EKG- Electrolytes

Question 1

What is flattening and/or inversion of T-waves which indicates no ventricle relaxation?

Answer 1

HYPOKalemia- <3.5 w/ see EKG changes

Question 2

Less K will mean less repolarization, what else will show on EKG?

Answer 2

ST depression and prominent U-waves- BC ventricle most contract at some point

Question 3

What is the junction of the QRS and beg of ST segment?

Answer 3

J point.

Question 4

What are cause and result of hypokalemia?

Answer 4

Hydrochlorothiazides, Furosemide.
Ventricular arrhythmia risk.
Check K+ and MG labs

Question 5

Ekg has the following. what electrolyte is causing these disturbances?
1. Peaked T waves 
2. Prolong PR 
3. Absent P- waves
4 Wide QRS.

Answer 5

HYPERkalemia- level 5.5, ventricle in long contraction

Question 6

What is the MC cause of HYPERkalemia

Answer 6

chronic renal failure-

imbalance of aldosterone

Question 7

What can lead to torsades?

Answer 7

HYPOKalemia no relax, irregular torsades

Question 8

What electrolyte level can lead to V-tach?

Answer 8

HYPERkalemia, long relaxed sinusoidal rhythm

Question 9

Which electrolyte imbalance is correctable?

Answer 9

HYPERKalemia

1. Calcium, Saline-stabilize membrane
2. Insulin- Lateral-shift K level
3. Furosemide, Sodium Bicarb- excretors

Question 10

What leads are HYPERkalemia seen and what else is seen?

Answer 10

MC precordial leads V1-V6.

1. DEEP QRS V2
2. LBBB-V1 or V6

Question 11

Which RX drug is treatment and proarrhythmia in CVD?

Answer 11

Digoxin- treat HF and arrhythmias

Question 12

How does Digoxin affect PRI?

Answer 12

INC AV nodal refractory period.
2. Pos. Ionotropic/contract and NEG conotrophic/ DEC HR.
LONG contraction, slower HR.

Question 13

What are CP signs of toxicity w/ Digoxin?

Answer 13

HA, weak, seizure, drowsiness, AN, N/V yellow halo, palpitation, dec HR

Question 14

What else should be monitored with Digoxin?

Answer 14

K levels- can also lower K

Question 15

What will Digitalis toxicity show on EKG?

Answer 15

1. Shorter QT
2. SCOOP of ST-T-
3. ST+T fused w/in scoop
4. PRI prolonged
5. Bradycardia
6. U wave

Question 16

What will the scoop look like?

Answer 16

1. Hockey stick R mustache

2. lowercase h followed with U wave (hence HYPOKalemia risk)

Question 17

What are the QT prolongation drugs and T wave inversion/flattening?

Answer 17

Quinidine, Procainamide, disopyramide

Question 18

What is seen with hypothermia?

Answer 18

1. Osborne J waves in precordial and inferior leads
   BUTTed up against Post QRS and b4 ST segment
2. Bradycardia

Question 19

Why would hypercalcemia produce J waves?

Answer 19

Tetany. Hypothermia Ventricular frozen in time

Question 20

What shows the severity of hypothermia?

Answer 20

Ht of the J-wave

Question 21

How do you distinguish J waves from RBBB?

Answer 21

J waves curved seen in INF and precordial.

RBBB- sharp curves in V1 or V6

Question 22

What is GS for DX of PE?

Answer 22

CT scan.

ECG can show PE, but no dX

Question 23

Describe each ECG finding of a PE?

Answer 23

1. Sinus tachy- faster to get blood to system d/t block
2. RV strain seen in VI -V4, relate to R side of heart pulmonary circuit to lungs
3. ST depression- ischemia tissue dying
4. RBBB-right side struggling

Question 24

Which Leads are significant signs of PE?

Answer 24

S1- deep S WAVE IN LIMB-I R-side heart.
Q3- Q WAVE IN LIMB3-lung strain
T3- INVERTED T-WAVE IN LEAD 3- ventricular strain

Question 25

Who needs a pre op EKG?

Answer 25

PHM- CVD, CVA, comorbidity, CAD, arry, PAD, structure heart. Bleeding risk

Question 26

What are concerns for pre op EKG?

Answer 26

1. Q Waves
2. STEMI, NSTEMI-dep
   3 LVH
3. QT long
4. BBB
5. Arrhythmias

Question 27

When is a nuclear stress test advised?

Answer 27

STABLE Angina DOE w/ TKR

Question 28

When is TM stress test advised?

Answer 28

STABLE Angina DOE, SOB.

Question 29

Ms. Niehaus has syncope, DOE but her EKG was NSR, what monitor is ideal for her?

Answer 29

Zio Patch-14, where outside clinic. Holter- 24-48h