Identify all components of a normal ECG rhythm- a typical, or normal ECG tracing of the heartbeat consists of a P. wave, a QRS complex, a T. wave and a U. wave (visible in 50-75% of cases).
Identify basic ECG rhythms -- ECG rhythms are printed on graph paper, the smaller squares represent .04 second; 1 second 25 small squares, etc. The basic rhythms are:
(Source: ECG Tutorial, 2006).
Identify basic dysrhythmias and relevant implications and nursing interventions -- There are a number of dysrhythmias that impact the nursing field: Sinus Bradycardia -- Heart rate less than 60 beats per minute, rhythm regular, duration normal, but slower respiration, may indicate beta blockers, brain injury, hypoglycemia, or substance use; Sinus Tachycardia -- excessive heart rate above 100 beats per minute, beats are normal but at a faster rate, may indicate fright, stress, or illness; Supraventricular Tacycardia (SVT) shows narrowing of BPM, thus increased activity is being caused by other organs, not the heart; Atrial Fibrillation, rhythm irregular, rate 100-160 BPM, P wave indistinguishable and firing randomly, PR level is not measurable; and numerous others. For the nurse interpreter, the warning signs are: distance between peaks (amplitude), odd QRS shapes,...
Or T. waves, or irregularity in rhythm over time (ECG Rhythms, 2006).
REFERENCES
AHA Diagnostic ECG Electrode Placement. (n.d.) Welchallyn.com. Cited in:
http://www.welchallyn.com/documents/Cardiopulmonary/Electrocardiographs/PC-Based%20Exercise%20Stress%20ECG/poster_110807_pcexerecg.pdf
ECG Tutorial. (2006). Mauvila.com. Cited in: http://www.mauvila.com/index.htm
ECG Rhythms. (2006). Ambulance Technician Study. Cited in:
http://www.ambulancetechnicianstudy.co.uk/rhythms.html
Your Heart's Electrical System. (2009). National Heart, Lunch and Blood Institute. Cited in:
http://www.nhlbi.nih.gov/health/dci/Diseases/hhw/hhw_electrical.html
MacDonald, M. (2009). Your Body: The Missing Manual. Sebastopol, CA: Pogue Press.
Amplitude -- or height; Isoelectric is O; above isoelectric is positive, below is negative
QRS complex= the ventricles depolarizing; normal rhythm has three; R. is first above, Q below, S, after
Isoelectric line- baseline of the measurement
T wave -- everything that polarizes must depolarize
P Wave, when atria trigger; gives clues to where this electrical activity in the heart began
