ECG Interpretation Incredibly Easy

386 Pages·2011·10.26 MB·English

EECCGG__FFMM..iinndddd ii 77//88//22001100 1122::4488::1166 PPMM
EECCGG__FFMM..iinndddd iiii 77//88//22001100 1122::4488::2200 PPMM
EECCGG__FFMM..iinndddd iiiiii 77//88//22001100 1122::4488::2200 PPMM
Staff The clinical treatments described and recommended
in this publication are based on research and consulta-
tion with nursing, medical, and legal authorities. To the
Publisher best of our knowledge, these procedures reflect cur-
Chris Burghardt rently accepted practice. Nevertheless, they can’t be
considered absolute and universal recommendations.
Clinical Director
For individual applications, all recommendations must
Joan M. Robinson, RN, MSN be considered in light of the patient’s clinical condition
and, before administration of new or infrequently used
Clinical Project Manager
drugs, in light of the latest package-insert information.
Jennifer Meyering, RN, BSN, MS The authors and publisher disclaim any responsibility
Product Director for any adverse effects resulting from the suggested
procedures, from any undetected errors, or from the
David Moreau
reader’s misunderstanding of the text.
Product Manager
Jennifer K. Forestieri © 2011 by Lippincott Williams & Wilkins. All rights
reserved. This book is protected by copyright. No part
Editor of it may be reproduced, stored in a retrieval system, or
Tracy S. Diehl transmitted, in any form or by any means—electronic,
mechanical, photocopy, recording, or otherwise—
Art Director
without prior written permission of the publisher, except
Elaine Kasmer for brief quotations embodied in critical articles and
reviews and testing and evaluation materials provided by
Illustrator
publisher to instructors whose schools have adopted its
Bot Roda
accompanying textbook. Printed in China. For informa-
Design Assistant tion, write Lippincott Williams & Wilkins, 323 Norristown
Road, Suite 200, Ambler, PA 19002-2756.
Kate Zulak
Vendor Manager ECGIE5E11010
Beth Martz
Associate Manufacturing Manager Library of Congress Cataloging-in- Publication Data
Beth J. Welsh ECG interpretation made incredibly easy!. —
5th ed.
Editorial Assistants
p. ; cm.
Karen J. Kirk, Jeri O’Shea, Linda K. Ruhf Includes bibliographical references and index.
ISBN 978-1-60831-289-4 (pbk. : alk. paper)
1. Electrocardiography. 2. Heart—Diseases—
Nursing. I. Lippincott Williams & Wilkins.
[DNLM: 1. Electrocardiography—Nurses’
Instruction. 2. Arrhythmias, Cardiac— Nurses’
Instruction. WG 140 E172 2011]
RC683.5.E5E256 2011
616.1’207547—dc22
ISBN-13: 978-1-60831-289-4 (alk. paper)
ISBN-10: 1-60831-289-5 (alk. paper) 2010022956
iv
EECCGG__FFMM..iinndddd iivv 77//88//22001100 1122::4488::2244 PPMM
Contents
Contributors and consultants vi
Not another boring foreword vii
Part I ECG fundamentals
1 Cardiac anatomy and physiology 3
2 Obtaining a rhythm strip 23
3 Interpreting a rhythm strip 43
Part II Recognizing arrhythmias
4 Sinus node arrhythmias 63
5 Atrial arrhythmias 87
6 Junctional arrhythmias 111
7 Ventricular arrhythmias 127
8 Atrioventricular blocks 153
Part III Treating arrhythmias
9 Nonpharmacologic treatments 175
10 Pharmacologic treatments 205
Part IV The 12-lead ECG
11 Obtaining a 12-lead ECG 239
12 Interpreting a 12-lead ECG 255
Appendices and index
Practice makes perfect 286
ACLS algorithms 304
Brushing up on interpretation skills 310
Look-alike ECG challenge 348
Quick guide to arrhythmias 359
Glossary 364
Selected references 366
Index 367
v
EECCGG__FFMM..iinndddd vv 77//88//22001100 1122::4488::2244 PPMM
Contributors and consultants
Diane M. Allen, RN, MSN, ANP, BC, CLS Karen Knight-Frank, RN, MS, CNS, CCRN, CCNS
Nurse Practitioner Clinical Nurse Specialist, Critical Care
Womack Army Medical Center San Joaquin General Hospital
Fort Bragg, N.C. French Camp, Calif.
Nancy Bekken, RN, MS, CCRN Marcella Ann Mikalaitis, RN, MSN, CCRN
Nurse Educator, Adult Critical Care Staff Nurse, Cardiovascular Intensive Care
Spectrum Health Unit (CVICU)
Grand Rapids, Mich. Doylestown (Pa.) Hospital
Karen Crisfulla, RN, CNS, MSN, CCRN Cheryl Rader, RN, BSN, CCRN-CSC
Clinical Nurse Specialist Staff Nurse: RN IV
Hospital of the University of Pennsylvania Saint Luke‘s Hospital of Kansas City (Mo.)
Philadelphia
Leigh Ann Trujillo, RN, BSN
Maurice H. Espinoza, RN, MSN, CNS, CCRN Clinical Educator
Clinical Nurse Specialist St. James Hospital and Health Center
University of California Irvine Medical Center Olympia Fields, Ill.
Orange
Rebecca Unruh, RN, MSN
Kathleen M. Hill, RN, MSN, CCNS-CSC Nurse Manager – Cardiac Intensive Care
Clinical Nurse Specialist, Surgical Intensive Unit & Cardiac Rehabilitation
Care Unit North Kansas City (Mo.) Hospital
Cleveland Clinic
Opal V. Wilson, RN, MA, BSN
Cheryl Kabeli, RN, MSN, FNP-BC, CNS-BC RN Manager, PC Telemetry Unit
Nurse Practitioner Louisiana State University Health Sciences
Champlain Valley Cardiothoracic Surgeons Center
Plattsburgh, N.Y. Shreveport
vvii
EECCGG__FFMM..iinndddd vvii 77//2233//22001100 11::0066::1144 PPMM
Not another boring foreword
If you’re like me, you’re too busy to wade through a foreword that uses pretentious
terms and umpteen dull paragraphs to get to the point. So let’s cut right to the chase!
Here’s why this book is so terrific:
1. It will teach you all the important things you need to know about ECG interpretation.
(And it will leave out all the fluff that wastes your time.)
2. It will help you remember what you’ve learned.
3. It will make you smile as it enhances your knowledge and skills.
Don’t believe me? Try these recurring logos on for size:
Ages and stages identifies variations in ECGs related to patient age.
Now I get it offers crystal-clear explanations of complex procedures, such as how to
use an automated external defibrillator.
Don’t skip this strip identifies arrhythmias that have the most serious consequences.
Mixed signals provides tips on how to solve the most common problems in ECG
monitoring and interpretation.
I can’t waste time highlights key points you need to know about each arrhythmia for
quick reviews.
See? I told you! And that’s not all. Look for me and my
friends in the margins throughout this book. We’ll be there
to explain key concepts, provide important care reminders,
and offer reassurance. Oh, and if you don’t mind, we’ll be
spicing up the pages with a bit of humor along the way, to
teach and entertain in a way that no other resource can.
I hope you find this book helpful. Best of luck
throughout your career!
Joy
vii
EECCGG__FFMM..iinndddd vviiii 77//88//22001100 1122::4488::2244 PPMM
EECCGG__FFMM..iinndddd vviiiiii 77//88//22001100 1122::4488::2266 PPMM