Review for NHA EKG Exam

Lynne Clarke, Ed.D., RN Livebinder for students Password: arjhspct

The ______________ is the primary pacemaker of the heart.

Sinoatrial node

The intrinsic rate of the sinoatrial node is:

beats per minute (bpm)

Where is the Angle of Louis and why is it important?

It provides a reference for locating the 4 th intercostal space

What does the term asymptomatic mean?

Without symptoms

The EKG Technician can administer drugs. T or F

FALSE

What is the correct position of the patient’s arm when taking blood pressure?

At the level of the heart supported by a table or arm of chair.

What is the correct name of the dysrhythmia shown below?

What is the correct name of the dysrhythmia shown below? Atrial Flutter this is considered controlled since the ventricular rate is <100 bpm

Impulses are conducted to the Perkinje fibers by the __________________

Bundle branches

You are educating a patient about their upcoming stress test. You should remind them that

Do not eat or drink caffeine products (chocolate, soda, tea, coffee or Excedrin®) for 24 hours before exam. Note: Decaffeinated products contain caffeine. Consult your physician about going off beta blockers for 48 hours and calcium channel blockers 24 hours before your exam. Do not eat or drink for 3 hours before your appointment. Drinking water is okay. If you are unable to exercise on the treadmill, a medication will be administered to stress your heart. If you are undergoing this type of an exam, you may take all your heart and blood pressure medications as instructed by your physician. If you have diabetes, please speak to your physician prior to this exam to receive special instructions you may need regarding your medications. Please bring all your medications or a list of them with doses to your appointment.

What shape is the p-wave in a junctional rhythm?

Inverted Normal p wave

What changes in the ST segment indicate a heart problem?

ST segment depression Ischemia Left ventricular hypertrophy Electrolyte abnormalities ST segment elevation Ischemia Pericarditis

The left atrium receives blood from the ___________

Pulmonary Vein

Where is the apex of the heart?

Where is the apex of the heart? It points down and to the left

What is cardiac output?

The amount of blood pumped by the heart per minute.

Which chamber of the heart has the thickest myocardium and why?

The left ventricle because it has to pump blood throughout the body.

What is somatic tremor and what type of patient’s are most likely to show it?

A type of artifact Parkinson’s patients

What is an interval?

A wave plus a segment

If you patient is short of breath you may have to place them in the _____________ position to do an EKG.

Semi-Fowler’s position (45 degree angle)

The target heart range for a stress test is determined by _____________

Subtracting the patient’s age from 220 Example: a 50 year old would be 170 (220-50)

Which wave represents atrial depolarization?

P wave

What exchange takes place in the lungs?

Oxygen and carbon dioxide

The vertical axis of the EKG measures __________ and ______________

voltage and amplitude

A prolonged or widened QRS indicates ________ or _________.

A ventricular dysrhythmia or a bundle branch block

The artifact called wandering baseline is due to

Dried out electrodes or loose electrodes

What is the standardization button on the EKG machine used for?

To check the calibration of the machine Should be 10mm

What is the dysrhythmia shown below?

What is the dysrhythmia shown below? Atrial fibrillation

What is mitral stenosis?

A narrowing of the mitral valve beteen the left atrium and the left ventricle

The layer of the heart muscle that produces contractions is the ____________

This type of artifact is called AC Interference and is caused by ______________.

Electrical interference – move unnecessary electrical devices away from the patient and turn them off, especially nonmedical devices

What is the dysrhythmia shown below?

What is the dysrhythmia shown below? Ventricular fibrillation

What does a red line on the EKG paper mean?

It is time to change the roll of paper – this is just like what you would see on a cash register receipt

What is the dysrhythmia shown below?

What is the dysrhythmia shown below? Ventricular tachycardia

Where is the pericardium?

It is the protective sac around the heart

Which electrode is used for grounding?

Right leg

The EKG Technician can apply an AED. T or F

True

Where are the leads placed for a 3-leads EKG to continuously monitor a patient?

What is the dysrhythmia shown below?

What is the dysrhythmia shown below? 3 rd degree Heart Block

Where is the j point and what is it’s significance?

The point where the QRS ends and the ST segment begins. This is where ventricular repolarization begins – abnormalities related to myocardial infarction occur after this point (during ventricular repolarization)

How is Target Heart Rate determined?

An exercise stress test is performed until 85% of the patient’s target heart rate is reached (provided that patient can tolerate). The formula to determine this is: 220 – patient’s age = target heart rate x 85% Ex. For a 40 year old patient 220 – 40 = 180 x 85% = 153 BPM required for test to be valid