Cardiac Rhythm Interpretation, Exams of Nursing

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NHA CCMA

Oral temperature about 100* F (37.8C) - Fever 97.6 F - 99.6* F (36.4* C-37.6* C) - Normal Temperature Above 101* F (38.3* C) - Rectal or ear fever temp 100.4* F (38* C) - Pediatric Rectal Fever Systolic less than 120 Diastolic less than 80 - Normal BP Systolic 120- Diastolic 80-89 - Prehypertension Systolic 140- Diastolic 90-99 - Hypertension (stage 1) Systolic 160 or above Diastolic 100 or above - Hypertension (stage 2)

Systolic 180 or above Diastolic 110 or above - Hypertensive Systolic 90 or below Diastolic 60 or below - Hypotensive 60 - 100 beats per min - Normal (Resting) Heart Rate Resting heart rate of 100 beats per min or higher - Tachycardia Resting heart rate of less than 60 beats per min - Bradycardia 12-20 per min - Respiration Rate Vital Signs - Blood pressure, Temperature, and Respiration. Diastole - Vein constricts, valve opens, ventricle relaxes, semi-lunar valves close. Systole - Ventricle closes, ventricle contracts, semi-lunar valves open. BP cuff, stethoscope, antiseptic wipes. -

Gather for taking blood pressure. Regular adult, pediatric, large, obese - Blood pressure cuff size one inch above the brachial artery. - Blood pressure cuff should be placed. Temperature - a measure of the body's ability to generate, loses heat. 30 - Eating, drinking, smoking, and exercise past ___ min can affect temperature reading. Hemorrhoids, rectal bleeding, surgery, tendency of bleeding, recent prostate surgery, diarrhea, colostomy, sever heart disease, rash in rectal area, patient refuses. - Avoid rectal temperature readings. (10 Reasons) Tympanic Thermometer - Measures infrared heat waves that determine temperature aurally. Patients over age 3 - Pull pinna up and back. (Aural Temp) Patients younger than age 3 - pull pinna down and back (Aural Temp) Pediatric Anthropometric measurements - Head circumference (birth-3 yrs old) Remove diaper what weighing Measure from head to foot.

(C x 9/5) + 32 = F - Convert C to F (F - 32) x 5/9 = C - Convert F to C lb x 0.45 = kg - Convert lb to kg Kg x 2.2 = lb - Convert Kg to lb. in x 2.54 = cm - Convert in to cm. cm x 0.39 = in - Convert cm to in. Supine Position - Patient lies flat face up. Dorsal Recumbent - Patient lies face up with knees bent. Fowler's position - Patient lies on table with head of table elevated to 90. Semi-Fowler's position - Patient lies on table with head of table elevated to 45

Prone Position - Patient lies face down. Sim's Position - Patient lies on left side with right leg sharply bent with knee on the table. Knee chest Position - Patient rest on knees and chest with head turned to one side. Trendelenburg Position - Patient is supine, bottom of the table is elevated 30*. Sims' Position - The proper position for a patient receiving a rectal temperature. Lancet - Small, sterile, pointed blade Finger, heel stick Ventricular depolarization - R Wave Birth - 3 yrs old - Head circumference age Benzalkonium Chloride - May be used instead of alcohol for a venipuncture draw. Class A fire extinguisher - Ordinary combustible materials that require water to extinguish.

