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Ateneo de Zamboanga University College of Nursing

NURSING SKILLS OUTPUT (NSO) Report No. 10 Electrocardiogram

ESCRIPTION! An electrocardiogram (ECG or EKG is one o! t"e simplest and !astest proced#res #sed to eval#ate t"e "eart. Electrodes (small$ plastic patc"es are placed at certain locations on t"e c"est$ arms$ and legs. %"en t"e electrodes are connected to an ECG mac"ine by lead &ires$ t"e electrical activity o! t"e "eart is meas#red$ interpreted$ and printed o#t !or t"e doctor's in!ormation and !#rt"er interpretation. (t records t"e electrical activity o! t"e "eart. )"e "eart prod#ces tiny electrical imp#lses &"ic" spread t"ro#g" t"e "eart m#scle to ma*e t"e "eart contract. )"ese imp#lses can be detected by t"e ECG mac"ine. +o# may "ave an ECG to "elp !ind t"e ca#se o! symptoms s#c" as palpitations or c"est pain. ,ometimes it is done as part o! ro#tine tests - !or e.ample$ be!ore yo# "ave an operation.

"#TERI#LS$E%UIP"ENTS NEE E !

,ensors Electrocardiograp" 6i1#id gel )iss#e Electrodes

PROCE URE! 1. E.plain t"e proced#re to t"e client. /. 0osition t"e patient in a s#pine position com!ortably &it" ade1#ate s#pports. 2. 3ave t"e patient remove clot"ing above t"e &aist and place in a clot" go&n opening to t"e bac* i! desired 4. 5a*e t"e patient com!ortable lying do&n on t"e e.am table. E.pose t"e arms and legs.

7. Using an appropriate s*in prep$ abraid t"e s*in lig"tly at eac" electrode site prior to electrode placement.

8. 0lace t"e sensors on a smoot" !les"y area o! t"e #pper arms and lo&er legs. Attac" t"e limb leads. 9. 0lace t"e 8 C"est sensors on t"e patient:s c"est as !ollo&s; <1 =o#rt" intercostal space at rig"t border o! t"e stern#m </ =o#rt" intercostal space at le!t border o! t"e stern#m <2 5id&ay bet&een position </ and position <4 <4 At t"e mid-clavic#lar line in t"e !i!t" intercostal space <7 At t"e anterior a.illary line on t"e same "ori>ontal level as <4 <8 At t"e mid-a.illary line on t"e same "ori>ontal level as <4 and <7 Attac" t"e c"est leads ?. 0ress on to s&itc" #nit on. %ait 10 seconds !or #nit to stabili>e. @. 0ress AU)A to record and print. 0ress 5AN 0R(N) to record a man#al R"yt"m ,trip !or 20 seconds. 0ress stop to stop t"e printo#t. 0ress stop again to transport t"e paper to t"e start position. Bisconnect and "ave patient dress i! no concerns.

iagram$ Illustration

NURSING RESPONSI&ILITIES

'() &E)ORE PROCE URE

+o#r doctor or t"e tec"nician &ill e.plain t"e proced#re to yo# and o!!er yo# t"e opport#nity to as* any 1#estions t"at yo# mig"t "ave abo#t t"e proced#re. Generally$ !asting is not re1#ired be!ore t"e test. Noti!y yo#r doctor o! all medications (prescribed and over-t"e-co#nter and "erbal s#pplements t"at yo# are ta*ing. Noti!y yo#r doctor i! yo# "ave a pacema*er. Cased on yo#r medical condition$ yo#r doctor may re1#est ot"er speci!ic preparation.

*()

URING T+E PROCE URE

+o# &ill be as*ed to remove any De&elry or ot"er obDects t"at may inter!ere &it" t"e proced#re. +o# &ill be as*ed to remove clot"ing !rom t"e &aist #p. )"e tec"nician &ill ens#re yo#r privacy by covering yo# &it" a s"eet or go&n and e.posing only t"e necessary s*in. +o# &ill lie !lat on a table or bed !or t"e proced#re. (t &ill be important !or yo# to lie still and not tal* d#ring t"e proced#re$ so as not to inter!ere &it" t"e tracing. (! yo#r c"est$ arms$ or legs are very "airy$ t"e tec"nician may s"ave or clip small patc"es o! "air$ as needed$ so t"at t"e electrodes &ill stic* closely to t"e s*in. Electrodes &ill be attac"ed to yo#r c"est$ arms$ and legs. )"e lead &ires &ill be attac"ed to t"e s*in electrodes.

Ance t"e leads are attac"ed$ t"e tec"nician may *ey in identi!ying in!ormation abo#t yo# into t"e mac"ine's comp#ter. )"e ECG &ill be started. (t &ill ta*e only a s"ort time !or t"e tracing to be completed. Ance t"e tracing is completed$ t"e tec"nician &ill disconnect t"e leads and remove t"e s*in electrodes. ,() #)TER T+E PROCE URE +o# s"o#ld be able to res#me yo#r normal diet and activities$ #nless yo#r doctor instr#cts yo# di!!erently. Generally$ t"ere is no special care !ollo&ing an ECG. Noti!y yo#r doctor i! yo# develop any signs or symptoms yo# "ad prior to t"e test (!or e.ample$ c"est pain$ s"ortness o! breat"$ di>>iness$ or !ainting . +o#r doctor may give yo# additional or alternate instr#ctions a!ter t"e proced#re$ depending on yo#r partic#lar sit#ation.

References! "ttp;EE&&&."op*insmedicine.orgE"ealt"libraryEtestFproced#resEcardiovasc#larEelectr ocardiogramF@/$009@90E "ttp;EE&&&.c"ildrens"ospital.orgEa>E,ite4@4Emainpage,4@401."tml "ttp;EEs"s-man#al.#csc.ed#EpolicyEelectrocardiogram-proced#re "ttp;EE&&&.patient.co.#*E"ealt"Eelectrocardiogram-ecg

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