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18 Cards in this Set
- Front
- Back
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Identify the correct lead placement for a 12 lead ECG:
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RA: right arm
RL: right leg LA: left arm LL: left leg V1: 4th intercostal space, right sternal boarder V2: 4th intercostal space, left sternal boarder V3: Halfway between V2 and V4 V4: 5th intercostal space, left mid clavicular line V5: Anterior auxillary line, left V6: Mid auxillary line, left |
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How to identify a good trace with an ECG:
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- ask patient to remain as still as possible
- wait approximately 10 seconds for a good trace to emerge |
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What immediate nursing actions should you take if your patient has chest pain?
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- Sit patient up in bed
- put on O2 mask, 8-10L - request for a GTN order - take vital signs (OBS) - Ask questions about chest pain - ECG - depending on setting - MET call - document later |
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What questions do you ask to confirm that your patient is experiencing chest pain?
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PQRST Method:
Provokes - What improves it - What makes it worse? Quality - What type of pain is it? e.g stabbing, burning, crushing? Radiates - Does the pain radiate? - Is it localised to one area? - Did it start elsewhere? Severity: - How bad is the pain? (pain score 0-10) Time: - When did the pain start? OTHER: - have you had this pain before? - if yes, what do you normally do to relieve it? - it is worse on inspiration? - Any recent chest trauma? - Any family history of chest pain? |
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Identify normal sinus rhythm:
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Rate: 60-100 bpm
Rhythm: regular P waves before QRS: yes PR interval: 3-5 small squares QRS complexes look alike: yes |
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Identify Atrial Fibrillation:
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Rate: 350-400 bpm
Rhythm: irregular P waves before QRS: no PR interval: NA QRS complexes look alike: yes |
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Identify Ventricular Tachycardia:
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Rate: 101-250 bpm
Rhythm: regular ventricular rhythm P Waves before QRS: no PR interval: not measurable QRS complexes look alike: yes, wide and bizarre |
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Identify Ventricular Fibrillation
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Rate: Not discernable
Rhythm: rapid, unorganised P waves before QRS: no PR interval: none QRS complexes look alike: none |
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Identify Asystole:
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no electrical activity
- appears as a 'flat line' |
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Identify ST Elevation:
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(orange highlights in image)
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Identify ST Depression:
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What does it mean is the ECG shows ST elevation?
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Myocardial infarction
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What does it mean if the ECG shows ST depression?
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Myocardial ischaemia
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What is a STEMI?
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ST elevation myocardial infarction - blockage
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What is a NSTEMI?
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non-ST elevation myocardial infarction - partial blockage
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What are some other causes of chest pain?
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- Pulmonary embolism
- reflex - fractured rib/sternum - chest trauma - anxiety - pneumothorax etc |
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What medications are used to treat cardiac chest pain? How do they work?
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ACE Inhibitor: vasodilator - decrease resistance
Anticoagulants: prevent clots forming, or existing clots from increasing in size. eg. aspirin Beta blockers: decrease heart contractility and CO Calcium channel blockers: decrease contractility, relax blood vessels Diuretics: reduce volume of blood --> lowered BP Digoxin: slows arrythmias Morphine: Pain managment GTN: vasodilator |
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What observations do you need to take with these medications?
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- monitor HR
- monitor BP - monitor SP02 |
