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1. Relate coronary artery perfusion to cardiac musculature and the conduction system.
2. Utilize a nine-step systematic approach to interpret EKGs.
3. Discuss the basic electrophysiology of the heart: Electrical versus mechanical function.
4. Discuss and review bedside monitoring leads and EKGs to include 12-lead, posterior leads and right-sided.
5. Identify the types of bradycardias and heart blocks and state treatment modalities.
6. Determine the appropriate clinical management of the various patient problems encountered.

Fundamentals of Rhythm Interpretation
Cardiac Conduction System Electrical Activity
Action Potential

• Depolarization and Repolarization
• Correlation of waveforms
• Calculating rate and measurement of intervals

Monitoring Leads and Associated Anatomy: From Bedside Monitoring to Twelve-Lead EKG

• 3-lead telemetry
• 5-lead telemetry
• 6-lead telemetry

EKG Interpretation

• Frontal plane limb leads
• Horizontal plane chest leads
• Importance of the positive electrode
• Rule of electrical flow
• Layout of the 12-Lead EKG/ 15-Lead EKG/R-sided EKG
• Utilize a systematic approach: Rhythm/Rate/Axis interpretation/ Examination of waveforms

Coronary Artery Perfusion

• Relate coronary perfusion to cardiac musculature and the conduction system

Cardiac Monitoring: The Best Leads for
Waveform and Arrhythmia Detection

• QT Monitoring
• ST segment/ T wave observation for ischemia/ infarct/abnormal repolarization
• Arrhythmia detection

Mechanical Activity: Is there a Pulse?

• Contraction
• Cardiac Output
• Compensatory Mechanisms
• Pulseless electrical activity
• Asystole

Rhythm Review: Differentiating Stable from
Unstable Rhythms
Bradycardic Rhythms: Observe and monitor or treat

• Sinus Bradycardia
• Sinus Arrest / Sinus Pause
• Sick Sinus Syndrome
• Escape Rhythms
• AV Heart Blocks
• First Degree
• Second degree type 1 and 2
• Complete heart block

Tachycardic Rhythms

• Sinus Tachycardia: Determine the cause

Pathophysiology of Supraventricular
Arrhythmias: AV nodal reentry or enhanced automaticity

• Atrial tachycardias
• Atrial Fibrillation
• Atrial Flutter
• Junctional tachycardia

Ventricular dysrhythmias: Perfusing or not Perfusing?

• PVCs
• Monomorphic ventricular tachycardia
• Polymorphic ventricular tachycardia
• Torsades de Points
• Ventricular fibrillation

Practice Review: What did you learn today?

Cathy Lockett, RN, MHA, BSN, CCRN-K., has been practicing critical care nursing for over 35 years. Her critical care background includes working in medical, surgical, neuro, cardiac, cardiovascular care, and critical care transport with most of her clinical experience in the areas of medical cardiology and cardiovascular surgery. She has provided cardiovascular care in the role of staff nurse, preceptor, educator, supervisor and manager.

Utilizing her vast knowledge and experience, Cathy has presented on numerous topics related to cardiac and pulmonary care, including advanced and basic EKG interpretation, the heart in detail, hemodynamic monitoring, basic and advanced arrhythmia, pulmonary diseases and IABP therapy. Additionally, Cathy is a Training Center Faculty member for the American Heart Association in the disciplines of Basic Life Support, Advanced Life Support, and Pediatric Advanced Life Support. Cathy is also a former co-owner of an educational healthcare company.

Cathy’s teaching style is dynamic and high-energy while remaining informal and easy to understand. Attending this seminar will enhance your learning experience, improve your long-term retention of key concepts and provide more effective patient care. Cathy’s teaching style indeed personifies that learning can be fun and informative. Speaker Disclosures:
Financial: M. Cathy Lockett is an independent contractor and receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: M. Cathy Lockett has no relevant non-financial relationships.

For U.S. and Canadian customers, a CE test is available for $9.99 USD per participant. International CE rates may vary; please contact our Customer Service at 1-800-844-8260 for more details.

Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self study is an acceptable form of continuing education. Please refer to your state rules and regulations.

Certificates of Successful Completion may be emailed, faxed or mailed to participants completing the post-test/evaluation and paying the CE fee.

**Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards.

All members of the PESI, Inc. planning committee have provided disclosures of financial relationships with ineligible organizations and any relevant non-financial relationships prior to planning content for this activity. None of the committee members had relevant financial relationships with ineligible companies or other potentially biasing relationships to disclose to learners. For speaker disclosures, please see the faculty biography.

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Cardiovascular Technology Professionals
Cardiovascular Credentialing International (CCI) recognizes programs and providers approved by the American Nurses Credentialing Center’s Commission on Accreditation (ANCC). This self-study package will qualify for 6.3 contact hour.

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Nurses/Nurse Practitioners/Clinical Nurse Specialists - Credit Expired: 4/16/2018
No CE available for this board.

California Nurses: PESI, Inc. is a provider approved by the California Board of Registered Nursing, Provider #:17118 for 6.0 self-study contact hours.

You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

Florida Nurses: PESI, Inc. is an approved provider by the Florida Board of Nursing. Provider #: FBN2858. These materials qualify for 6.0 self-study contact hours.

Iowa Nurses: PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 6.3 self-study contact hours.

Copies of the evaluation may be sent to the IBON. You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.

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Other Professions
This self-study activity qualifies for 6.25 clock hours of instructional content as required by many national, state and local licensing boards and professional organizations. Retain your certificate of completion and contact your board or organization for specific filing requirements.

Disclaimer: **Information obtained in this course should be used within your scope of practice.
**It is your ethical responsibility to report accurate hours to your licensing board.
**All self-study participants must complete and pass (80% or better) a post-test and evaluation prior to receiving a certificate of completion. If you require a copy of the test/evaluation for CE purposes, please print at the time you take the test. Or you may call our customer service department and a copy of your test/evaluation will be emailed to you. Please allow 30-45 days.

Nurses