Rhythm analysis lecture notes - NURS 405 Complex Disease...

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1 NURS 405 Complex Disease III Rhythm Analysis Lab Objectives 1. Summarize the anatomy, physiology, and basic cell function of the cardiovascular system. 2. Explain the configuration of the normal electrocardiogram (ECG) wave pattern and its relationship to cardiac function. 3. Discuss the normal ECG tracing and lead placement. 4. Calculate heart rate, rhythm, PR interval, QRS complex, and QT interval, using standard ECG paper grid. 5. Differentiate among the following rhythms by defining the terms and discussing the etiology. o Normal Sinus Rhythm o Sinus Dysrhythmias: Sinus Bradycardia; Sinus Tachycardia; Sinus Dysrhythmia; and Sinus Arrest. o Atrial Dysrhythmias: Premature Atrial Contraction; Atrial Flutter; Atrial Fibrillation; Supraventricular Tachycardia; Paroxysmal Atrial Tachycardia; and Wandering Atrial Pacemaker. o Junctional Dysrhythmias: Junctional Escape Rhythm; Accelerated Junctional Rhythm; Premature Junctional Contraction; and Junctional Tachycardia. o Heart Blocks: First-Degree; Mobitz I/Wenckebach; Mobitz II; Third- Degree/Complete Heart Block; and Bundle Branch Block. o 12-lead ECG: Changes associated with acute myocardial infarction (MI): Anterior Wall MI, Posterior Wall MI, and Lateral Wall MI
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2 Electrocardiogram (EKG) Records the electrical activity of the heart Movement of ions create electrical changes on the surface of each cardiac cell. The ECG measures movement of the electrical charge Electrodes: An electrode is an adhesive pad that contains conducting gel Two electrodes placed at a distance from each other are called a lead The electrodes are connected to a monitor with lead wires Three Lead System: There are 3 electrodes that are placed on the chest. From these 3 points, 3 “leads” are generated. Each lead is simply an electrical comparison of 2 points on the chest.
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Lead III These 3 leads compose “Einthoven’s Triangle”. Modified Chest Leads Five Lead System MCL 1 MCL 1 Lead I Lead II - + - + - +
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4 The computer inside the ECG monitoring equipment switches the roles of the electrodes automatically. All we have to do is change settings, from lead I to lead II, for example These 3 leads compose “Einthoven’s Triangle ”. Most often used for telemetry
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5 Modified Chest Leads Five Lead System MCL 1 + + -
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6
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7 Augmented Leads: Vector: force applied in specific direction MCL 6 + -
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8 3 more leads can be constructed using the average of 2 leads against the 3rd: Lead aVF (to the Foot) Lead aVL (Left arm) Lead aVR (Right arm) Leads I, II, III and the augmented leads are called the limb leads Usually a fourth electrode (RL) is necessary to obtain the augmented lead tracings aVF: To the Foot Average of A & B aVL : Left Arm
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9 aVR: Limb Leads Lead ( - ) Electrode (+) Electrode Lead I RA LA Lead II RA LL Lead II LA LL aVR LA + LL RA aVL RA + LL LA aVF RA + LA LL -
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10 Precordial Leads 12 Lead ECG Electrode Placement V Leads Used for 12 - Lead System
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11 Leads: I, II, III, aVF, V3, V4, V5, V6 Leads: aVR, V1 Leads: aVL, V2
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12 Normal ECG tracing is isoelectric with an upright T wave Ischemia Myocardial Ischemia Myocardial Injury T-Wave Inversion
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13
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  • Fall '16
  • heart rate, Cardiac electrophysiology, PR interval, atrial tachycardia, Rhythm analysis

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