Going crazy, please help! NCLEX formulas

elizabells, BSN, RN · Oct 23, 2007

I'm not sure I understand the question. I don't recall anything about using a formula for determining heart rate in NS, on the NCLEX, or in practice. So I'd say don't freak out about it, but maybe someone else knows.

JulieRN07 · Oct 23, 2007

I didn't have any of those kinds of questions on my NCLEX-or in my practice questions. You calculate a heartrate on an EKG strip using calipers-or the quick way is to count the tops of the QRS by 10's. Sorry I can't be more help!

elizabells, BSN, RN · Oct 23, 2007

count the tops of the QRS by 10's.

That was my first thought too, but I couldn't figure out if that was specific to FHR strips or neonates.

I should make the disclaimer that my NS was horrifically deficient in teaching us EKGs. We only had to learn to recognize fatal rythms.

EricJRN, MSN, RN · Oct 23, 2007

If you're referring to determining the rate on a rhythm strip, you can either use the six-second method x10 that Jules suggests, or with adults and older children you can take 300 and divide it by the # of large boxes between the R waves. The 300 method does tend to get less precise for the faster rates of peds though.

SteveNNP, MSN, NP · Oct 25, 2007

On a fetal heart rate strip, you don't count beat-to-beat, unless they have a fetal scalp electrode (which you would count beats like a regular EKG)

You would count a fetal HR by looking at the fetal monitor HR tracing line, which "draws" a horizontal line on paper that is divided vertically with numbers like 130, 145, etc. (trend of heart rate)

All fetal monitors also have a doppler probe that lets you and the machine "hear" the heartbeat, which the machine displays as a number on the screen. You just have to make sure it's not accidentally picking up mom's heartbeat.

roadmap · Oct 25, 2007

I swear I was given a study question by Kaplan that said something to the effect of "estimate fetal heart rate on this six second strip." Correct me if I am wrong but if each small square was 0.04 seconds I could count from peak to peak and divide the resultant number into 1500 to estimate the number of beats per minute?

SteveNNP, MSN, NP · Oct 26, 2007

I swear I was given a study question by Kaplan that said something to the effect of "estimate fetal heart rate on this six second strip." Correct me if I am wrong but if each small square was 0.04 seconds I could count from peak to peak and divide the resultant number into 1500 to estimate the number of beats per minute?

That's pretty simple.....

Multiply the number of beats in that 6-second strip by 10. That's your fetal HR.

roadmap · Oct 26, 2007

Yeah, except the strip they showed as an example was only the portion that showed two qrs waves. And explained that each large square was 0.2 of a second.

dawngloves, BSN, RN · Oct 27, 2007

That's strange. I didn't know how to read a rhythm strip until I took a telemetry course at work.

And I have no idea how to read a fetal monitor. I can guess, but....