Podcast
Questions and Answers
What is the preferred method for preparing the skin in the electrode area?
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?
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?
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?
Where should the V5 electrode be placed?
What is the significance of proper lead placement for a 12-lead ECG?
What is the significance of proper lead placement for a 12-lead ECG?
What action should be taken after obtaining an artifact-free ECG tracing?
What action should be taken after obtaining an artifact-free ECG tracing?
Which of the following describes the correct lead placement for the right wrist?
Which of the following describes the correct lead placement for the right wrist?
In what position should the patient be placed during the ECG procedure?
In what position should the patient be placed during the ECG procedure?
What is the primary purpose of placing the nurse call system within the patient's reach?
What is the primary purpose of placing the nurse call system within the patient's reach?
Which of the following actions is NOT included in promoting patient safety according to the performance expectations?
Which of the following actions is NOT included in promoting patient safety according to the performance expectations?
What should be recorded when terminating the electrocardiogram procedure?
What should be recorded when terminating the electrocardiogram procedure?
How is performance rated when the steps of a procedure are performed with significant omissions?
How is performance rated when the steps of a procedure are performed with significant omissions?
What is indicated by a performance expectation rated as 'Completely Done'?
What is indicated by a performance expectation rated as 'Completely Done'?
In the context of obtaining an ECG, what should be done after documenting patient learning?
In the context of obtaining an ECG, what should be done after documenting patient learning?
Which of the following options indicates an action that contributes to patient comfort and well-being?
Which of the following options indicates an action that contributes to patient comfort and well-being?
What rating would you give performance that is inconsistent and has insignificant omissions during a procedure?
What rating would you give performance that is inconsistent and has insignificant omissions during a procedure?
What is the primary purpose of performing hand hygiene before obtaining a 12-lead electrocardiogram?
What is the primary purpose of performing hand hygiene before obtaining a 12-lead electrocardiogram?
Why should the patient's legs not be crossed during the procedure?
Why should the patient's legs not be crossed during the procedure?
What should be done with excessive hair in the area where electrodes will be placed?
What should be done with excessive hair in the area where electrodes will be placed?
What is the maximum angle at which the head of the bed should be elevated during the procedure?
What is the maximum angle at which the head of the bed should be elevated during the procedure?
Which of the following actions should be avoided when preparing the skin for electrode placement?
Which of the following actions should be avoided when preparing the skin for electrode placement?
What procedure should be followed to identify the patient before starting the ECG?
What procedure should be followed to identify the patient before starting the ECG?
What is the best way to ensure reduced skin impedance during the electrode placement?
What is the best way to ensure reduced skin impedance during the electrode placement?
In what position should the patient be placed for a standard 12-lead ECG?
In what position should the patient be placed for a standard 12-lead ECG?
Flashcards
Patient Identification
Patient Identification
Verifying patient identity using at least two identifiers (e.g., name and date of birth) according to agency policy.
Hand Hygiene
Hand Hygiene
Washing hands before the procedure to reduce the spread of germs.
Patient Positioning for ECG
Patient Positioning for ECG
Placing the patient in a supine position with the head of the bed at a maximum of 30 degrees.
ECG Electrode Placement
ECG Electrode Placement
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Skin Preparation for ECG
Skin Preparation for ECG
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12-Lead ECG Machine Setup
12-Lead ECG Machine Setup
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Avoidance of Skin Drying Agents During ECG Prep
Avoidance of Skin Drying Agents During ECG Prep
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Patient Instructions for ECG Procedure
Patient Instructions for ECG Procedure
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Chest Lead Placement
Chest Lead Placement
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Extremity Lead Placement
Extremity Lead Placement
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ECG Machine Error Check
ECG Machine Error Check
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ECG Artifact Avoidance
ECG Artifact Avoidance
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ECG Tracing Delivery (STAT)
ECG Tracing Delivery (STAT)
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12-Lead ECG Accuracy
12-Lead ECG Accuracy
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Patient Comfort
Patient Comfort
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Lowering the Bed
Lowering the Bed
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Accessible Nurse Call System
Accessible Nurse Call System
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Recording ECG Details
Recording ECG Details
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Patient Learning Evaluation
Patient Learning Evaluation
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Completely Done
Completely Done
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Partially Done
Partially Done
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Not Done
Not Done
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Performance Rating Scale
Performance Rating Scale
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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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