Equipment
■ Alcohol pads.
■ Gauze pads.
■ Washcloth.
■ Shaving supplies or scissors, if necessary.
■ Disposable electrodes.
■ For hardwire monitoring, add: cardiac monitor; cable with lead wires; safety pin; 1-in. tape.
■ For telemetry, add: transmitter with lead wires (with a new battery inserted before each use); pouch to carry transmitter.
Assessment
■ Check for history of dysrhythmias.
■ Assess cardiovascular status, including:
■ Heart sounds.
■ Pulse rate.
■ BP.
■ Check for the presence of pain.
■ Be Smart! Assess skin integrity of the chest before applying electrodes.
■ Skin lesions contraindicate the application of leads to the affected area.
Post-Procedure Reassessment
■ Evaluate changes in the patient’s cardiac rhythm.
■ Check skin integrity, and replace the electrodes at least every 24 hours.
Key Points
■ Plug in the monitor and turn it on. Connect the cable with lead wires into the monitor.
■ Identify electrode sites based on the monitoring system and the patient’s anatomy.
■ Gently rub the placement sites with a gauze pad until the skin reddens slightly.
■ Use an alcohol pad to clean the areas for electrode placement; allow to dry.
■ Connect lead wires to the electrodes.
■ Be Smart! If the patient’s chest is very hairy, shave small areas for the electrodes.
■ Apply the electrodes, pressing firmly.
■ Check the ECG tracing on the monitor. If necessary, adjust the gain to increase the waveform size.
■ Be Safe! Set the upper and lower heart rate alarm limits and turn them on.
■ Obtain a rhythm strip by pressing the “record” button.
■ Be Smart! If you are not getting a good reading, recheck the leads, replace leads, or move leads if necessary.
Documentation
■ Chart the date and time monitoring was instituted and the monitoring lead selected.
■ Document a rhythm strip every 8 hours and with changes in the patient’s condition according to agency policy.
■ Label the rhythm strip (if the monitor does not label it for you) with the date, time, patient’s name, and room number.
■ Indicate on the strip when symptoms and treatment interventions occurred.
■ Document the patient’s response to treatment.
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| The monitoring system specifies lead placement |
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| Evaluate the cardiac rhythm |
2 comments:
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