NUR-3343 Adult Health Nursing Week 10 Obtaining a 12-Lead Electrocardiogram PDF

NUR-3343 Adult Health Nursing Week 10 Obtaining a 12-Lead Electrocardiogram Student Name.…………………………………………….… Student's ID ……….……………. Lab Section………………….… Date………………………….………....

NUR-3343 Adult Health Nursing Week 10 Obtaining a 12-Lead Electrocardiogram Student Name.…………………………………………….… Student's ID ……….……………. Lab Section………………….… Date………………………….………. Quality of Performance Completely Partially Not Steps Rationale Done Done Done 2 1 0 Equipment List - 12-lead electrocardiograph - 10 ECG leads with alligator clip, suction cup or snap-on attachments - 10 ECG electrodes (disposable, self-adhesive) - Clean, dry towel or sponge wipes Preparatory Phase 1. Identify patient using at least two identifiers (e.g., name and birthday or name and medical record number) according to agency policy. Performance Phase 1. Perform hand hygiene and prepare patient for Reduces transmission of micro- procedure: organisms. 1.1. Remove or reposition patient’s clothing to ex- Facilitates correct placement of pose only patient’s chest and arms. Keep ab- cardiac leads and maintains pa- domen and thighs covered. tient’s modesty. Improper lead placement produces artifact. 1.2. Place patient in supine position with head of Electrodes must be placed on bed no higher than 30 degrees. anterior chest for standard 12- lead ECG. 1.3. Instruct patient to lie still without talking and Body movement or talking pro- to not cross legs. duces artifact. 2. Turn on machine; enter required demographic information. 3. Clean and prepare skin for isolated electrode Proper skin preparation before placement with soap and water. Wipe area ECG electrodes are placed de- with rough washcloth or gauze or use edge of creases skin impedance and sig- electrode to gently scrape skin. Clip excessive nal noise, thereby producing hair from electrode area. Where possible, clean, accurate recording. Do avoid the use of products that dry the skin, not use alcohol to clean area. It such as alcohol-based skin preps. will dry out skin. Clipping hair in electrode area is preferred. Shaving leaves nicks that predis- pose to infection. AY24-25-Fall Semester-NUR-3343 Adult Health Nursing 1-Laboratory Page 1 of 3 Obtaining a 12-Lead Electrocardiogram (Continued) Quality of Performance Completely Partially Not Steps Rationale Done Done Done 2 1 0 4. Apply electrodes in correct positions. Proper placement of leads is very important for accurate in- terpretation of 12-lead ECG. En- sure that correct lead is in cor- rect location. If any leads are misplaced, ECG reading will be inaccurate. a. Chest (precordial) leads V1—Fourth intercostal space (ICS) at right sternal angle. V2—Fourth ICS at left sternal border. V3—Midway between V2 and V4. V4—Fifth ICS at midclavicular line. V5— Left anterior axillary line at level of V4 horizontally. V6—Left midaxillary line at level of V4 horizon- tally. b. Extremities: One lead on each extremity; right wrist, left wrist, left ankle, right ankle. 5. Check 12-lead machine for messages to cor- rect electrode or lead issues. If no messages occur, press button to obtain 12-lead ECG. 6. If you obtain ECG tracing without artifact, dis- connect leads and gently remove from pa- tient’s skin. 7. If STAT, immediately deliver ECG tracing (if not If non-STAT 12-lead ECG, place computerized) to appropriate health care pro- in patient’s chart or designated vider for interpretation. area. 8. Help patient to a comfortable position. Restores comfort and sense of well-being. 9. Raise side rails (as appropriate) and lower bed Promotes safety and prevents to lowest position. falls. 10. Place nurse call system in an accessible loca- Ensures patient can call for as- tion within patient’s reach. sistance if needed and promotes safety and prevents falls. AY24-25-Fall Semester-NUR-3343 Adult Health Nursing 1-Laboratory Page 2 of 3 Obtaining a 12-Lead Electrocardiogram (Continued) AY24-25-Fall Semester-NUR-3343 Adult Health Nursing 1-Laboratory Page 3 of 3 Obtaining a 12-Lead Electrocardiogram (Continued) Quality of Performance Completely Partially Not Steps Done Done Done 2 1 0 Terminating & Summary Phase 1. Record date and time ECG was obtained, reason for obtaining ECG, and to whom ECG was given for interpretation. 2. Document your evaluation of patient learning. Rating Scale Point: No. Key Performance Expectation 2 Completely Done Acceptable performance. Consistent in logically following a taught set of rules within a reasonable timeframe or using a reasonable alternative approach that would probably give the same effect. 1 Partially Done Perform with insignificant omission. Inconsistent in logically following a taught set of rules and a reasonable timeframe 0 Not Done Perform with significant omission. Failure to logically follow a taught set of rules and a reasonable timeframe. Or the student has not performed the ac- tion at all. Reference: Perry A.G., Potter P.A., Ostendorf W.,Laplante N.(2022).Clinical Nursing Skills & Techniques. (10th Ed.).Elsevier AY24-25-Fall Semester-NUR-3343 Adult Health Nursing 1-Laboratory Page 4 of 3