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					ELECTROCARDIOGRAM

SKILLS LAB
DEFINITION:
Records the electrical
activity generated in the
heart during the cardiac
cycle.
RATIONALE:
1. To provide grounds for the diagnosis of cardiac
   arrhythmias, arteriosclerotic heart disease, cardiac
   enlargement, electrolyte abnormalities, and myocardial
   infarction.
2. To assess the status of a client in a life threatening
   situation as a basis for medical or nursing action.
3. To provide a visual image of the heart’s rhythm.
EQUIPMENT:
1. ECG Machine – machine capable of transcribing to
   graph paper the electrical activity of the heart.
2. Electrodes – placed at strategic positions on the
   extremities and chest precordium and is capable of
   conducting electrical activity from the heart to the
   ECG machine.
3. KY jelly / electrode paste or alcohol swabs – ensures
   good contact between the clients skin and the
   electrode.
4. ECG paper – a graph paper with horizontal & vertical
                axes.
     PLANNING & IMPLEMENTATION:
1. Elicit and record the clients :
♥ age
♥ Sex
♥ Height
♥ Weight
♥ blood pressure
♥ symptoms and medications
♥ unusual position of the client during examination
♥               presence of thoracic deformities, amputation,
                respiratory distress, or muscle tremors.
                  * Facilitates interpretation of the EKG/ECG
2.Ask the client if he or she has ever had
  an EKG before. Explain the procedure
  will take only 10 to 15 minutes and is
  painless.
* Simple explanation reduces the client’s
  anxiety. If the client has had an ECG,
  the old ECG should be obtained for
  comparison.
3. Assist the client to assume a
supine position.
*   Facilitates good recording.
4. Close the door and bedside
curtains.
* Provide privacy for the client
5.   Secure electrodes on the flat inner aspects
     of the clients wrists and ankles with
     extremity straps adjusted to hold the
     electrodes firmly in place.
     Use electrode paste/alcohol swabs/KY jelly
     between the electrodes and the clients skin.
* If the straps are places too tightly, circulation
  to the extremity could be compromised.
  Electrode paste or alcohol swabs ensures
  good contact between the clients skin and
  the electrode.
6. Attach the chest leads.
       V1 – at the 4th ICS at the right sternal border               (RED)
       V2 – at the 4th ICS at the left sternal border                (YELLOW)
       V3 – at the midpoint between V1 and V4                        (GREEN)
       V4 – at the 5th ICS at the midclavicular line                 (BROWN)
       V5 – at the level of V4, at the left anterior axillary line   (BLACK)
       V6 – at the level of V4, at the left midaxillary line.        (VIOLET)



* The recording will vary according to the placement of
      the leads.
Frontal and Horizontal Plane Lead Diagram
7. Turn on the lead selection switch to record all 12
   leads.
     * Promotes the client’s comfort.
8. Removes the leads and any paste that may be
   remaining.
     * Communicates to the other members of the
     health care team and contributes to the legal
     record by documenting the care given to the
     client.
9.        Place the ECG results on the chart and note
                 the time and condition of the client.

				
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posted:8/21/2012
language:English
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