NURS 3370 TEST 4 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED

NURS 3370 TEST 4 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED step 1 of reading ECG: HEART RATE -normal strip is 6 seconds long -5 big boxes is 1 sec -tiny box is 0.04 sec -5 tiny boxes= 1 big box= 0.2 sec -U wave= low K, not a normal occurrence on ECG -high T wave= high K (ex, renal dz), inverted T= low K (ex diuretics) -top of complex= R wave, count Rs and multiply by 10 for a 6 second strip= HR step 2 of reading ECG: HEART RHYTHM -looking at atrial & ventricular rhythm -atrial rhythm: mark where P waves are (first 2) and see if they are the same across all complexes, in afib they will NOT be the same -ventricular rhythm: mark R to R -rhythm can only be monitored with ECG step 3 of reading ECG: P WAVE -is there a P wave before each QRS? -are they all the same smooth and upright waves? -if they disappear or are upside down= junctional rhythm step 4 of reading ECG: PRI -P-R interval -mark beginning of P wave to beginning of R wave, line up with bottom of strip to see how long it is -size of big box is 0.2 sec -normal is 0.12 to 0.20 sec (no more than 1 big box and no less than 3 little boxes) step 5 of reading ECG: QRS COMPLEX -normal is 0.04-0.12 (1 little box to 3 little boxes) -want them to be thin -do all the QRS complexes look alike? -PVC= different QRSs, could have problem with deficiency in magnesium or K, or ischemia to heart -PEA= pulseless electrical activity, will show electrical activity on ECG but have no pulse or BP, so you need to manually feel pulse and check BP don't just look at strip sinus tachycardia -100-160 BPM, everything else is normal -#1 cause is hypovolemia, fluid bolus will fix -if febrile= every degree of fever makes HR go up by 10 BPM, so don't give a drug to slow HR, treat fever! -pain, anxiety and fear can also make HR go up -nothing else is wrong except fast HR -called sinus bc SA node is still pacemaker of heart asystole -flat line, dead -dont defibrillate a dead patient, if you do= severe edema around heart and can ruin chance of them coming back -CPR & epinephrine, warm them up sinus bradycardia -under 60 BPM -SA node is still working if P waves are smooth and present before each QRS -everything else is normal -if symptomatic (chest pain, altered LOC, clammy) give atropine -atropine is drug of choice -inhalation of chemicals (pesticides), constant cholinergic response: give atropine as antidote, is an anticholinergic and will reverse bradycardia -only time atropine doesn't work is if pt had heart transplant bc their heart is enervated -give these pts epinephrine, a vasoconstrictor -athletes may normally have low HR -if on lanolin (digoxin) and have bradycardia, is bad -probably have low K and high d