NPCC RN 4S T1 Telemetry question n answers graded A+ 2023/2024

NPCC RN 4S T1 TelemetryECG or EKG A record of the electrical activity of the heart, consisting of waves called P,Q,R,S,T and sometimes U 12 Lead 10 electrodes (6 on the chest, 4 on the limbs) Limb electrodes away from bony prominances If you must place limb leads on trunk note on the strip because the readings will be skewed.The chest electrodes provide the V (Vector) or precordial lead views: V1 through V6. • V1- 4th intercostal space, R of sternum • V2- 4th intercostal space, L of sternum • V3- 5th intercostal space, halfway between V2 and V4. • V4- 5th intercostal space, Left midclavicular line. • V5- 5th intercostal space, L anterior axillary line. • V6- 5th intercostal space, L midaxillary line. 5 Lead * Continuous bedside monitor (ICU) *Telemetry- small box worn by patient transmits info to centrally located monitor station *Holter moniror- lightweight monitor worn by the patient at home setting. When pt feels pain push a button to mark time on strip. RA: 2nd intercostal space right side midclavicular-white lead LA 2nd intercostal space left side midclavicular- black lead RL: 8th intercostal space midclavicular right side-green lead LL: 8th intercostal space midclavicular left side-red lead Chest: 4th intercostal space right side of sternum-brown lead Lead Selection * V1 is the best lead to view ventricular activity and diggerentiate between right and left bundlw branch blocks. * Only 12 Lead and 5 Lead have V1 view 3 Lead Most common but not the optimal monitoring option EASI Lead EASI is a method of continuous electrocardiogram (ECG) monitoring that is an alternative to both the commonly used 5-electrode lead bedside monitoring system and the traditional 10-electrode Mason-Likar 12-lead ECG system. The EASI lead configuration enables continuous 12 lead ECG ambulatory monitoring using only 5 electrodes. The EASI 12-lead ECG is derived from a set of 5 leads; 4 recording electrodes and one grounding electrode. The placement of these leads is as follows [4]. E: Lower extreme of the sternum A: Left mid-axillary line, same transverse line as E S: Sternal manubrium I: Right mid-axillary line, same transverse line as E G: Fifth electrode is the ground and can be placed anywhere on the torso Trouble Shooting and Tips Change the electrodes everyday if loose. Make sure all electrical patient care equipment is grounded. Be sure all the lead cables are intact. Some manufacturers require changing the cables periodically. Be sure the patient's skin is clean and dry. Make sure the leads are connected tightly to the electrodes. Patient movement frequently causes interference. For example, the action of brushing teeth may cause interference that mimics V-Tach. Change the electrodes everyday if loose. Make sure all electrical patient care equipment is grounded. Be sure all the lead cables are intact. Some manufacturers require changing the cables periodically. Be sure the patient's skin is clean and dry. Make sure the leads are connected tightly to the electrodes. Patient movement frequently causes interference. For example, the action of brushing teeth may cause interference that mimics V-Tach. Change the electrodes everyday if loose. Make sure all electrical patient care equipment is grounded. Be sure all the lead cables are intact. Some manufacturers require changing the cables periodically. Be sure the patient's skin is clean and dry. Make sure the leads are connected tightly to the electrodes. Patient movement frequently causes interference. For example, the action of brushing teeth may cause interference that mimics V-Tach. Telemetry Strip An ECG complex represents the electrical events occurring in one cardiac cycle. A complex consists of 5 waveforms labeled with the letters P,Q,R,S, and T, and sometimes a U wave. The middle 3 letters, QRS are referred to as a unit, the QRS complex. P wave represents atrial depolarization QRS represents ventricular depolarization