Heart Conduction

What area of the heart is responsible for delay of conduction between the atrium and ventricles? A. AV Node B. Right bundle branches C. Bachmann's bundle D. Bundle of his

A. AV Node

What part of the heart delivers richly, oxygenated blood to the body?

Aorta

Name the medication class and examples of class II anti-dysrhythmias used to decrease heart rate and conduction velocity:

Beta blockers-Sotalol hydrochloride, Esmolol hydrochloride and Propranolol hydrochloride. Beta blockers decrease heart rate and conduction.

What medication should be held for 48 hours prior to cardioversion?

Digoxin

What drug is used to slow ventricular conduction? (Anti-dysrhythmic)

Diltazem

The PR Segment is the:

Electrical impulse traveling through the AV Node.

When preparing a patient for an ECG, what interventions should the nurse perform to ensure the best signal transmission?

The patient should have clean and dry skin, avoid areas with scar tissue, clip hair in the area being used. (The gel on the electrodes should be moist and lotions on the area should be avoided prior to ECG)

Where is the SA Node located?

The right atrium

T/F Bachmann's bundle is located in the left atrium

True

T/F Depolarization of the heart muscle is when the muscle contracts and repolarization is when the heart muscle rests

True

T/F the bicuspid valve is located on the left side of the heart

True

The QRS complex represents:

Ventricular depolarization

List the 6 pathways steps of blood flow through the heart on the LEFT SIDE (Think of your drawing)

1. Pulmonary vein 2. Left atrium 3. Bicuspid valve 4. Left ventricle 5. Aortic valve 6. Aorta ...which then goes to the rest of the body

List the 6 pathway steps of blood flow through the heart on the RIGHT SIDE (Think of your drawing)

1. Superior/Inferior Vena Cava 2. Right atrium 3. Tricuspid valve (Try before you buy) 4. Right ventricle 5. Pulmonic valve 6. Pulmonary artery ....which then goes to the lungs

How many large blocks represent a 6 second strip?

30

What rate does the SA Node fire at?

60-100 BPM

The nurse is caring for a patient two hours post-op. The patient appears confused and has the following vital signs: BP 88/40, HR 125, O2 94%, RR 24. The nurse analyzes the cardiac rhythm and determines the patient is in sinus tachycardia. What action should the nurse take FIRST and why? A. Call for assistance B. Administer Digoxin IV C. Decrease the IV fluids D. Initiate the Valsalva Maneuver

A. Call for assistance because a patient with tachycardia and hypotension should not be left alone. You would need an order for Digoxin and to decrease IV fluids, and a nurse should not initiate the Valsalva Maneuver.

The nurse is caring for a patient who was admitted with chest pain. while performing a cardiac assessment, the nurse determines that the patient's apical pulse is 90 and the radial pulse is 75. What action by the nurse is priority? A. Contact the health care provider B. Document the findings in the chart C. Assess the patient's BP D. Administer PRN nitroglycerin sublingual

A. Contact the health care provider This patient is demonstrating a pulse deficit which indicates decreased peripheral perfusion. The BP should be checked but the deficit shows that there is something going on with the patient so the provider should be contacted, as it is more important.

What part of the heart delivers un-oxygenated blood to the lungs? A. Pulmonary artery B. Pulmonary vein C. Aorta D. Left ventricle

A. Pulmonary artery

What part of the cardiac conduction system is responsible for ventricular depolarization? A. Purkinje fibers B. SA Node C. Transitional cell node D. AV node

A. Purkinje fibers Purkinje fibers are responsible for the rapid conduction of electrical impulses throughout the ventricles, which leads to ventricular depolarization.

What part of the heart's conduction system is known as the "gate keeper?"

AV Node

What area of the heart forms the PR Segment on an EKG?

AV Node and right & left bundles

When might you see an inverted T Wave?

After myocardial damage.

An atrial kick results in:

An increased cardiac output

It is important to always assess and treat the _______________, not the _____________.

Assess and treat the patient, not the monitor.

What is the nurse's first action upon looking at the monitor and noticing ventricular tachycardia?

Assess the patient. Always go and lay eyes on the patient. It can be something as small as to fix their electrodes.

The P Wave represents:

Atrial depolarization (contraction)

What areas of the heart's electrical conduction is known as the "pacemaker" of the heart? A. Bundle of his B. SA Node C. Purkinje fibers D. AV Node

B. SA Node

The nurse is caring for a patient who just had a 12-lead ECG. The nurse notices that the ECG is different from the previous ECG reading in most leads. Which action should the nurse take FIRST? A. Contact the health care provider B. Perform a full head-to-toe assessment C. Check the electrode placement on the patient D. Ask the UAP personnel to repeat the ECG

C. Check the electrode placement on the patient. Correct placement is crucial to accurate results. If a nurse is comparing readings, they should be very similar.

