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Nclex Study Guide

This document summarizes key aspects of cardiac sounds, the electrocardiogram (ECG) waveform, and congestive heart failure. It describes: - The four main heart sounds (S1, S2, S3, S4) and what each represents - Components of the ECG waveform including the P wave, PR segment, QRS complex, and T wave and what each indicates - Common ECG changes seen with myocardial infarction, medications like digitalis and quinidine, and electrolyte abnormalities - Signs and symptoms of right-sided and left-sided heart failure - The four classes of congestive heart failure based on limitations to physical activity and symptoms at rest.

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Sara Pirman
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1K views4 pages

Nclex Study Guide

This document summarizes key aspects of cardiac sounds, the electrocardiogram (ECG) waveform, and congestive heart failure. It describes: - The four main heart sounds (S1, S2, S3, S4) and what each represents - Components of the ECG waveform including the P wave, PR segment, QRS complex, and T wave and what each indicates - Common ECG changes seen with myocardial infarction, medications like digitalis and quinidine, and electrolyte abnormalities - Signs and symptoms of right-sided and left-sided heart failure - The four classes of congestive heart failure based on limitations to physical activity and symptoms at rest.

Uploaded by

Sara Pirman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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CARDIAC

HEART
Sounds
S1 Tricuspid & Mitral Valve Closes
S2 Pulmonary & Aortic Valve Closes
S3 Ventricular Filling Complete
S4 Elevated Arterial Pressure (Atrial Kick)
WAVE REVIEW

P Wave: Atrial
depolarization
PR Segment: AV node
conduction
QRS Complex:
Ventricular
Depolarization
U Wave: Hypokalemia
creates U-wave
InDepth

ST Segment:
Ventricles depolarized
T Wave: Ventricular
repolarization

P Wave: Small upward wave indicating atrial depolarization


QRS Complex: initial downward deflection followed by large
upright wave, followed by small downward wave; represents
ventricular depolarization; masks arterial repolarization; enlarged
R portion- enlarged ventricles; enlarged Q portion may indicate probable heart attack
T Wave: Dome shaped wave; Indicates ventricular repolarization; flat when insufficient O2; elevated
when K levels
P-R Interval: Interval from beginning of P wave to R wave; represents conduction time from initial
excitation to initial ventricular excitation; Good diagnostic tool; usually normal <0.25

S-T Segment: Time from the end of S to beginning of T wave; represents time between end of
spreading impulse through ventricles and ventricular repolarization; in heart attack; with
insufficient oxygen
Q-T Interval: Time for singular depolarization and repolarization of the ventricles. Conduction
probs, myocardial damage, or congenital heart defects can prolong this.

ECG Changes with MI


T wave inversion
ST segment elevation
Abnormal Q waves
ECG Changes with Digitalis
Inverts T wave
QT segment shorter
Decreases ST segment
ECG Changes with Quinidine
Inverts T wave
Q segment longer
QRS segment longer
ECG Changes with K+
Hyperkalemia: Lowers P Wave; width of QRS
Hypokalemia: Lowers T wave; causes U
ECG Changes with Ca
Hypercalcemia: makes a longer QRS segment
Hypocalcemia: increases time of QT interval

Right Sided Heart Failure


Right Upper Quadrant Pain
Right Ventricular Heave
Tricuspid Murmur
Weight gain
Nausea
Elevated Right Atrial Pressure
Elevated Central Venous Pressure

Peripheral Edema
Ascites
Anorexia
Hepatomegaly

Left Sided Heart Failure


Left Ventricular Heave
Confusion
Paroxysmal Nocturnal Dyspnea
DOE
Fatigue
S3 Gallop
Crackles

Tachycardia
Cough
Mitral Murmur
Diaphoresis
Orthopnea

CONGESTIVE HEART FAILURE


Class I describes a patient who is not limited with normal physical activity by symptoms.
Class II occurs when ordinary physical activity results in fatigue, dyspnea, or other symptoms.
Class III is characterized by a marked limitation in normal physical activity.
Class IV is defined by symptoms at rest or with any physical activity.
Causes: CAD, Valvular heart disease, Cardiomyopathies, Endocarditis, Extracardiac infection, Pulmonary
embolus
Symptoms: Skin cold or cyanotic, Wheezing, Mitral valvular deficits, Lower extremity edema, Pulsus
alternans, Hypertension, Tachypnea

NEURO

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