## EKG Question #20

### Question

The nurse is caring for a client who requires application of a five-lead telemetry (American standard color coding). The nurse correctly applies the white lead to the 2nd intercostal space (RA). Where will the other four leads be placed?

1. LA (left arm at 2nd intercostal space) = Red; Chest V (area right sternal border) = Brown; LL (left leg or left lower position) = Black; RL (right lower leg or right lower position) = Green
• Rationale:
2. LA (left arm at 2nd intercostal space) = Black; Chest V (area right sternal border) = Brown; LL (left leg or left lower position) = Red; RL (right lower leg or right lower position) = Green
• Rationale:
3. LA (left arm at 2nd intercostal space) = Black; Chest V (area right sternal border) = Brown; LL (left leg or left lower position) = Green; RL (right lower leg or right lower position) = Red
• Rationale:
4. LA (left arm at 2nd intercostal space) = Red; Chest V (area right sternal border) = Red; LL (left leg or left lower position) = Brown; RL (right lower leg or right lower position) = Black
• Rationale:

### Explanation

The five-lead electrode system uses RA, RL, LA, LL, and Chest lead or V lead locations to display bipolar leads I, II, III, plus V1-6. If red, black, white, green, and yellow leads are used (European standard color coding), then RA = red; LA = yellow; RL = black; LL = green, and V lead = white. The nurse must be familiar with policies and which type of lead coding is used.