sources?

    <p>All of the above</p> Signup and view all the answers

    To measure the atrial rate on the EKG, you will count which of the following?

    <p>The P waves</p> Signup and view all the answers

    The U wave can be defined as which of the following?

    <p>All of the above are true of the U wave</p> Signup and view all the answers

    Which of the following information must be used to label an EKG when the EKG machine does not automatically label the strip?

    <p>All of the above</p> Signup and view all the answers

    Which of the following leads are recorded from the 6 chest electrodes?

    <p>Leads V1-V6</p> Signup and view all the answers

    How many leads are recorded strictly from the 4 extremities electrodes?

    <p>6</p> Signup and view all the answers

    The standardization of the EKG machine on each machine tells the technician which of the following?

    <p>All of the above</p> Signup and view all the answers

    When would the technician need to adjust the paper speed?

    <p>Both A &amp; B</p> Signup and view all the answers

    V4 is considered which of the following?

    <p>Chest or precordial lead</p> Signup and view all the answers

    V6 is considered which of the following?

    <p>Chest or precordial lead</p> Signup and view all the answers

    V3 is considered which of the following?

    <p>Chest or precordial lead</p> Signup and view all the answers

    Which of the following is the intermationally accepted standard speed for the EKG recording?

    <p>25 mm/sec</p> Signup and view all the answers

    V1 is considered which of the following?

    <p>Chest or precordial lead</p> Signup and view all the answers

    If there is a lot of interference on the EKG tracing, which of the following could the technician do to help eliminate the interference?

    <p>All of the above</p> Signup and view all the answers

    Lead I is considered which of the following?

    <p>Bipolar limb lead</p> Signup and view all the answers

    Which limb is positive in the AVF lead?

    <p>Left leg</p> Signup and view all the answers

    The R wave can be defined as which of the following?

    <p>first positive inflection in the QRS complex</p> Signup and view all the answers

    The QRS complex can be defined as which of the following?

    <p>It represents the depolarization of the ventricles, it represents a ventricular impulse</p> Signup and view all the answers

    The T wave can be defined as which of the following?

    <p>A long wave following QRS during repolarization of the ventricles</p> Signup and view all the answers

    A rhythm strip is which of the following?

    <p>All of the above</p> Signup and view all the answers

    The vertical scale of the ECG paper measures which of the following?

    <p>Voltage</p> Signup and view all the answers

    In lead three which of the following electrical impulses are recorded?

    <p>Left arm and left leg</p> Signup and view all the answers

    How many electrodes make up the 12 lead EKG?

    <p>10</p> Signup and view all the answers

    The standard leads are comprised of which of the following leads?

    <p>Lead one, two, and three</p> Signup and view all the answers

    When the monitor shows a straight line, you should begin troubleshooting by checking which of the following?

    <p>All of the above</p> Signup and view all the answers

    Which wave form would not be seen in a normal ECG?

    <p>V wave</p> Signup and view all the answers

    Which of the patient's limbs are the ground lead?

    <p>Right leg</p> Signup and view all the answers

    A positive wave will be pointing in which of the following directions?

    <p>Upward</p> Signup and view all the answers

    Poor electrode contact can cause which of the following?

    <p>All of the above</p> Signup and view all the answers

    Multi-channel recordings...

    <p>Take less time</p> Signup and view all the answers

    A small wave sometimes appearing between the T wave and P wave is which of the following?

    <p>U wave</p> Signup and view all the answers

    The device that detects skin voltage is which of the following?

    <p>Sensor</p> Signup and view all the answers

    Leads 1, 2, and 3 are the____leads

    <p>Limb</p> Signup and view all the answers

    The greatest disadvantage of using sensor paste over gel or cream is which of the following?

    <p>It dries hard and you must thoroughly clean after each use</p> Signup and view all the answers

    You are recording lead I and notice a negative R wave, what would you do?

    <p>Stop recording and check to be sure the correct lead wires are connected to the sensors</p> Signup and view all the answers

    In what order are the waves named?

    <p>P wave, Q wave, R wave, S wave, T wave</p> Signup and view all the answers

    When sensor paste is allowed to accumulate on the sensors, it will cause which of the following?

    <p>A variety of artifacts</p> Signup and view all the answers

    The medical term meaning relating to the heart and lungs is which of the following?

    <p>Cardiopulmonary</p> Signup and view all the answers

    PAT is an abbreviation that stands for which of the following?

    <p>Paroxysmal Atrial Tachycardia</p> Signup and view all the answers

    AF is an abbreviation that stands for which of the following?

    <p>Atrial fibrillation</p> Signup and view all the answers

    Telemetry is a term that refers to which of the following?

    <p>Transmitting EKG signals via radio waves</p> Signup and view all the answers

    SA is an abbreviation that stands for which of the following?

    <p>Sinoatrial</p> Signup and view all the answers

    The medical term meaning relating to the heart and blood vessels is which of the following?

    <p>Cardiovascular</p> Signup and view all the answers

    Impulses traveling through the heart's upper chambers (the atria) are delayed in the area between the upper and lower chambers (the AV node) and fail to make the ventricles beat at the right moment.

