Patient Monitoring and Safety Flashcards

When attaching cardiac monitoring electrodes, which skin preparation step is most important to reduce artifact?

Answer: Cleaning and lightly abrading the skin to remove oils and dead cells before electrode placement

Proper skin preparation by cleaning with an alcohol swab and lightly abrading the skin significantly reduces electrode-skin impedance, improving signal quality and reducing artifact.

Current of microampere levels that may cause cardiac fibrillation when applied directly to the heart through invasive catheters is called what?

Answer: Microshock

Microshock refers to small electrical currents (as low as 10-100 microamperes) that can trigger ventricular fibrillation when applied directly to the heart via invasive lines or cardiac catheters, bypassing normal skin resistance.

During continuous cardiac monitoring, an alarm is triggered for a critical low heart rate. What should the monitor technician do first?

Answer: Assess the patient clinically and notify the nurse or clinician immediately

A critical alarm must always prompt immediate patient assessment — alarms should never be silenced without clinical evaluation, as critical bradycardia may represent a life-threatening rhythm.

Why should the defibrillator be kept readily accessible near monitored patients in the cardiac care unit?

Answer: Life-threatening arrhythmias such as VF or pulseless VT can occur without warning and require immediate defibrillation

Immediate defibrillation within the first minutes of VF is the most critical determinant of survival, so defibrillators must be immediately available in monitored care settings.

When a patient with a pacemaker is receiving electrocautery during surgery, which pacemaker problem can occur?

Answer: Oversensing of electrocautery current causing pacemaker inhibition

Electrosurgical (Bovie) current can be sensed by the pacemaker as cardiac activity (oversensing), inhibiting pacing output — dangerous in pacemaker-dependent patients who may develop bradycardia or asystole.

A monitor shows a sudden change to a flat line in one lead. What is the first action a rhythm technician should take?

Answer: Check the patient directly and verify electrode and lead connections before calling a code

A flat line must be verified as a true rhythm rather than artifact by checking the patient, the electrodes, and the connections in all leads before escalating to a code response.