EKG Interpretation
1. You are a nurse working in the Emergency Department of a hospital. You are asked to admit a patient who came in with chest pain. When you arrive to assess the patient you find them unresponsive.
a. Please analyze the rhythm (below). R-R, Regular or Irregular (.1 pt.) irregular Rate: (.1 pt.) Unmeasurable
PR interval: (.1 pt.) Not measurable QRS: (.1 pt.) none
QT: (.1 pt.) 8 sec Rhythm: (.3 pt.) highly irregular
b. What is the necessary immediate intervention? (.1 point)
The next action for this patient is to defibrillate very soonest to stop the patient from going to cardiac arrest
c. What are two typical precipitating factors that occur with this rhythm? (.1 pt.)
i. Is having an untreated ventricular tachycardia, electrocution accidents and presents of heart conditions at birth. ii. Chaotic, rapid and irregular rhythms hence causing ventricular Fibrillation
2. You are a nurse caring for a patient on a telemetry unit. The patient was admitted for hypotension and tachycardia several days ago. The patient has stabilized and needs to achieve therapeutic levels for prophylactic treatment prior to discharge.
a. Please analyze their strip (below).
Regular or Irregular (.1 pt.)Regular Rate: (.1 pt.) 101-160 bpm
PR interval: (.1 pt.) 0.12-0.20seconds QRS: (.1 pt.) 0.06—0.12 seconds
QT: (.1 pt.) 6 sec Rhythm: (.3 pt.) Regular The patient has been determined to have this dysrhythmia chronically and is
Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.
To further explain Joe’s rapid heart rate, the student may request an electrocardiogram to investigate any presenting heart arrhythmia's.
African American male that is seen today for followup post hospital discharge. He is a 48-year-old gentleman with complicated cardiac history as well as neurological history including congestive heart failure. History of strokes 01/2017, possible sick sinus syndrome. He has an implanted pacemaker that was placed in 06/2017, as well as hypertension. He was taken to the Central Hospital on 09/01 with presentation of chest pain, noted to be around his pacemaker site. He identified being in seizure and suddenly felt chest pain with shortness of breath, and was offered nitro, he developed headaches and dyspnea post nitro treatment, of note is that the EKG that was obtained during that process, did not identify any pacemaker spike despite having a
A patient who becomes unresponsive may be experiencing arrhythmia. If a patient has fainted and there is no response immediately notify the physician also provide oxygen. loosen any tight clothing, cover the patient with a blanket for warmth. Once the emergency passes,obtain a set of vital signs and document all activities in the patient's medical
EKG is an electrocardiogram, a machine used to check on problems with your electrical activity with your heart. An electrocardiogram machine translates the heart’s electrical pattern into lines that specific professionals can read it. The first EKG was made by Willem Einthoven, a Dutch Java island (now called Indonesia) born citizen. Willem was born the 21st day of May 1860. His father, Jacob Einthoven, was born and educated in Groningen (Netherlands). His father was also
The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the
A young professional hockey player collapsed during a game that had no previous symptoms or problems before the collapse. People began CPR and used an automated external defibrillator (AED) 3 times before paramedics arrived. This ultimately prevented him from dying from sudden cardiac arrest. He received an implantable cardioverter-defibrillator to correct his heart rhythms and was released without medications.
He stated that in order to ascertain heart conundrums it is essential to look at the spacing of the lines on the EKG. The thinner narrow lines on the EKG usually indicate regular heart beats, and in contrary, the thicker wider lines on the EKG generally indicate an irregular heart pulse or rhythm which is also known as arrhythmia. In addition, our second patient was suffering from shortness of breath and what she said she experienced was “fluttering” in her chest. In addition, psychological factors were in place as well, she mentioned expressing stressful feelings and anger to her husband based upon minor situational arrangements. In the past, our patient had also experienced a brain bleed also known as subdural hematoma. Dr. Katzenberg began to check her vitals, her pulse and lungs with his stethoscope and after he recommended that she takes a stress-echo test to study and get a read of her heart rate capacity. Next, our third patient is suffering from stage IV breast cancer, according to her pet/cat scan information it revealed that she had developed edema and possibly spasms of the esophagus. Due to this data, her oncologist has deduced that the cancer has metastasized (cancer-spreading) throughout her lungs resulting in her to pursue chemotherapy for 6 months to 2 years. During this transition, she has experienced much emotional distress as well as physical stress. She came in for a checkup because she was
Patient A was assigned several nurses during her three days stay at the hospital. Everything went well until the second night at the hospital room. A new nurse was
IST is a medical entity that should be diagnosed by exclusion, medical history and physical examination and should be assessed thoroughly, aiming to the potential causes of sinus tachycardia, thus, thyroid disease, medications, hypovolemia, panic attacks, anxiety and substance abuse should be ruled out. A 12-lead EKG is useful for recording tachycardia and defining sinus rhythm, which helps differentiate IST from
6- The correct use of a Defibrillator. 7- Know the recovery position and how to place a patient in it.
of heart failure leading to death. Often times, it is difficult to determine whether cardiac
In addition, scientists have found that genetics also plays a role in cardiac arrhythmias and that in some cases patients have commented that they had no symptoms before they succumbed to some form of episode of cardiac distress, like a sudden heart attack. This has proven to be standard for many different forms of arrhythmias, whether it’s due to genetics or not. One such case is the long QT syndrome (LQTS) which is estimated to affect one in every 5000 people and is recognized as a family disorder, frequent in children during their childhood years (Wilde, and Bezzina 1352–1358.) Patients with this disorder can have symptoms of a fluttering heartbeat, shortness of breath, and chest pain, while other patients might not experience any symptoms at all (Wilde, and Bezzina 1352–1358.) Another known disorder is cardiac conduction disease, which is mostly due to some form of cardiac injury (Wilde, and Bezzina 1352–1358.) Symptoms for this
Joanna is an experienced nurse taking care of Mrs. Kelly, who was Joanna’s patient many times in the past for her primary problem which is COPD. This time Mrs. Kelly was admitted with complaints of abdominal pain what was different from her primary diagnoses. Her vital signs were with normal limits and no significant changes from privies results, but for the nurse she looks sick, and Joanna know that something is wrong. She calls the resident doctor, but he tell her to watches and calls back with series changes. Joanna multiple attempts to report that something needs to be done to evaluate the cause of Mrs. Kelly pain was ask to calm down. However nobody took patient symptoms series and the next day patient died.
Recording an electrocardiogram or ECG, is a procedure which is performed daily all over the United Kingdom by thousands of healthcare workers and in particular nurses (Jacobson, 2000). The way in which this procedure is performed varies from geographical location to location and occasionally even more so, between staff on the same ward (Amos, 2000). This reason stated by Amos (2000), formed the basis of my decision to choose this topic.