CPT Coding - 5 Digits 4.7 - 6.1 mm^3 - Normal RBC count for males 4.2 - 5.4 mm^3 - Normal RBC count for females Chief Complaint - CC. Buccal - Tablets are placed between tooth and gum. Used as a quick pain reliever. Sublingual - Tablets are placed under the tongue and are absorbed into the bloodstream quickly. Arterial Depolarization - P Wave Low-density lipid protein - LDL LDL - Test for cardiac risk assessment. Tunica intima - Inner endothelial tissue of a blood vessel. Tunica Tunica Media -

The inner smooth layer of a blood vessel. 25 gauge - Needle size for subcutaneous injections 45 degree angle - Angle of subcutaneous injections Abdomen, upper buttocks, back upper arm, outer thigh - Sight of subcutaneous injections 15 degree angle - Angle of intradermal injection Volar forearm - Sight of intradermal injection Dosage, Method, Location - Record about intradermal injection Subcutaneous injection - Only massage if Dr. Requires. Intradermal Injection - No Massage. Intramuscular Injection - Massage sight to work medication into the muscle. 90 degree angle - Angle of intramuscular injection

Deltoid - Sight of Intramuscular injection. Cerumen - Removed when performing ear irrigation. Foams - Used for wound with large amounts of drainage. Alginates - Used for cleaning exudation wounds and aids in debridement. Inner Canthus - The location to aim the solution into to begin eye irrigation. Hydrogels - Used on wounds that are sloughing off, have necrotic tissue of are burns. Class C fire extinguisher - Electrical Fires 135 - 145 m Eq/L - Normal Sodium Range 3.5 - 5 m Eq/L - Normal Potassium 130-400 mm^3 - Normal Platelet Count

Thyroid Stimulating Hormone - TSH Human Chorionic Gonadotrin (pregnancy) - HCG Glucose Tolerance Tests - GTT Class B fire extinguisher - Used for flammable liquids and vapors Quantity Not Sufficient - QNS Spirometer - Device used to perform Pulmonary Function Test (PFT) Patients Bill of Rights - Protects patients from being denied fair treatment or participation in research studies. Gauze - Used on minor wounds or as secondary dressings. Wandering Baseline - Occurs when the stylus moves from the center of the EKG. Can be a result of too much lotion or sweat on the skin, an inadequate attachment to the skin. Alphabetic, numeric, alphanumeric, Subject - 4 Filing Methods

Authentication - For a chart to be admissible as evidence in court, the person dictating or writing the entries must be able to attest that they were true and correct at the time that they were written. This is done best by initialing entries made to the MR. Endocardium, Myocardium, epicardium. - 3 layers of the heart Tunica Adventitia - The outer layer of tissue of a blood vessel wall, composed of elastic and fibrous connective tissue. Right eye - OD tissue - histo- Hematoma - A localized collection of blood outside the blood vessels, usually in liquid form within the tissue. cartilage - chondr- Endothelial cells - cells lining the blood vessels Standard Precautions - the minimum infection prevention practices that apply to all patient care, regardless of suspected or confirmed infection status of the patient, in any setting where healthcare is delivered. Standard Precautions include: 1) hand hygiene, 2) use of personal protective equipment (e.g., gloves, gowns, masks), 3) safe injection practices, 4) safe handling of potentially contaminated equipment or surfaces in the patient environment, and 5) respiratory hygiene/cough etiquette.

Tricuspid Valve - A valve that is situated at the opening of the right atrium of the heart into the right ventricle Referral - Transfer of patient care from one physician to another. Apical pulse - A more accurate measurement of the heart rate and it is taken over the apex of the heart by auscultating using the stethoscope. Common Vehicle - A mode of bacterial transmission that would take place when and infectious agent was transmitted through a item such as food or water. Oral Medication - Liquid, Tablets, Capsule Topical Medication - lotions, liniments, ointments, or transdermal patch. Transdermal Medication - The patch transfers medication slowly through the skin. Parenteral Medications - Topical, Transdermal, Intramuscular, Intradermal, and Subcutaneous Amount, Location, Any reaction - Record in Medical Record (Topical) Place new patch in different location. Leave old patch on for 30 min after. - When replacing old patch...

