Real Nursing Skills 2.

0 Cardiorespiratory Care: Cardio Respiratory Monitoring: Placing Electrodes for a 12-Lead Electrocardiogram (ECG) Purpose

To place electrodes so that electrocardiogram can measure electricity produced by heart muscle

Delegation Both licensed and unlicensed personnel can obtain 12-lead electrocardiogram providing that proper training has been given prior to performing task* *Always check agency policy and applicable scope of practice Preparation

Become familiar with how to run electrocardiogram machine by reviewing manual Identify child and introduce self; use at least two client identifiers when providing care, treatment, or services Explain the purpose of procedure; discuss need for child to remain still during electrocardiogram Provide for child privacy Perform hand hygiene and adhere to standard precautions Prepare equipment: o Electrocardiogram recorder o Patches with leads; 12-leads provide optimal recording

Post-Procedure Remove electrodes and any conductive gel with moistened gauze pads Assess childs response to procedure Tell child to inform you of any discomfort (these instructions should be given before, during, and after procedure); if child is too young to verbalize discomfort, observe for signs or cues of discomfort Provide any instructions for child Pediatric Nursing Skills - 2012 Pearson Education, Inc. Page 1 of 2

Real Nursing Skills 2.0 Clean work area and provide for child comfort Perform hand hygiene and adhere to standard precautions

Expected Outcome

Electrodes will be correctly placed to obtain accurate electrocardiogram

Unexpected Outcome: Electrodes will be incorrectly placed and inaccurate electrocardiogram will be obtained Child will not remain still in order to perform procedure Documentation Follow institutional guidelines Collect tracing from electrocardiogram recorder Have tracing read, following institutional policy Sample Documentation EKG machine will print out a final reading of childs test results; result should be placed in childs chart to become part of permanent medical record; no other documentation needed Resources and References Ball, J.W., Bindler, R. C. & Cowen, K. J. (2010). Child health nursing: Partnering with children and families (2nd ed). Upper Saddle River, NJ: Pearson Education, Inc. Binder, R. C. & Ball, J. W. (2008). Clinical skills manual for pediatric nursing: Caring for children (4th ed). Upper Saddle River, NJ: Pearson Education, Inc.

Pediatric Nursing Skills - 2012 Pearson Education, Inc.

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