Essentials of monitoring the electrocardiogram

The electrocardiogram is a useful noninvasive source of information on the various functions and dysfunctions of the heart. With it we can easily detect dysrhythmias and conduction abnormalities, anatomic orientation of the heart, hypertrophy of individual chambers, ischemia or infarction, electrolyte and chemical abnormalities, and drug toxicity. Since each abnormality produces distinctive tracings on the electrocardiogram, the nurse must be able to evaluate the patient's cardiac function when presented with clinical signs and symptoms. The ability to systematically and critically interpret electrocardiographic function should be paramount in the nurse's store of knowledge. Utilization of the electrocardiogram in conjunction with other standard and hemodynamic assessment tools will enable the nurse to perceive cardiac dysfunction, and accurately determine the clinical disorder.