ECG Preparation and Procedure Quiz

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Questions and Answers

What is the preferred method for preparing the skin in the electrode area?

Clipping the hair (correct)

Using wax to remove hair

Shaving the hair

Applying alcohol-based skin preps

Which of the following lead placements is correct for the V2 electrode?

Midway between V2 and V3

Left anterior axillary line at level of V4

Fifth ICS at midclavicular line

Fourth ICS at left sternal border (correct)

What should be done if messages indicate electrode or lead issues on the 12-lead machine?

Disconnect all leads and restart the machine

Press the button to obtain the ECG without addressing the messages

Ignore the messages if the ECG seems fine

Check leads and correct issues before obtaining an ECG (correct)

Where should the V5 electrode be placed?

At the left midaxillary line at level of V4 Signup and view all the answers

What is the significance of proper lead placement for a 12-lead ECG?

It ensures accurate interpretation of the ECG Signup and view all the answers

What action should be taken after obtaining an artifact-free ECG tracing?

Disconnect leads and gently remove them from the patient's skin Signup and view all the answers

Which of the following describes the correct lead placement for the right wrist?

A extremity lead Signup and view all the answers

In what position should the patient be placed during the ECG procedure?

Reclined comfortably Signup and view all the answers

What is the primary purpose of placing the nurse call system within the patient's reach?

To ensure the patient can summon help if needed. Signup and view all the answers

Which of the following actions is NOT included in promoting patient safety according to the performance expectations?

Keeping the patient's call light out of reach. Signup and view all the answers

What should be recorded when terminating the electrocardiogram procedure?

The date and time of the ECG obtained. Signup and view all the answers

How is performance rated when the steps of a procedure are performed with significant omissions?

Not Done. Signup and view all the answers

What is indicated by a performance expectation rated as 'Completely Done'?

The procedure was consistently and logically followed. Signup and view all the answers

In the context of obtaining an ECG, what should be done after documenting patient learning?

Ensure the ECG is sent for interpretation. Signup and view all the answers

Which of the following options indicates an action that contributes to patient comfort and well-being?

Maintaining the patient's privacy during procedures. Signup and view all the answers

What rating would you give performance that is inconsistent and has insignificant omissions during a procedure?

Partially Done. Signup and view all the answers

What is the primary purpose of performing hand hygiene before obtaining a 12-lead electrocardiogram?

To prevent the transmission of micro-organisms. Signup and view all the answers

Why should the patient's legs not be crossed during the procedure?

It prevents body movement that produces artifact. Signup and view all the answers

What should be done with excessive hair in the area where electrodes will be placed?

Clip it to ensure proper adhesion of the electrodes. Signup and view all the answers

What is the maximum angle at which the head of the bed should be elevated during the procedure?

30 degrees Signup and view all the answers

Which of the following actions should be avoided when preparing the skin for electrode placement?

Using alcohol to clean the area. Signup and view all the answers

What procedure should be followed to identify the patient before starting the ECG?

Use at least two identifiers, such as name and birth date. Signup and view all the answers

What is the best way to ensure reduced skin impedance during the electrode placement?

Properly prepare the skin by cleaning it and removing excess hair. Signup and view all the answers

In what position should the patient be placed for a standard 12-lead ECG?

Supine position with the head of the bed no higher than 30 degrees. Signup and view all the answers

Study Notes

Equipment List

12-lead electrocardiograph
10 ECG leads with alligator clips, suction cups, or snap-on attachments
10 ECG electrodes (disposable, self-adhesive)
Clean, dry towels or sponge wipes

Preparatory Phase

Identify patient using at least two identifiers (name and birthday, or name and medical record number)
Perform hand hygiene

Performance Phase

Prepare the patient by removing or repositioning clothing to expose the chest and arms, keeping the abdomen and thighs covered.
Position the patient supine (lying on their back) with the head of the bed no higher than 30 degrees.
Instruct the patient to lie still without talking and not to cross their legs.
Turn on the machine and input required demographic information.
Clean and prepare the skin for electrode placement using soap and water, a rough washcloth or gauze, or the edge of an electrode.
Remove excess hair from the electrode area. Avoid using products that dry the skin, such as alcohol-based skin preps.

Rationale

Reduces transmission of microorganisms
Facilitates correct placement of cardiac leads and maintains patient modesty.
Prevents artifacts (distortions) in the ECG due to improper lead placement.
Electrodes should be placed on the anterior chest for a standard 12-lead ECG.
Body movement or talking produces artifacts.
Proper skin preparation reduces skin impedance and improves signal quality.
Do not use alcohol to clean skin as it dries it out. Clipping excessive hair is preferred.

Applying Electrodes

Apply electrodes in correct positions (chest and extremities).
Chest leads (precordial)
- V1: Fourth intercostal space (ICS) at the right sternal angle
- V2: Fourth ICS at the left sternal border
- V3: Midway between V2 and V4
- V4: Fifth ICS at the midclavicular line
- V5: Left anterior axillary line on the level of V4 horizontally
- V6: Left midaxillary line on the level of V4 horizontally
Extremities: One lead on each extremity - Right wrist, Left wrist, Left ankle, Right ankle.

Additional Steps

Check the 12-lead machine for messages concerning electrode or lead issues. If no messages, press a button to obtain the 12-lead ECG.
Disconnect the leads and remove them from the patient’s skin if tracing is made without artifacts.
If the ECG is STAT, immediately deliver the tracing (if non-computerized) to the appropriate healthcare provider for interpretation.
Help the patient to a comfortable position.
Raise side rails (as appropriate) and lower the bed to the lowest position.
Put a nurse call system in an accessible place within the patient’s reach.

Terminating and Summary Phase

Record date and time of ECG, the reason for obtaining it, and who the ECG was given to for interpretation.
Document the evaluation of the patient's learning.

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Description

Test your knowledge on the equipment and procedures required for performing an electrocardiogram (ECG). This quiz covers patient preparation, equipment usage, and essential steps in the ECG process. Ensure you understand the importance of patient identification, hygiene, and electrode placement.