NUR 431L FINAL EXAM (ELECTRICAL)
QUESTIONS AND ANSWERS
1. Senses the patient's own rhythm using a sensing circuit (sensing)
2. Sends out electrical signals using an output circuit (capturing) - Answer-The
pacemaker has 2 key functions:
•ECG is a graphic tracing of the electrical impulses produced in the heart.
•waveforms= electrical activity
•One or more ECG leads can be used to continuously monitor a patient.
•The most common leads selected are leads II and V1 - Answer-ECG:
*Place electrodes on chest (all electrodes with tabs facing down).
•V1 - 4th intercostal space, right sternal border
•V2- 4th intercostal space, left sternal border
•V3- midway between V2 and V4
•V4- 5th intercostal space, left midclavicular line
•V5- 5th intercostal space, left anterior axillary line
•V6- 5th intercostal space, left midaxillary line - Answer-Correct placement for 12 lead
ECG:
Telemetry - Answer--observation of a patient's HR and rhythm at a site distant from the
patient
-can help rapidly identify dysrhythmias, ischemia, or infarction
•Treatment of choice to end VF and pulseless VT.
•Rapid defibrillation (within 2 minutes) is critical to a successful patient outcome.
•goal is that the following repolarization of heart cells will allow the SA node to
•resume the role of pacemaker. - Answer-Defibrillation
•TOC with VT w/ a pulse of SVT (aflutter, RVR)
•Synchronizer switch must be turned on
•Same procedure as defib except patient is sedated before
•Narrow Regular (SVT): 50-100J
•Narrow Irregular (Afib): 120-200J biphasic or 200J monophasic
•Wide Regular (Vtach): 100J
•Wide Irregular (Polymorphic Vtach/Torsades): Defibrillation dose (not synchronized) -
Answer-Synchronized cardioversion
•Used to provide adequate HR & rhythm in an emergency
•Noninvasive, temporary until transvenous pacemaker is inserted or other therapy
•Tell patient is will be uncomfortable, tell them what to expect, provide proper analgesics
•Hemodynamically unstable bradycardia if atropine ineffective
•Do not delay if rapid deterioration or IV unavailable
QUESTIONS AND ANSWERS
1. Senses the patient's own rhythm using a sensing circuit (sensing)
2. Sends out electrical signals using an output circuit (capturing) - Answer-The
pacemaker has 2 key functions:
•ECG is a graphic tracing of the electrical impulses produced in the heart.
•waveforms= electrical activity
•One or more ECG leads can be used to continuously monitor a patient.
•The most common leads selected are leads II and V1 - Answer-ECG:
*Place electrodes on chest (all electrodes with tabs facing down).
•V1 - 4th intercostal space, right sternal border
•V2- 4th intercostal space, left sternal border
•V3- midway between V2 and V4
•V4- 5th intercostal space, left midclavicular line
•V5- 5th intercostal space, left anterior axillary line
•V6- 5th intercostal space, left midaxillary line - Answer-Correct placement for 12 lead
ECG:
Telemetry - Answer--observation of a patient's HR and rhythm at a site distant from the
patient
-can help rapidly identify dysrhythmias, ischemia, or infarction
•Treatment of choice to end VF and pulseless VT.
•Rapid defibrillation (within 2 minutes) is critical to a successful patient outcome.
•goal is that the following repolarization of heart cells will allow the SA node to
•resume the role of pacemaker. - Answer-Defibrillation
•TOC with VT w/ a pulse of SVT (aflutter, RVR)
•Synchronizer switch must be turned on
•Same procedure as defib except patient is sedated before
•Narrow Regular (SVT): 50-100J
•Narrow Irregular (Afib): 120-200J biphasic or 200J monophasic
•Wide Regular (Vtach): 100J
•Wide Irregular (Polymorphic Vtach/Torsades): Defibrillation dose (not synchronized) -
Answer-Synchronized cardioversion
•Used to provide adequate HR & rhythm in an emergency
•Noninvasive, temporary until transvenous pacemaker is inserted or other therapy
•Tell patient is will be uncomfortable, tell them what to expect, provide proper analgesics
•Hemodynamically unstable bradycardia if atropine ineffective
•Do not delay if rapid deterioration or IV unavailable
