EKGS for the nurse practitioner and physician assistant

354 Pages·2021·60.626 MB·English

by  Maureen A. Knechtel

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EKGs E
for the C
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L M A. K
AUREEN NECHTEL
Nurse Practitioner
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and Physician G EKGs
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Assistant

Third Edition f
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M A. K , MPAS, PA-C h
AUREEN NECHTEL
Nurse Practitioner
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A comprehensive, systematic approach to 12-lead EKG interpretation covering all the relevant
topics you’ll encounter in clinical practice—including treatment options! u
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Delivering clear and concise explanations to help students easily grasp key concepts, this book provides a e
comprehensive, no-nonsense approach to EKG interpretation for nurse practitioner and physician assistant
P and Physician
students, as well as practicing clinicians who need a quick refresher.
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The third edition retains the book’s systematic, physiologic approach that trains readers to follow the same a
steps in evaluating EKG tracings. After working through this book, you’ll gain a genuine understanding of EKG c
interpretation and will no longer need to memorize EKG strips. Using the patient’s presenting symptoms as a t
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starting point, abundant clinical scenarios demonstrate real-life applications for interpreting EKG readings. With t
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over 75 figures and tables and more than 260 EKG tracings, this resource delivers everything you need to provide o
expert, quality care to your patients. n
e Assistant
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New to the Third Edition

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• Treatment options included for premature atrial and ventricular contractions, atrial and ventricular n
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arrhythmias, ischemia and infarction, and heart block
• 14 in-depth chapter case scenarios to further challenge you and increase your proficiency in EKG P
interpretation
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• 60 new EKG tracings, providing you with more than 260 tracings throughout the book
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• Evidence-based approaches to differentiate between similar EKG patterns s
• New high-risk EKG descriptions, including multiple types of high-grade heart block and Wellen’s i
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syndrome for acute myocardial infarction
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• Risk stratification techniques for heart block, acute coronary syndromes, and supraventricular and a
ventricular arrhythmias utilizing the EKG n

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Key Features
s
s
• Addresses EKG interpretation using a systematic, physiologic approach, eliminating the need for is
memorization t
a
• Uses the patient’s presenting clinical symptoms as a starting point to teach critical thinking
n
• Includes more than 75 figures and tables and 260 EKG tracings to further illustrate concepts
t
• Offers 140 end-of-chapter review questions to help solidify your knowledge
• Includes 70 case studies with EKG tracings and teaching points at the end of the book, plus additional T h i r d E d i t i o n
case studies in each chapter, to connect key concepts with real-world learning E T
• Purchase includes digital access for use on most mobile devices or computers di hi
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ISBN 978 -0-8261 -7672-1 i d
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n
11 W. 42nd Street
New York, NY 10036-8002
www.springerpub.com
Knetchel_9780826176721_mech.indd 1 11/20/20 11:00 AM
EKGs

for the Nurse
Practitioner and
Physician Assistant
Maureen A. Knechtel, MPAS, PA-C, received a bachelor’s degree in health sciences and
a master’s degree in physician assistant studies from Duquesne University in Pittsburgh,
Pennsylvania. She has spent her clinical career as a physician assistant specializing in
general cardiology and cardiac electrophysiology. She teaches e lectrocardiogram (EKG)
recognition and interpretation to both physician assistants and nurse practitioners and
has been a guest lecturer nationally and locally on topics including EKG interpretation,
chronic angina, and ischemic heart disease in women, hypertension, and mixed hyper-
lipidemia. Ms. Knechtel is a fellow member of the American Academy of Physician
Assistants and the Tennessee Academy of Physician Assistants and currently serves as
academic coordinator and associate professor with the Milligan University Physician
Assistant Program in northeast Tennessee.
M A. K , MPAS, PA-C
AUREEN NECHTEL
EKG
for the
S
Nurse Practitioner
and Physician
Assistant
T h i r d E d i t i o n
Copyright © 2021 Springer Publishing Company, LLC
All rights reserved.
First Springer Publishing edition 2013; subsequent edition 2017.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form
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Acquisitions Editor: Suzanne Toppy
Compositor: diacriTech
ISBN: 978-0-8261-7672-1
e-book ISBN: 978-0-8261-7673-8
DOI: 10.1891/9780826176738
Qualified instructors may request supplements by emailing textbook@ springerpub.com
Instructor’s PowerPoints ISBN: 978-0-8261-7674-5
20 21 22 23 / 5 4 3 2 1
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Library of Congress Cataloging-in-Publication Data
Names: Knechtel, Maureen A., author.
Title: EKGs for the nurse practitioner and physician assistant / Maureen A. Knechtel.
Description: Third edition. | New York, NY : Springer Publishing Company, LLC, [2017] | Includes
bibliographical references and index.
Identifiers: LCCN 2017000289| ISBN 9780826168887 | ISBN 9780826168894 (e-book) | ISBN 9780826169013
(Instructors powerpoints) | ISBN 9780826168917 (Student image bank)
Subjects: | MESH: Electrocardiography--nursing | Electrocardiography—methods | Heart Diseases—
nursing | Heart Diseases—diagnosis
Classification: LCC RC683.5.E5 | NLM WG 140 | DDC 616.1/207547--dc23 LC record available at
https://lccn.loc.gov/2017000289
Contact [email protected] to receive discount rates on bulk purchases.
Publisher’s Note: New and used products purchased from third-party sellers are not guaranteed for
quality, authenticity, or access to any included digital components.
Printed in the United States of America
To Maddox and Avery: Dream big, little ones.

Contents
Reviewers ix
Foreword Theresa M. Campo, DNP, FNP-C, ENP-BC, FAANP, FAAN xi
Preface xiii
PART I Basics of Cardiac Physiology and Relationship to the EKG Rhythm Output
1. Introduction to the EKG, Cardiac Anatomy, and Electrical
Conduction System 3
2. Defi ning the Intervals 11
3. Lead Review 27
PART II Interpreting the 12-Lead EKG
4. Rate 47
5. Rhythm 55
6. Axis 71
7. Heart Block 83
8. Ischemia and Infarction 109
PART III Commonly Occurring Arrhythmias and EKG Findings
9. Supraventricular Tachycardia 143
10. Ventricular Arrhythmias 169
11. Paced EKGs 191
12. Drug and Electrolyte Effects on the EKG 209
13. Clinical Conditions That Affect the EKG 221
vii
viii Contents
PART IV Clinical Application
14. Applying EKG Skills to Clinical Practice 241
PART V Answer Keys
15. Answers to End-of-Chapter Review Questions 315
16. Answers and Teaching Points to Chapter 14 EKGs 319
Index 333
Reviewers
R. Keith Kramer MD, FACC
Cardiologist
Cardiovascular Associates of Kingsport
Kingsport, Tennessee
Janet Powell MSN, FNP-BC
Electrophysiology Nurse Practitioner
Cardiovascular Associates of Kingsport
Kingsport, Tennessee
ix