write a virtual clinical practicum  

This week learning was based on ECG.I learned through a EkG simulation game called “skulls stats game” and educational videos to practice and learned how to identify 27 of the most common cardiac rhythms, causes and treatments.  9:00 am – 11am : I learned about the normal values of a 12 lead ECGsuch as the P wave, PR interval, QRS  interval, St segment, T wave and QT interval .First,  itis important to determine the rate, and whether it is regular or irregular . I was able to  use the calipers to  track the  P waves and QRS complexes. I was able to demonstrate accurate measurements of heart rate, PR intervals, QRS width, ST segments and QT .  11am-1pm. I learned and was able to identify the basic principles of ECG lead placement and selection. I learned that having both good skin contact and adequate conductive jelly in the center of the electrode will help assure a good ECG signal is received. The ECG electrode conductive jelly typically dries up within two to three days. It is important to  Remove hair prior to applying the electrode. Clean the  sweat  and any bodily fluids from the  skin and use a dry towel to mildly scrub the skin before electrode application (Jones, 2008).  1:00pm-3pm: I learned to identify rhythms including sinus, atrial, junctional, ventricular, AV blocks, and paced rhythms along with characteristics, causes, clinical significance, and interventions for each. For instance in Afib there is no p- wave and the atrial electrical activity is very fast and possible causes can be copd,mitral valve disorders, Cad, digoxin toxicity.  First thing. the nurse need to assess the patient and check the patient Blood pressure as a result of a loss of atrial kick also,  the patient may experience some heart palpitations as a result of rapid heart rate , possible treatments before attempting cardioversion are anticoagulants to prevent embolic complications, diltiazem, digoxin, amiodarone to control the ventricular rate .    3pm-5pm: I learned to identify the lethal cardiac rhythms such as PEA. V-fib , V-tach , Asystole , how to assess the patient, when to call the code and what possible treatment to expect. For instance in V-fib the ventricle are not contracting and the patient will not have a pulse, blood pressure or cardiac output. Possible causes could be acute MI, electrolytes imbalances, it is imperative for the nurse to prioritize that patient and check for an airway, breathing, and pulse per Basic Life Support (BLS) standards. Call for help if the patient is found  pulseless, and unresponsive. Begin CPR. VF treatment requires defibrillation. Resuscitation requires defibrillation and emergency drugs per ACLS VF guidelines. The sooner the patient is defibrillated, the greater likelihood of achieving spontaneous circulation. The longer the patient is in VF, the more difficult it is to convert the rhythm.    5pm-7pm. Review and summary of how to identify and interpret cardiac rhythms originating in the sinus, junctional, ventricular areas. Heart blocks and life threatening rhythms as well as nursing priorities and potential treatment strategies were also discussed with my preceptor.