Aspirate - During intramuscular injection, how do you prevent injecting into a blood vessel? Intradermal Injection - TB skin test. Prone postion, Upper back - Intradermal injection position and sight for allergy Test Pulmonary Function Test - Test to help determin lung diseases, and extent disease has progressed. Refrain from using nebulizers, bronchodilators, or smoking for 6 hours. - Prerequisites for PFT 20 - Feet away from Snellen Chart Tearing, or squinting, Leaning forward or backward - What to observe during a Visual Acuity Test Patient makes more than 2 mistakes - Visual Acuity Test ends when.. 14-16 inches. - Distance visual acuity card from eyes Visual Acuity Card - This is what the patient reads during a Near-Vision Screening

Label in front of patient, and label specimen on container. (Not on the Lid) - Rules for Labeling specimens routine specimens, midstream specimens, clean catch urine specimens, first of the morning, timed, fasting. - Type of Urine Tests 3-5 mL - Amount of sputum required for Sputum Test. Sputum Test - Patient coughs deeply and I collect the material that the patient expels during that cough with a sterilized container. Room Temp - Temperature Sputum Test specimens should be transported at. Saliva Test - Test that monitors hormone, drug, and alcohol levels. Frozen - Temperature Saliva must be before sending to a lab for testing Fecal Testing - Detects the presence of parasites, blood, and bacteria. 1 hr. - Semen sample should be tested within Protect from light, keep at body temperature - Rules for transporting semen.

Lower conjunctiva sac - Aim the solution during Eye Irrigation Time, Date, and amount of solution used - Record this information in medical record for Eye Irrigation. Signs of shock - Gray, ashen, or blue skin that is cool to the touch. Syncope - Skin is flush, heavily sweating, the patient feels dizzy or nauseated. (Possibly faint) measure vital signs, do not leave patient alone - If the patient has syncope 250-320* F - Temperature range for sterilization Autoclave - Machine used for sterilization. Disinfectants - Chemical formulations made to kill microbes. Bleach - An effective disinfectant that can be used with human bodily fluids or viruses. 1:10 Solution of household bleach and water. - The least expensive and most readily available disinfectant for surfaces such as counter tops. Sanitation -

Cleans items to reduce microbes and viruses and prepares items for disinfection and sterilization. Appropriate Introduction - Name, Identify myself as a MA, inform patient of procedure going to be performed. remove bandage for 15 min, and avoid heave lifting for at least 1 hour. - After a phlebotomy procedure patient should not... How long it should take Level of pain Experience after the procedure. - Explanation of the procedure of the blood draw should include: Test requisition - Name of ordering physician Patients first name, middle initial, and last name Patients DOB Type of Test Date of Test Test Status Special Precautions Testing status - Fasting, Basal state, or timed Special precautions - Latex allergy, or mastectomy, or other information that may effect blood draw. In-Patient - The patient is __________ if the requisition includes patients medical record number, room number, and bed number.

Out-Patient - The patient is_____________if the requisition includes billing information, and ICD-9-CM Codes. Median cubital, basilic, or cephalic veins - For venipuncture use one of these three veins: Dorsal part of the hand - This is the second choice location for venipuncture. Capillary collection - Preferred over venipuncture for infants less than age 2. Scalp, wrist, medial ankle - venipuncture sites for patients less than 1 year old. Medial or lateral plantar portions of the heel - For patients younger than 1 possible capillary collection sites. the side of the middle or ring finger - For patients older than 2 years old this is the capillary collection site. requisition form - Note non compliance here if patient has not conformed to the requirements for a blood draw. The physician - Who decides of the blood test should still be performed if the patient has not conformed to the requirements. Empty his bladder at least 10 min before EKG Wear loose clothing

Rest for 30 min before - Before performing an EKG ask the patient to: List of all medications and supplements - When acquiring proper information for an EKG, besides full name, gender, and age of patient. Also include date and time of EKG and_____________. White - RA Lead (color) Black - LA Lead (color) Green - RL Lead (color) Red - LL Lead (Color) RA Lead - EKG lead that attaches to the patients right arm. LA Lead - EKG lead that attaches to the patients left arm RL Lead - EKG lead that attaches to the patients right leg LL - EKG lead that attaches to the patients left leg.

