NURS 6900 Monitoring Lecture Exam With
Complete Solutions
What are the minimum requirements for clinical monitoring? - ANSWER 1. Monitor,
evaluate, and document the patient's physiologic status as appropriate for
procedure/agent
2. Variable pitch and threshold alarms should be on and audible
3. BP, HR, and RR should be documented q 5 min
4. CV: EKG and BP
5. Resp: SpO2
6. Ventilation: EtCO2
7. Thermoregulation
8. Neuromuscular (when utilizing a NMBD)
What are the monitoring systems we are being tested on? - ANSWER 1. Cardiac
2. Respiratory
3. Temperature
5. Neurological
What cardiac monitoring do we have in anesthesia? - ANSWER 1. EKG
2. BP
3. CVP
4. PA catheter
What is the EKG? - ANSWER This is an electrical vector diagram that demonstrates the
movement of electrically charged particles during a cardiac action potential
There are bipolar and unipolar leads
,Bipolar leads - ANSWER There are 2 surface leads, one positive and one negative
I: + lead on L arm, negative lead R arm
II: + lead on L leg, negative lead on R arm
III: + lead on L leg, negative lead on L arm
Unipolar leads - ANSWER These have one positive surface lead and include aVF, aVL,
and aVR
aVR: Right shoulder
aVL: Left shoulder
aVF: Foot
What are the precordial leads? - ANSWER AKA the chest leads, V1-V6
V1: 4th intercostal, R sternal border
V2: 4th intercostal, L sternal border
V3: 5th intercostal
V4: 5th intercostal, midclavicular
V5: 5th intercostal
V6: 5th intercostal, mid-axillary
What is the coloring for EKG placement? - ANSWER R arm: White
R leg: Green
L arm: Black
L leg: Red
Precordial: Brown
What are the limb leads? - ANSWER I, II, III, aVR, aVL, aVF
, Each QRS is complex is different for each limb lead
What does the QRS complex look like in Lead I? - ANSWER All the defelctions are in the
same upward direction, QRS lacks any negative deflection, small amplitude
What does the QRS complex look like in Lead II? - ANSWER Largest amplitude of QRS
and T wave, both have positive deflections
What does the QRS complex look like in Lead III? - ANSWER Positive QRS, smaller
amplitude than Lead II
What does the QRS complex look like in Lead aVR? - ANSWER All negative deflections of
p wave, QRS, and T wave
What does the QRS complex look like in Lead aVL? - ANSWER Very small amplitude,
both positve and negative QRS defelcetion, postive T wave
What does the QRS complex look like in Lead aVF? - ANSWER Looks similar to Lead II,
all positive deflections but a little less amplitude
What are the precordial leads? - ANSWER AKA chest leads
V1-V6
*QRS starts negative and lead V1 and will be positive in lead V6
*Lead V3 is the "transition" lead, there is equiphasic QRS
*There should be gradual increase in QRS amplitude in V1-V4
What is the mean electrical axis? - ANSWER This is the average of all the electrical
vectors occurring simultaneously during depolarization
What is the sequence of depolarization in the ventricles? - ANSWER 1. AV node
Complete Solutions
What are the minimum requirements for clinical monitoring? - ANSWER 1. Monitor,
evaluate, and document the patient's physiologic status as appropriate for
procedure/agent
2. Variable pitch and threshold alarms should be on and audible
3. BP, HR, and RR should be documented q 5 min
4. CV: EKG and BP
5. Resp: SpO2
6. Ventilation: EtCO2
7. Thermoregulation
8. Neuromuscular (when utilizing a NMBD)
What are the monitoring systems we are being tested on? - ANSWER 1. Cardiac
2. Respiratory
3. Temperature
5. Neurological
What cardiac monitoring do we have in anesthesia? - ANSWER 1. EKG
2. BP
3. CVP
4. PA catheter
What is the EKG? - ANSWER This is an electrical vector diagram that demonstrates the
movement of electrically charged particles during a cardiac action potential
There are bipolar and unipolar leads
,Bipolar leads - ANSWER There are 2 surface leads, one positive and one negative
I: + lead on L arm, negative lead R arm
II: + lead on L leg, negative lead on R arm
III: + lead on L leg, negative lead on L arm
Unipolar leads - ANSWER These have one positive surface lead and include aVF, aVL,
and aVR
aVR: Right shoulder
aVL: Left shoulder
aVF: Foot
What are the precordial leads? - ANSWER AKA the chest leads, V1-V6
V1: 4th intercostal, R sternal border
V2: 4th intercostal, L sternal border
V3: 5th intercostal
V4: 5th intercostal, midclavicular
V5: 5th intercostal
V6: 5th intercostal, mid-axillary
What is the coloring for EKG placement? - ANSWER R arm: White
R leg: Green
L arm: Black
L leg: Red
Precordial: Brown
What are the limb leads? - ANSWER I, II, III, aVR, aVL, aVF
, Each QRS is complex is different for each limb lead
What does the QRS complex look like in Lead I? - ANSWER All the defelctions are in the
same upward direction, QRS lacks any negative deflection, small amplitude
What does the QRS complex look like in Lead II? - ANSWER Largest amplitude of QRS
and T wave, both have positive deflections
What does the QRS complex look like in Lead III? - ANSWER Positive QRS, smaller
amplitude than Lead II
What does the QRS complex look like in Lead aVR? - ANSWER All negative deflections of
p wave, QRS, and T wave
What does the QRS complex look like in Lead aVL? - ANSWER Very small amplitude,
both positve and negative QRS defelcetion, postive T wave
What does the QRS complex look like in Lead aVF? - ANSWER Looks similar to Lead II,
all positive deflections but a little less amplitude
What are the precordial leads? - ANSWER AKA chest leads
V1-V6
*QRS starts negative and lead V1 and will be positive in lead V6
*Lead V3 is the "transition" lead, there is equiphasic QRS
*There should be gradual increase in QRS amplitude in V1-V4
What is the mean electrical axis? - ANSWER This is the average of all the electrical
vectors occurring simultaneously during depolarization
What is the sequence of depolarization in the ventricles? - ANSWER 1. AV node
