N 434 Dysrhythmias.pptx - N 434 Dysrhythmias Janice Conlee...

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N 434 Dysrhythmias Janice Conlee MS, CNE, CNP, RN
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ECG/ EKG Monitoring 12 recording leads in an ECG (6 are measuring electrical forces in the frontal plane. These are bipolar – both positive and negative. The remaining 6 measure horizontal plan and are unipolar) Commonly use lead II when monitoring continuously All leads are measuring electrical activity produced by depolarization and repolarization (Which is the electrical activity produced by the movement on ions across the membranes of myocardial cells)
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Remember……. SA node – dominant pacemaker 60- 100 BPM AV bundle (Bundle of His) back up pacemaker _____BPM Purkinje fibers- back up pacemaker ______BPM
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Standard limb leads bipolar (negative to positive) Lead I (wave forms upright) Lead II (wave forms upright) Lead III (waveforms upright) 12 Lead ECG
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Augmented limb leads Unipolar (electrical flow in one direction) aVR (right arm) (downward waveforms) aVL (left arm) (biphasic QRS waveform) aVF (left foot) (upright waveforms) 12 Lead ECG (cont)
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Placement
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Cardiac Monitoring May be a 12 lead obtained without additional single lead monitoring May be continuous Telemetry (remotely read) Hardwire (Critical care units, crash cart, ER)
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Atrial depolarization Ventricular depolarization
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Waveforms P wave- should not be over 0.11 seconds in duration Precedes QRS PR interval should not be more than 0.12 to 0.20 seconds Should be upright in all leads except aVr
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Waveforms: QRS Ventricular depolarization Should be 0.04 seconds to 0.10 interval Q wave is the downward deflection of the initial portion of QRS Upward deflection is the R Downward deflection following the R
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Rhythm both atrial (p wave) and ventricular (r wave) Regular Irregular Regularly irregular Rate Atrial and ventricular (tachycardia, bradycardia, normal sinus rhythm) Rhythm interpretation
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  • Spring '12
  • Cardiac electrophysiology,  SA node

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