Catch the Beat! EKG Lesson Plan

Lesson Content

• Lesson Plan Template:

  CTE Lesson Plan

• CTE Course Info and Benchmark Notes

  
  

  Program Title (as applicable): Practical Nursing

  Course Title: Medical Surgical Nursing 1

  Course Number: PRN0290

  Career Cluster: Health Science

  CIP Number: 0351390101

  Course Type: Career Preparatory

  Standard(s) or benchmarks

  22.06.01 - Care for the patient with a cardiovascular/circulatory disease/disorder.

• Unit Outline

  
  

  This unit involves the diagnostic test, the electrocardiogram (ECG), how it is used for the patient with a cardiovascular/cardiac disorder, and what actions to take with the ECG results.

  Lesson 1: Introduce the diagnostic test called the 12-lead electrocardiogram (ECG) for the patient with a cardiac disorder.

  Lesson 2: Evaluate the ECG rhythm using the components of an ECG.

  Lesson 3: Care for the patient with an abnormal ECG.

• Career Connection

  
  

  ECG evaluation can be completed by specially trained ECG technicians, practical nurses, registered nurses, and is a particularly important skill for cardiac intensive care unit (cardiac ICU) nurses, or those who work in a cardiology office.

• Learning Objectives

  
  

  Students will be able to:

  • Assess what components of the ECG are present or absent.
  • Analyze whether the ECG reading is normal sinus rhythm or not.
  • Prioritize care based on the ECG reading; if the reading is abnormal, notify the care team by reporting and documenting the occurrence.

• Prior Knowledge

  
  

  Students should be familiar with:

  • The PQRST elements of the ECG tracing and what they indicate about the electrical and functional activity of the heart.
  • The correct order for PQRST is P wave, QRS complex, T wave.

• Guiding Questions

  
  
  • What do each of the letters PQRST mean when looking at an ECG tracing?
  • What action should be taken if there are abnormalities in the electrical tracing?

• Procedure

  
  
  1. To introduce the lesson, review PQRST with a group activity that organizes the order and specifics (time/amplitude) of each letter. Use the extra-large card sequencing activity (Catch the Beat Group Activity provided) and have students provide the parameters for each component. Have the students create groups of three students in each group. Provide one set of extra-large cards for each group. Have the students move around to put the components of the ECG in order and describe what part of the heart cycle each component correlates to and how wide or narrow it is (how long it should take).
  2. Have the students discuss how the electrical current components relate to the muscular activity in the heart using the terms atrial, ventricular, depolarization, and repolarization.
  3. To reinforce the lesson, have the students work as a class with guided practice to analyze 3 normal and not normal ECG patterns. Have the students discuss why each ECG is normal or not normal (Rate, rhythm, components in a six-second ECG strip).
  4. Have the students work as smaller teams to evaluate five sample ECGs working for accuracy in the first round.
  5. To bring the lesson to a close, have the students work individually to evaluate five sample ECGs working for speed in determining normal and not normal ECGs. If there are any “not normal” ECGs, they will need to be reported. Use a stopwatch to determine the fastest time and evaluate for accuracy because time is of the essence in heart related abnormalities and treatment.

• Teacher Notes

  
  
  • A common error in thinking is that the nursing student needs to understand all possible abnormalities of an ECG. A practical nursing student needs to be able to differentiate normal from abnormal results and take action.
  • The extra-large card activity (Catch the Beat Group Activity provided) for sequencing will need to be printed double-sided on cardstock prior to class. One set for each group of three students in your class.
  • At least 15 copies of ECG tracings will be needed for the activities, either printed or a link in a learning management system for viewing. ECG tracings can be found in many free online resources.

• Optional

  
  

  Formative Assessment Ideas:

  • Group activity – evaluate three ECGs with guided practice and determine normal and not normal. Report any abnormal ECG readings.
    • Teachers can use the group activity as a formative assessment. Have each group of students evaluate three of the ECGs on the handout provided by the instructor or available in the learning management system and determine whether the tracings are normal or abnormal and report any abnormal ECG readings to the instructor. Discussion among the group as to what factors make the reading normal or abnormal should be encouraged and the instructor should provide intermittent guidance. Students should make any notes in a notebook.

  Summative Assessment Ideas:

  • Individual activity – evaluate five ECGs and determine normal and not normal. Report any abnormal ECG readings.
    • Teachers can use the individual activity as a summative assessment. Have each student evaluate five of the ECGs on the handout provided by the instructor or available in the learning management system and determine whether the tracings are normal or abnormal and report any abnormal ECG readings to the instructor. Students should indicate the answers to their questions in a notebook and submit to the instructor.

  Accommodation Suggestions:

  • Provide a normal ECG reading for a student to compare the activity readings with and determine if the rhythm is the same or different (not the rate).

  Extension Ideas:

  • Have students draw their own ECG template (PQRST) on a small piece of cardstock (bookmark size) with parameters for each component to use as a reminder when analyzing and evaluating ECGs in the future.