What area of the heart forms the QRS Complex on an EKG? A. Left and right bundles B. AV Node C. Purkinje fibers D. SA Node

C. Purkinje fibers

On a 12-lead ECG, which lead acts as a ground electrode? A. Chest lead B. Positive lead C. Right leg lead D. Precordial lead

C. Right leg lead

What specialized function of myocardial cells gives them a pacing function? A. Excitability B. Contractility C. Conductivity D. Automaticity

D. Automaticity This is the pacing function and the ability of the myocardial cells to generate an impulse.

Which property of the heart is considered it's mechanical activity? A. Excitability B. Conductivity C. Automaticity D. Contractility

D. Contractility This is the ability of the myocardial cells of atria and ventricles to shorten there fiber length in response to electrical stimulation.

The nurse is caring for a patient diagnosed with super ventricular tachycardia (SVT) with a non sustained ventricular response. Which symptom does the nurse anticipate the patient to report? A.Syncope B. Weakness C. SOA D. Occasional palpitations

D. Occasional Palpitations Patients with non sustained or slower ventricular response may have occasional palpitations or be asymptomatic.

What is the nurse's priority action when she notices a U Wave on an ECG? A. Check the patient's lead placement B. Prepare to administer magnesium sulfate C. Document the findings in the patient's chart D. Request that a stat potassium value is obtained.

D. Request a stat potassium level. U Waves (If seen) indicates hypokalemia. If a U Wave is seen, contact the health care provider to request that a stat potassium level is obtained.

What area of the cardiac conduction system is responsible for generating the electrical impulse in the heart? A. AV Node B. Bundle of his C. Purkinje fibers D. The sinus node

D. The sinus node The sinus node is the same thing as the SA node.

Which medication is prescribed to a patient who is at high risk of emboli?

Enoxaparin Emboli are blood clots. A-fib may increase the risk of emoji in a patient, therefor the patient is prescribed anticoagulant therapy to prevent embolus formation.

T/F The atriums are located below the ventricles

False

T/F Pulmonary veins take un-oxygenated blood away from the heart

False The pulmonary artery takes un-oxygenated blood away from the heart to the lungs to become oxygenated and then back through the pulmonary vein.

On an ECG, what waves are included in repolarization?

J Point, ST Segment, T and U Waves.

Repolarization is the __________________ event of the cycle. It is known as the restoring or resting state.

Last event

What are some problems that can potentially cause an abnormal T Wave?

MI, ventricular hypertrophy

The nurse is caring for a patient undergoing synchronized cardioversion. What interventions would the nurse do after the cardioversion?

Maintain a patent airway, monitor for dysrhythmias and assess the chest for burns from the electrodes.

What is an important electrolyte to monitor in your cardiac patients?

Potassium; Even small variances above or below the normal level can cause problems with the cardiac muscle conduction which causes dysrhythmias.

What part of the heart delivers oxygenated blood to the heart?

Pulmonary vein

The blood enters the left side of the heart through the __________________ and enters the left atrium. It then passes through the ___________________ to enter the left ventricle.

Pulmonary vein, bicuspid valve

On the right side of the heart, blood flows from the right ventricle to the?

Pulmonic valve, pulmonary artery

What are the normal heart sounds?

S1 and S2 S1=Lub & S2=Dub S3, S4 & murmurs are extra heart sounds which is abnormal.

On an EKG, the P Wave represents what area of the heart?

SA Node

What is the sequence for blood flow in the heart? (Think 12 steps)

SVC/IVC, right atrium, tricuspid valve, right ventricle, pulmonic valve, pulmonary artery, lungs, pulmonary veins, left atrium, bicuspid valve, left ventricle, aortic valve, aorta.

What is a leading cause of Premature Ventricular Contractions and what kind of education would you do for a patient experiencing PVC's?

Stress is a leading cause. Stress management is the education focus.

What components of a patient's ECG should be further evaluated if an MI is suspected?

T Wave and ST Segment. An abnormal T Wave and a prolonged ST Segment can indicate a myocardial infarction.

Tachycardia may be the result of a ____________ and may cause a decrease in __________________ and _______________.

Tachycardia may be the result of a fever and may cause a decrease in CO (cardiac output) and hypotension.

What is the function of T Cells in the atrioventricular junction area?

The T cells cause a delay in the conduction of impulses to the AV node.

The QT Interval represents:

The total time required for ventricular depolarization and repolarization.

What is the goal of the left side of the heart?

To get blood to the rest of the body that just LEFT the lungs.

What is the goal of the right side of the heart?

To take the unoxygenated blood RIGHT back to the lungs to get oxygenated.

What cardiac dysrhythmia results from a prolonged QT Interval?

Torsades de pointe

The T Wave represents:

Ventricular repolarization