NSG 223 MED SURG 2 exam 1
5-Lead ECG (Continuous Monitoring): - answer Right arm (RA):** White electrode
below the right clavicle.
Left arm (LA):** Black electrode below the left clavicle.
Left leg (LL):** Red electrode on the left side of the abdomen.
Right leg (RL):** Green electrode on the right side of the abdomen.
Precordial (V1):** Brown electrode placed at the fourth intercostal space, just to the right
of the sternum.
Mnemonic:** "White on right, smoke (black) over fire (red), green goes to the ground
(right leg), brown is central."
What is cardiac stress test? - answer the patient walks or runs on a treadmill (most
common) or pedals a stationary bicycle.
The test is stopped when the target heart rate is achieved or if the patient experiences
signs of myocardial ischemia.
Abnormal findings include
chest pain
ventricular arrhythmia
ST-segment depression
lack of heart rate or BP elevation with exercise
12 lead ECG placement - answer-Step 1—Place limb leads (I, II, III, aVR, aVL, aVF)
Right arm (RA):** White electrode below the right clavicle.
Left arm (LA):** Black electrode below the left clavicle.
Left leg (LL):** Red electrode on the left lower chest or abdomen.
Right leg (RL):** Green electrode on the right lower chest or abdomen (ground).
Proper electrode placement is essential to avoid artifacts and ensure accurate readings
Precordial (Chest) Leads (V1-V6):**
V1 Fourth intercostal space to the right of the sternum.
v2Fourth intercostal space to the left of the sternum
v3Midway between V2 and V4.
V4 Fifth intercostal space at the midclavicular line.
V5At the anterior axillary line, horizontal to V4.
, V6 At the midaxillary line, horizontal to V4 and V5.
What is pharmacological stress test - answerPatients who are cognitively impaired and
unable to follow directions or physically disabled or deconditioned will not be able to
achieve their target heart rate by exercising on a treadmill or bicycle.
must avoid xanthine derivatives (theophylline, aminophylline, caffeine) for 24-48hrs prior
(they block the effects of the vasodilating agents.)
NPO 3 hrs b4, abstain from all caffeine 24 hrs prior. Including chocolate and caffeine
free beverages ( tea)
What is 12 lead system ECG ? - answerThe number of electrodes needed for hardwire
cardiac monitoring and telemetry is dictated by the lead system used in the clinical
setting.
Electrodes need to be securely and correctly placed on the chest wall to accurately
capture arrhythmias
What medications are use for pharmacological stress t testing? - answerVasodilating
agents such as
dipyridamole,
adenosine
Or regadenoson given as an IV
Dobutamine
used to mimic the effects of exercise by maximally dilating normal coronary arteries and
identifying stenotic arteries that cannot vasodilate. The side effects of these agents are
related to the vasodilating action and include chest pain, headache, flushing, nausea,
heart block, and dyspnea
these drugs can be reversed with IV aminophylline. Adenosine has an extremely short
half-life (less than 10 seconds), so any severe effects subside rapidly
Nursing interventions for TEE - answerinstructs the patient not to eat or drink anything
for 6 hours prior to the study
recovery period, the patient must maintain bed rest with the head of the bed elevated to
45 degrees
monitors the patient for dyspnea and assesses vital signs, SpO2, level of
consciousness, and gag reflex as recommended
sore throat may be present for the next 24 hours
5-Lead ECG (Continuous Monitoring): - answer Right arm (RA):** White electrode
below the right clavicle.
Left arm (LA):** Black electrode below the left clavicle.
Left leg (LL):** Red electrode on the left side of the abdomen.
Right leg (RL):** Green electrode on the right side of the abdomen.
Precordial (V1):** Brown electrode placed at the fourth intercostal space, just to the right
of the sternum.
Mnemonic:** "White on right, smoke (black) over fire (red), green goes to the ground
(right leg), brown is central."
What is cardiac stress test? - answer the patient walks or runs on a treadmill (most
common) or pedals a stationary bicycle.
The test is stopped when the target heart rate is achieved or if the patient experiences
signs of myocardial ischemia.
Abnormal findings include
chest pain
ventricular arrhythmia
ST-segment depression
lack of heart rate or BP elevation with exercise
12 lead ECG placement - answer-Step 1—Place limb leads (I, II, III, aVR, aVL, aVF)
Right arm (RA):** White electrode below the right clavicle.
Left arm (LA):** Black electrode below the left clavicle.
Left leg (LL):** Red electrode on the left lower chest or abdomen.
Right leg (RL):** Green electrode on the right lower chest or abdomen (ground).
Proper electrode placement is essential to avoid artifacts and ensure accurate readings
Precordial (Chest) Leads (V1-V6):**
V1 Fourth intercostal space to the right of the sternum.
v2Fourth intercostal space to the left of the sternum
v3Midway between V2 and V4.
V4 Fifth intercostal space at the midclavicular line.
V5At the anterior axillary line, horizontal to V4.
, V6 At the midaxillary line, horizontal to V4 and V5.
What is pharmacological stress test - answerPatients who are cognitively impaired and
unable to follow directions or physically disabled or deconditioned will not be able to
achieve their target heart rate by exercising on a treadmill or bicycle.
must avoid xanthine derivatives (theophylline, aminophylline, caffeine) for 24-48hrs prior
(they block the effects of the vasodilating agents.)
NPO 3 hrs b4, abstain from all caffeine 24 hrs prior. Including chocolate and caffeine
free beverages ( tea)
What is 12 lead system ECG ? - answerThe number of electrodes needed for hardwire
cardiac monitoring and telemetry is dictated by the lead system used in the clinical
setting.
Electrodes need to be securely and correctly placed on the chest wall to accurately
capture arrhythmias
What medications are use for pharmacological stress t testing? - answerVasodilating
agents such as
dipyridamole,
adenosine
Or regadenoson given as an IV
Dobutamine
used to mimic the effects of exercise by maximally dilating normal coronary arteries and
identifying stenotic arteries that cannot vasodilate. The side effects of these agents are
related to the vasodilating action and include chest pain, headache, flushing, nausea,
heart block, and dyspnea
these drugs can be reversed with IV aminophylline. Adenosine has an extremely short
half-life (less than 10 seconds), so any severe effects subside rapidly
Nursing interventions for TEE - answerinstructs the patient not to eat or drink anything
for 6 hours prior to the study
recovery period, the patient must maintain bed rest with the head of the bed elevated to
45 degrees
monitors the patient for dyspnea and assesses vital signs, SpO2, level of
consciousness, and gag reflex as recommended
sore throat may be present for the next 24 hours
