Totally freaking out about EKG and cardic II test

Daytonite, BSN, RN · Oct 7, 2007

i don't know that there are any tricks. i worked on a stepdown unit for over 5 years and we had to read telemetry. in order to understand what is going on with abnormal egk rhythms you have to know the underlying pathophysiology of what is going on in the heart. so, you have to know the normal heart, blood flow and electrical pathway. from there everything that occurs is a result of what goes abnormal. each abnormal occurrence (pathophysiology) produces a sign/symptom. in the case of the heart it could be an arrhythmia, it could be the muscle of the heart going kaputz resulting in pump failure. the heart breaks down from the top toward the bottom. the arrhythmias go the same way. the first arrhythmias to appear in people are often in the atrium, usually involving the sa node, then the av node, junctional tissue, purkinje fibers, etc. in other words, you see arrhythmias start first in the atrium and progress toward the ventricles. i saw this time and again in our regular customers as their heart disease progressed. and, now, myself as i was diagnosed with sick sinus syndrome, an atrial problem, and had to have a pacemaker inserted in august. know the progression of heart failure as it also proceeds in steps and over time. i found a much easier explanation of preload and afterload, in of all places, a pharmacology book. the cleveland clinic is a premier heart care center and has a lot of patient teaching information about the heart on their website. you need to get into the heart center part of their website and then use the search box to search for specific information.

deeDawntee, RN · Oct 7, 2007

http://www.skillstat.com/ECG_Sim_demo.html

Hi,

Try to calm down...it will be OK. Here is a website that will give you some practice in a game-like format to get some practice in on identifying EKG's.

What are the rhythms in particular that you are having trouble with? Are you also needing to know interventions?

MistiroseRN · Oct 7, 2007

thank you for posting dee. I saved it to my favorites.

marilynmom, LPN, NP · Oct 8, 2007

Learning to read ECG's just takes time and reading many strips I think.

I agree with the above posts, you need to really understand the electrical activity of the heart and how that works, where it flows, etc. I know a lot of people don't really study that and go right for the strips.

I spent a lot of time at work (I work in an ICU) having the RNs and the monitor tech going over real life strips for me, and that really helped so if you have time at clinicals or work, it's nice to have an RN or monitor tech (or whatever they might be called) go over some with you.

Just keep practicing...the more you see ECG strips and "work" them the better at it you will get :)

DaFreak71 · Oct 8, 2007

When I got to that unit in school, my eyes just sort of glazed over and I felt a trickle of blood coming out of my ears.

They know it's hard to learn all the strips, so they are probably going to throw you the easy ones (bradycardia, tachycardia, maybe a-fib or a-flutter. Just focus on those and you'll at least have a fighting chance. Learn some funny ways to remember the patters, such as V-tack when sharks attack (cuz it looks like shark fins; all pointy and fast), etc.

And this is coming from someone who knows the patho of the heart, it was still a challenge. When it comes to blocks, just skip it and learn it on the job.

Side note--when I was doing my telemetry rotation, I got wicked motion sickness. Take it from me, don't stare at the lines constantly. I'd have died (well ok, vomited) if not for some zofran.

Daytonite, BSN, RN · Oct 8, 2007

http://www.intelihealth.com/IH/ihtIH/WSIHW000/8059/29694/317250.html?d=dmtContent

kukukajoo, LPN · Oct 8, 2007

Thanks- we have a pulmonary and cardiac combined test on Weds with 103 questions. 3 are on Ecg's and 3 on Acid Base.

DaFreak71 · Oct 9, 2007

Thanks- we have a pulmonary and cardiac combined test on Weds with 103 questions. 3 are on Ecg's and 3 on Acid Base.

Don't even sweat the strips. Know the basic ones and the patho behind them. Three questions out of 103 means that even if you bomb the EKG strips, it certainly isn't going to hurt your test scores. You'll lose about 3.1 points off the test for missing just those questions. Still leaves you with 99.9. Not too shabby, 'eh? Bomb all the EKG questions AND acid base questions, that still leaves you with a 96.8.

My advice is to NOT spend more than a respectable amount of time with these questions. Learn the absolute basics and then move on to the rest of the test content. Make a note for yourself that when you have time you'll go back and review/learn about them.

Chill and good luck on that test. I sure wish we were able to make a 103 on a test, lol. Nice padding factored in there.

kukukajoo, LPN · Oct 9, 2007

Oh no- not padding- EVER in my school! I could only dream of extra credit!!!

It is 103/103 so 102/103 would be a 99 still. each Q is worth just a tad over 1 point is all.

I spent a ton of time trying to understand this stuff before I found out it was only 6 Qs but hopefully it will pay off. Still a bit confused but thinking that the 3 on ECG will be brady sinus, brady tachy, and normal sinus...... Hoping anyhow! And today was a clinical day ICU and one of the nurses was really helpful in explaining the Acid/Base stuff and by golly I think I have it! He (the nurse) really spent a lot of time and we went over tons of scenarios.

DaFreak71 · Oct 11, 2007

Oh no- not padding- EVER in my school! I could only dream of extra credit!!!
It is 103/103 so 102/103 would be a 99 still. each Q is worth just a tad over 1 point is all.
I spent a ton of time trying to understand this stuff before I found out it was only 6 Qs but hopefully it will pay off. Still a bit confused but thinking that the 3 on ECG will be brady sinus, brady tachy, and normal sinus...... Hoping anyhow! And today was a clinical day ICU and one of the nurses was really helpful in explaining the Acid/Base stuff and by golly I think I have it! He (the nurse) really spent a lot of time and we went over tons of scenarios.

Excellent! Let us know how you did when you get the results back!