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Introduction

Describe the role of the medical assistant in cardiac procedures. 
 
Describe the role of the medical assistant in pulmonary procedures and treatments. 

Cardiovascular System Review 

The _______________________ chambers receive blood from the body and the _______________________ chambers pump blood out to the body.
 
The _______________________ divides the right and left sides of the heart.
 
Describe the location of the following valves.
Tricuspid valve
Pulmonary valve
Bicuspid or mitral valve
Aortic valve
Summarize the flow of blood and include the valves, chambers, and major arteries and veins involved. Start with the three structures that empty the blood into the right atrium. Finish the flow with the aorta.
 
Summarize the conduction system of the heart. Describe the structures in order starting with the “pace-maker of the heart.”
 
Describe the three states that the cardiac cells cycle through. Put the states in order starting with the resting state.

ECG Tracing

Complete the table below. Add the following information to the columns:
Summarized column: write the chamber and the state of the cardiac cells (e.g., atrial repolarization).
Conduction System column: describe the movement of the impulse and list the structures involved (e.g., impulse moves from the SA node and the AV node). 
Mechanical Action column: describe the contraction of chambers and the blood flow (e.g., atrial chambers contract, blood flows into the ventricles). 
 
WAVES SUMMARIZED CONDUCTION SYSTEM MECHANICAL ACTION
P wave      
PR segment      
QRS complex      
Q wave      
R wave      
S wave      
ST segment      
T wave      
U wave      
What is an interval?
Describe the PR interval and the Q-T interval.

12-Lead ECG

_______________________ electrodes and lead wires create _______________________ leads or pictures.
The following questions refer to the bipolar or standard lead.
What are names of the leads?
The bipolar leads provide pictures of the _______________________ plane of the heart.
What electrodes and lead wires are used to create the bipolar leads?
If you see an artifact on lead I, which two electrodes and lead wires should you look at?
If you see an artifact on lead II, which two electrodes and lead wires should you look at?
If you see an artifact on lead II, which two electrodes and lead wires should you look at?
If you see an artifact on leads I and III, which electrode and lead wire should you look at?
The following questions refer to augmented leads.
What are names of the leads?
The augmented leads provide pictures of the _______________________ or plane of the heart.
What electrodes and lead wires are used to create the augmented leads?
If you see an artifact on lead aVR, which electrodes and lead wires should you look at?
The following questions refer to the chest or precordial leads.
What are names of the leads?
The chest leads provide pictures of the _______________________ plane of the heart.
What electrodes and lead wires are used to create the chest leads?
If you see an artifact on lead V2, which electrode(s) and lead wire(s) should you look at?

ECG Supplies and Equipment

Describe the small and large boxes on the ECG paper.
When a provider analyzes the ECG tracing, what tool is used to measure the wave forms?
Describe how to handle and store thermal ECG paper. 
The vertical lines on an ECG tracing are used to measure the _______________________ or _______________________ of the waveform.
The horizontal lines measure the _______________________.
When the paper speed (chart speed) is set at 25 mm/second, each small box is ________ seconds and each large box equals ________ seconds.
The _______________________ on electrodes helps pick up the electrical impulses.
Describe the following ECG machine settings and address the normal default and reasons to change the default.
Chart speed
Gain or sensitivity 
Describe the appearance of the standardization mark. 

ECG Procedure 

Describe three ways the skin can be prepared for the electrodes.
Complete the table by describing where the electrode should be placed.
 
ELECTRODE PLACEMENT
Right arm (RA)  
Left arm (LA)  
Right leg (RL)  
Left Leg (LL)  
Chest V1 (V1)  
Chest V2 (V2)  
Chest V3 (V3)  
Chest V4 (V4)  
Chest V5 (V5)  
Chest V6 (V6)  
List four special situations that would require an electrode placement deviation. Also, describe the new placement.
The following questions relate to wandering baseline artifact.
Describe the appearance of the artifact.
Describe why the artifact occurs.
Describe how a medical assistant can prevent the artifact.
The following questions relate to somatic tremor artifact.
Describe the appearance of the artifact.
Describe why the artifact occurs.
Describe how a medical assistant can prevent the artifact.
The following questions relate to AC interference artifact.
Describe the appearance of the artifact.
Describe why the artifact occurs.
Describe how a medical assistant can prevent the artifact.
The following questions relate to interrupted baseline artifact.
Describe the appearance of the artifact.
Describe why the artifact occurs.
Describe how a medical assistant can prevent the artifact.
Describe the appearance of the following arrhythmias.
Premature atrial contraction (PAC)
Atrial flutter
Third-degree heart block
Premature ventricular contractions (PVCs)

Additional ECG Testing

Describe the preparations for an exercise stress test. 
Describe a Holter monitor test. 
Describe patient education required for the Holter monitor test. 
Describe the cardiac event recorder and discuss how the patient uses the recorder. 

Respiratory System

Describe the following pulmonary function tests.
Peak flow monitor
Spirometry
Arterial blood gas test
Pulse oximetry
A(n) _______________________ is a long tube that is attached to the mouthpiece of the metered-dose inhaler (MDI) and slows the delivery of medication into the lung.
Describe a nebulizer treatment.
Prior to a medical assistant applying oxygen to a patient, what must the medical assistant get from the provider?
SCIENCE
HEALTH SCIENCE
NURSING
PMA 2018

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