Red - V1 Lead Yellow - V2 Lead green - V3 Lead blue - V4 Lead Orange - V5 lead Purple - V6 Lead V1 Lead - Placement of EKG lead: 4th intercostal space, right sternal. V2 Lead - Placement of EKG lead: 4th intercostal space, left sternal V3 Lead - Placement of EKG lead: Halfway between leads V2 and V4. V4 Lead - Placement of EKG lead: 5th intercostal space, left midclavicular line. V5 Lead -

Placement of EKG lead: Horizontal line with V4 at the anterior axillary line. V6 Lead - Placement of EKG lead: Horizontal line with V3 at the midaxillary line. Channel one-negative - three-channel, seven-lead monitor: white Channel one-positive - three-channel, seven-lead monitor: red Channel two-negative - three-channel, seven-lead monitor: black Channel two-positive - three-channel, seven-lead monitor: brown Channel three-negative - three-channel, seven-lead monitor: blue Channel three-positive - three-channel, seven-lead monitor: orange Last Lead - three-channel, seven-lead monitor: green Channel one-negative - three-channel, seven-lead monitor: Right manubrial border of the sternum Channel one-positive - three-channel, seven-lead monitor: Left anterior axillary line, by the sixth rib

Channel two-negative - three-channel, seven-lead monitor: Left manubrial boarder of the sternum Channel two-positive - three-channel, seven-lead monitor: Approx 1 inch right of the xiphoid process Channel three-negative - three-channel, seven-lead monitor: Center of the manubrium Channel three-positive - three-channel, seven-lead monitor: Left mid-clavicular line on the sixth rib Last Lead - three-channel, seven-lead monitor: Lower right rib margin over the bone Channel three-negative - Three-channel, five-lead monitor: White Channel one-negative, two-negative - Three-channel, five-lead monitor: Red Channel two-positive, three-positive - Three-channel, five-lead monitor: Black Channel one-positive - Three-channel, five-lead monitor: Brown Last lead - Three-channel, five-lead monitor: Green

Channel three-negative - Three-channel, five-lead monitor: Right manubrium border on the clavical Channel one-negative, two-negative - Three-channel, five-lead monitor: Centered on the manubrium Channel two-positive, three-positive - Three-channel, five-lead monitor: Lower left rib margin over the bone Channel one-positive - Three-channel, five-lead monitor: Lower right rib margin over the bone Last lead - Three-channel, five-lead monitor: Lower right rib margin over the bone V7 Lead - Posterior lead attached at the posterior axillary line. V8 Lead - Posterior lead attached at the midscapular region. V9 Lead - Posterior lead attached at the paraspinal location Stressful activity - Eating, bowel movement, exercise, and sexual activity ambulatory monitor (holter monitor) - Patients should not shower while wearing this 24 hour log -

Record stressful activity, any instance of cardiac issues, or a significant emotional event when wearing a Holter Monitor. Systole is greater than 180 or Diastole is greater then 110 - Hypertensive Crisis Without - A-, An- Ambi- - Both two - Bi-, Di, Brady- - slow Hemi- - Half Mega- - Large Micro- - Small Mono- - one

Multi- - Many Olig- - scanty Pari- - all poly- - many Four - Quadra-, Tetra- Semi- - Part Tachy- - Fast Tri- - Three Uni- - Single, one Eu- - Normal Hyper- -

More/Increased Hypo- - Less/Decreased Infra- - Below/Beneath Meta- - Change Subra- - Excessive, outside Super- - Excessive, more Ultra - Excessive Ab- - Away from Ad- - Toward Anti- - Against Contra- - Against

Circum- - Around Peri- - Around De- - Not, down Dia- - Across, through Epi- - Upon, above Para- - Along, beside Per- - Through Post- - After Pre- - Before Re- - Again/back