    <p>Second-degree heart block</p> Signup and view all the answers

    An arrhythmia (abnormal heartbeat) in the ventricle characterized by a very fast heartbeat.

    <p>Ventricular tachycardia</p> Signup and view all the answers

    A portable device for recording heartbeats over a period of 24 hours or more.

    <p>Holter monitor</p> Signup and view all the answers

    Rapid, uncoordinated contractions of individual heart muscle fibers. The heart chamber involved can't contract all at once and pumps blood ineffectively, if at all.

    <p>Fibrillation</p> Signup and view all the answers

    The "natural" pacemaker of the heart. The node is a group of specialized cells in the top of the right atrium which produces the electrical impulses that travel down to eventually reach the ventricular muscle, causing the heart to contract.

    <p>Sinus (SA) node</p> Signup and view all the answers

    Blueness of skin caused by insufficient oxygen in the blood.

    <p>Cyanosis</p> Signup and view all the answers

    WNL is the abbreviation for which of the following?

    <p>Within normal limits</p> Signup and view all the answers

    The second sound heard when taking blood pressure is which of the following?

    <p>Diastolic pressure</p> Signup and view all the answers

    PMI is the abbreviation for which of the following?

    <p>Posterior myocardial infarction</p> Signup and view all the answers

    Palpitation is which of the following?

    <p>Rapid, throbbing or fluttering of the heart</p> Signup and view all the answers

    One complete heart beat, combining the contraction and relaxation phases is known as which of the following?

    <p>ECG cycle</p> Signup and view all the answers

    Study Notes

    Electrocardiogram (EKG) Fundamentals

    • Clear EKG tracing is obtained with the patient lying supine.
    • Augmented leads of the 12-lead EKG include aVR, aVL, and aVF, with electrode placements on the limbs and chest.
    • The EKG machine detects electrical impulses from the heart, converting them into graphical recordings.
    • Interference can originate from sources like muscle movements, electrical devices, and poor electrode contact.
    • Atrial rate is calculated by counting the number of P waves on the EKG tracing.
    • The U wave may indicate delayed repolarization of the ventricles.

    EKG Labeling and Lead Configuration

    • EKG strips must be manually labeled using patient identification, date, time, and lead information when automatic labeling fails.
    • Chest electrodes identify six leads: V1, V2, V3, V4, V5, and V6.
    • Four limb electrodes produce three leads (I, II, III) strictly from extremities.
    • EKG machine standardization defines voltage and ensures consistent result interpretation.
    • Adjust paper speed when recording heart rates above normal ranges or when observing abnormal rhythms.

    Lead Positions and Specifications

    • V4 is positioned at the fifth intercostal space in the midclavicular line.
    • V6 is located at the same level as V4, but in the left midaxillary line.
    • V3 is placed between V2 and V4.
    • The international standard speed for EKG recording is 25 mm/sec.
    • V1 is placed in the fourth intercostal space at the right sternal border.
    • Lead I records electrical activity from the right arm to the left arm, with the left arm as the positive lead in lead configurations.

    EKG Interpretation

    • R wave indicates ventricular depolarization, peaking in the QRS complex.
    • QRS complex represents ventricular depolarization, with a normal duration of 0.06 to 0.10 seconds.
    • T wave reflects ventricular repolarization.
    • A rhythm strip displays one or more leads for continuous monitoring.
    • Vertical scale of ECG paper quantifies voltage, typically in millivolts.

    Electrode Considerations and Troubleshooting

    • The ground lead is often connected to the right leg or a designated ground point.
    • Positive waves are directed towards positive electrodes, showcasing electrical activity's path.
    • Poor electrode contact can result in artifacts or false readings.
    • Accumulation of sensor paste can interfere with signal quality.
    • If negative R waves are observed, recalibrating or repositioning electrodes may be necessary.

    Medical Terms and Abbreviations

    • SA stands for Sinoatrial node, the heart's natural pacemaker.
    • PAT refers to Paroxysmal Atrial Tachycardia, a rapid heart rhythm originating in the atria.
    • AF stands for Atrial Fibrillation, characterized by an irregular heartbeat.
    • Telemetry involves remotely monitoring heart rhythms using electronic devices.
    • WNL means within normal limits, indicating standard ranges for vital signs or measurements.
    • PMI refers to Point of Maximal Impulse, the location apex beat is best felt.
    • Palpitation describes the sensation of irregular heartbeats.

    Clinical Observations

    • Bateness of skin can result from hypoxia or insufficient oxygenation.
    • One complete heartbeat, encompassing contraction (systole) and relaxation (diastole), is known as a cardiac cycle.
    • Arrhythmias may involve abnormal rhythms, with ventricular arrhythmias causing fast heartbeats.
    • A Holter monitor is used for extended heart rhythm recording over 24 hours or more.

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    Description

    This quiz covers the fundamental concepts of EKG tracing, including the importance of patient positioning for accurate results. Test your knowledge on how different placements affect the clarity of the EKG readout.

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