Comprehensive Cardiac Rhythm Analysis and Troubleshooting, Exams of Nursing

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The first negative deflection noted in the QRS complex Q wave Atrial fibrillation with a slow ventricular response has an ventricular rate less than 60 BPM Patient education in self-monitoring includes with of the following: - when to disconnect the device

• what to do when the device emits an alert sound
• what type of symptoms to record during the monitoring period x who to call in case of an emergency x how to wear the device while driving Which of the following rhythms may be characterized by regular P-P and regular R-R intervals at different rates? complete heart block While conducting a routine transtelephonic pacemaker check, the patient states he is short of breath, and atrial fibrillation is noted in the presenting rhythm strip. The technician's next step should be to: Put the patient on hold and call his cardiologist What is the best method for obtaining a good recording from a handheld, ambulatory, post event cardiac monitor? Ensure two of the four electrodes are pressed gently to the left of the sternum Which valves prevent the backflow of blood from the aorta and pulmonary arteries into the ventricles during diastole?semilunar A patient with a TTM suddenly begins slurring his words and complaining that he has tingling in his left arm. What is the most appropriate action? activate EMS The relationship between the conducted P waves and the QRS complexes in a sinus arrhythmia is one P wave per QRS complex The p wave on the electrocardiogram represents an electrical impulse that spreads through the atria During sinus rhythm, an early narrow complex beat without a P wave preceding it would be interpreted as PJC Which of the following are types of artifact that need to be recognized during rhythm analysis. Choose four reponses - somatic tremor
• AC interference

• junctional baseline
• paced interference
• wandering baseline
• interrupted baseline The patient requires a 30-day cardiac monitoring device. Which of the following items would be the least important education related to the patients self-monitoring? what type of cardiac monitoring device is in use In the absense of a release form, a patient's health information may be shared with the patient's ___ without committing a HIPAA violation physician Which of the following BEST describes idioventricular rhythm? heart rate 20-40 BPM, almost always regular, no P waves preceding a wide QRS Which of the following items would be considered standard instructions when placing a 24h monitoring device on a pateint in a clinical setting? - explain the importance of not getting the monitor wet
• encourage teh patient to leave the monitor on the entire time
• inform the patient of physical limitations while the monitor is worn First degree AV block is determined by teh measurement of the PR interval The normal gain setting for ECG acquisition is ___ mm/mV 10 The conduction system terminates with the Purkinje network Atrial fibrillation is best defined as chaotic, asynchronous electrical activity in atrial tissue What should be done when a patient reports that their demographic information is incorrect? Follow the organizational procedure and correct the error immediately What process is used to clean monitoring equipment between patient use Disinfecting Which of the following essential tools are required to begin remote cardiac device monitoring? - batteries
• electrodes
• adhesive tape
• cardiac device

An in-hospital telemetry technician arrives for his shift and notices that the report for the prior shift has not been completed. The telemetry technician should notify the supervisor or senior technician of the situation to seek advice on how to proceed ECG preliminary findings are most frequently recorded by the technician After completion of ECGs, the equipment must be cleaned and secured per facility guidelines On standard ECG paper the horizontal lines are a measurements voltage A Parkinsonian tremor will typicall manifest itself on an ECG tracing as an erratic baseline During a monitoring period which symptoms would be most appropriate for a patient to record? - dizziness

• chest pain
• out of breath A regular rhythm with a rate of 158 BPM and with a narrow QRS complex is best described as supraventricular tachycardia Where is the most appropriate location ot place a "patch cardiac monitor"? center of chest mid sternum A characteristic of third deg AV block is the conduction of the atrial impulse failing to reach the ventricle What occurs when a ventricle pacemaker senses electrical current from sources other than the heart? oversensing Which waveform represents ventricular repolarization on an ECG strip? T wave In a normal sinus rhythm, the sinus node fires at a rate of 61-100 BPM Which of these rates could be considered a junctional tachy 130 BPM (>100 BPM) A PVC that occurs during the relative refractory period is referred to as R-on-T phenomenon A regular rhythm with a narrow QRS complex with no noted P waves and a rate between 40-60 BPM is nown as junctional escape rhythm What is sinus bradycardia? HR < 60 bpm In standard calibration ECG graph paper, a deflection of the tracing upward or downward by one large box, from baseline represents 0.5 mV What method can you use to calculate the ventriuclar rate of a cardiac rhythm when the R-R interval is regular? Divide the number of large boxes between 2 R waves ino 300

Atrial tachycardia is a rapid arrhythmia which is irregular and occurs paroxysmally What is the proper procedure if your patient has a seizure during the ECG? repeat ECG after the seizure is over Supraventricular tachycardia is narrow compelxed tachycardia greater than 150 BPM Which cardiac chamber contains most of the muscle mass of the heart? left ventricle Which rhythm is characterized by P waves with three or more different morhpologies wandering atrial pacemaker An ECG caliper measurement of peak to peak flutter waves is five small boxes. What is the atrial rate for this rhythm? 300 BPM What must be done promptly after recording an ECG rhythm? provide to the interpreting practitioner Where should the ECG tracing be placed after it has been obtained per facility guidelines and protocols On an ECG strip pacemaker spikes without P waves or QRS complexes are seen. This is loss of caputure If a dual chamber pacemaker's ventricular lead senses a non-cardiac signal, what is most likely to occur? failure to capture ventricle What best describes asystole on an ECG a flat line tracing Normal sinus rhythm HR ranges from 60-100 BPM