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EKG > E2: Drugs And Electrolyte > Flashcards

E2: Drugs And Electrolyte Flashcards

1
Q

What are the EKG findings of benign early repolarization?

A
  • J point notching
  • T wave asymmetry, concordance with QRS
  • upsloping ST segment
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2
Q

What is electrical alternans and when do you see it?

A
  • Changing amplitude of the QRS complex

- Seen with large pericardial effusion and the heart may rotate freely

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3
Q

What EKG findings can you see with a pulmonary embolism?

A
  • Sinus tachycardia if the embolism is small

- if passive PE, may see S1 Q3 T3

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4
Q

What is S1Q3T3?

A

-Large S wave in lead 1, deep Q wave in lead III, and inverted T wave in lead 3

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5
Q

What is Long QT syndrome?

A

A rare congenital condition that results in delayed repolarization following depolarization, which is associated with ventricular dysrhythmias including V fib and Torsades

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6
Q

What is the QTc interval?

A
  • The “corrected Qt interval”

- represents depolarization and repolarization but is corrected for HR

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7
Q

What QTc interval should make you concerned about your patient developing Torsades?

A

Men: >0.44
Women: >0.46

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8
Q

What is the visual tip to determine if the QT interval is normal?

A

Normal QT is less than half the R-R interval

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9
Q

What EKG characteristics does Hyperkalemia cause?

A
  • Tall peaked T waves
  • Flattened P waves
  • 1st degree AV heart block
  • Widened QRS complex
  • Merging of S and T wave forming a “sine wave” pattern
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10
Q

What are the EKG findings of Hypokalemia?

A
  • Flattening of the T waves
  • Appearance of U waves
  • ST segment depression
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11
Q

What are the EKG findings with Hypercalcemia?

A
  • Increased PR interval and QRS interval

- Short ST and QT interval

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12
Q

What are the EKG findings with Hypokalemia, hypocalcemia, and hypomagnesemia?

A

-Prolonged QT

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13
Q

What are the general effects of Digoxin?

A
  • Affects the movement of sodium and calcium during depolarization and repolarization (slows sodium movement into the cell and facilitation’s movement of calcium out of the cell )
  • Increases myocardial contractility and improves the hearts pumping ability
  • Slows heart rate and AV conduction
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14
Q

What happens in toxic levels of Digoxin?

A
  • Will see conduction blocks and/or tachy-dysrhythmias which are increases with renal disease, hypokalemia, and aging
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15
Q

What are the EKG changes you will see with therapeutic levels of Digoxin?

A
  • Shortened QT interval
  • flattened T waves
  • Asymmetric ST depression and T wave inversion in leads with tall R waves
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16
Q

What EKG findings might you see with toxic levels of Digoxin?

A
  • Since it slows conduction through the AV node, may see 1st, 2nd, or third degree AV block
  • can cause virtually any tachy-dysrhythmia
  • PAT with second degree AV block is the most characteristic rhythm disturbance
17
Q

What are the types of drugs that can prolong the QT interval?

A
  • Anti-arrhythmics
  • TCAs
  • Phenothiazines
  • Macrolides
18
Q

When monitoring QT interval when a patient is on Digoxin, at what point should you discontinue the Digoxin?

A

If >25^ prolongation develops, or QTc exceeds 0.5 seconds

19
Q

What are the EKG findings in TCA overdose?

A
  • Prolonged QT
  • Narrow QR portion, widened RS portion
  • Often long PR interval
20
Q

What are the EKG findings in Hypothermia?

A
  • All intervals are prolonged
  • Distinctive type of ST segment elevation with an abrupt ascent at the J point, and then plunge back to baseline (Osborn waves)
  • Sinus brady and slow a fib are common
  • muscle artifact due to shivering
21
Q

What is Brugada syndrome?

A

-A rare clinical syndrome due to an inherited autosomal dominant genetic defect that results in EKG abnormalities which cause sudden death due to V fib.

22
Q

What is the treatment of Brugada syndrome?

A

Implantable cardioverter-defibrillator (ICD)

EKG (8 decks)

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