Podcast
Questions and Answers
What adjustment should be made if any part of the waveform extends beyond the paper during ECG recording?
What adjustment should be made if any part of the waveform extends beyond the paper during ECG recording?
What should be done immediately after completing the 12-lead ECG recording?
What should be done immediately after completing the 12-lead ECG recording?
Which of the following actions is important during the evaluation of the ECG?
Which of the following actions is important during the evaluation of the ECG?
What should be documented along with the ECG strip?
What should be documented along with the ECG strip?
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What is an important step after disconnecting the lead wires from the electrodes?
What is an important step after disconnecting the lead wires from the electrodes?
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Which electrode is positioned at the fourth intercostal space at the left sternal border?
Which electrode is positioned at the fourth intercostal space at the left sternal border?
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What is the correct placement for the red or RA lead electrode?
What is the correct placement for the red or RA lead electrode?
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At what speed should the paper speed selector be set for recording the ECG?
At what speed should the paper speed selector be set for recording the ECG?
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Which lead is applied at the fifth intercostal space at the left midclavicular line?
Which lead is applied at the fifth intercostal space at the left midclavicular line?
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What should be done before applying the contact electrodes?
What should be done before applying the contact electrodes?
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What is required of the patient during the recording of the ECG?
What is required of the patient during the recording of the ECG?
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Which lead is connected to the left leg?
Which lead is connected to the left leg?
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How many leads does the machine record automatically when the AUTO button is pressed?
How many leads does the machine record automatically when the AUTO button is pressed?
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What is the primary function of the sinoatrial (SA) node in the heart?
What is the primary function of the sinoatrial (SA) node in the heart?
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Which leads on an ECG are considered bipolar leads?
Which leads on an ECG are considered bipolar leads?
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What is the typical duration of a P wave in an electrocardiogram?
What is the typical duration of a P wave in an electrocardiogram?
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What does the QRS complex on an ECG represent?
What does the QRS complex on an ECG represent?
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Which type of lead is formed by the combination of electrodes on the left arm and left leg?
Which type of lead is formed by the combination of electrodes on the left arm and left leg?
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What does an abnormal ECG typically indicate?
What does an abnormal ECG typically indicate?
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Which waves on an ECG are primarily associated with ventricular repolarization?
Which waves on an ECG are primarily associated with ventricular repolarization?
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What characterizes unipolar leads in an electrocardiogram?
What characterizes unipolar leads in an electrocardiogram?
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What should the client do during the ECG procedure to ensure accurate readings?
What should the client do during the ECG procedure to ensure accurate readings?
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What is a primary purpose of obtaining an electrocardiogram (ECG)?
What is a primary purpose of obtaining an electrocardiogram (ECG)?
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How long does an ECG procedure typically take?
How long does an ECG procedure typically take?
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Which of the following actions should a client take if they experience chest pain during the ECG?
Which of the following actions should a client take if they experience chest pain during the ECG?
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What equipment is essential for conducting an ECG?
What equipment is essential for conducting an ECG?
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What should be avoided to ensure there is no electrical interference during an ECG?
What should be avoided to ensure there is no electrical interference during an ECG?
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What type of information can an ECG provide about the heart?
What type of information can an ECG provide about the heart?
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Why is it important to know the medications a client is taking before conducting an ECG?
Why is it important to know the medications a client is taking before conducting an ECG?
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What does an enlarged P wave deflection suggest?
What does an enlarged P wave deflection suggest?
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What does a prolonged PR interval signify?
What does a prolonged PR interval signify?
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Which potential condition is indicated by a depressed ST segment?
Which potential condition is indicated by a depressed ST segment?
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An absent or altered P wave suggests what about the electrical impulse?
An absent or altered P wave suggests what about the electrical impulse?
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What does a tall, peaked T wave suggest?
What does a tall, peaked T wave suggest?
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Which condition might be indicated by an enlarged Q wave?
Which condition might be indicated by an enlarged Q wave?
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What should be recorded for accurate ECG results?
What should be recorded for accurate ECG results?
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What could an increased time duration of the QRS complex imply?
What could an increased time duration of the QRS complex imply?
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Study Notes
Electrocardiogram (ECG or EKG) Overview
- An ECG records the heart's electrical impulses via electrodes and a galvanometer.
- Electrodes are placed on arms, legs, and chest to capture electrical activity.
- Standard ECG comprises 12 leads: six limb leads (I, II, III, AVF, AVL, AVR) and six precordial leads (V1-V6).
Electrical Activity of the Heart
- The sinoatrial (SA) node initiates electrical impulses, leading to atrial contraction (depolarization).
- Impulses travel to the atrioventricular (AV) node and the bundle of His, causing ventricular contraction.
- The heart's recovery phase involves repolarization, reflected in ECG waves and complexes:
- P wave: atrial depolarization
- QRS complex: ventricular depolarization
- ST segment, T wave, and U wave: ventricular repolarization
ECG Wave Characteristics
- P Wave: Normal duration is 0.12 seconds; changes may indicate atrial enlargement.
- PR Interval: Normal duration is 0.2 seconds; prolonged intervals may suggest AV conduction delay.
- QRS Complex: Normal duration is less than 0.12 seconds; enlargement suggests myocardial infarction or hypertrophy.
- ST Segment: Depressed segment indicates ischemia; elevated may signify myocardial infarction.
- T Wave: Inverted T wave can indicate ischemia; peaked T waves may indicate hyperkalemia.
Factors Affecting ECG Results
- Body movement and electromagnetic interference can distort results.
- Poor electrode contact with skin can lead to inaccurate readings.
Clinical Problems Identified by ECG
- Can detect dysrhythmias, hypertrophies, ischemia, electrolyte imbalances, and infarction.
Nursing Implications
- Document all medications the client is taking to correlate with ECG findings.
- Ensure the client relaxes and breathes normally during the ECG for accurate readings.
Purpose of ECG
- Identifies rhythm disturbances and assesses heart chamber size and position.
- Aids in diagnosing conditions like myocardial infarction (MI) and pericarditis.
- Evaluates medication effects and artificial pacemaker function.
Equipment Required
- ECG machine, ECG paper, electrodes with gel, and gauze pads or alcohol cotton balls.
Assessment Steps
- Review medical history and assess cardiac status.
- Prevent electrical interference during the procedure.
- Properly attach limb and precordial electrodes following standardized placements.
ECG Recording Procedure
- Set ECG machine to standard speed of 25 mm/second and full voltage.
- Instruct the patient to remain still and avoid talking during recording.
- Press AUTO to begin recording the 12-lead ECG; observe waveform quality and adjust as needed.
- Label ECG trace with patient information and document response during the recording.
Post-Procedure Care
- Remove electrodes, clean skin if necessary, and dispose of electrodes properly.
- Ensure the patient is comfortable post-procedure, adjusting the bed as needed.
- Maintain hygiene protocols and document findings in the patient's chart.
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