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Darwinism
Location is Everything
The Highest Form of Flattery
More Air Anyone?
She is a Sturdy old Vessel
100

What is the first expected change in an evolving MI?

What is hyper acute or peaked T waves

100
On this area is where the brown V lead goes

4th ICS right sternal border ~ V1 position

100

This MI mimic will show case diffuse ST segment elevation

What is pericarditis

100
Name 2 classic ischemic changes seen on EKG
What are T wave inversion, flattening, or ST depression
100
If your patient is experiencing an anterior MI, what coronary artey do you expect to be the culprit?
What is the LAD
200

What is the next expected evolution of EKG changes in the evolving MI after the T waves have become hyper acute

What is T wave inversion or flattening

200

This is how long electrodes are good for outside of the foil package

What is 24 hours

200
The first EKG cjange seen in hyperkalemia
What is peaked T waves globally
200
If ischemic changes are present what general intervention is needed
What are increased bloodflow, or decreased myocardial workload
200
If your patient is experiencing a lateral MI, what coronary artery do you expect to be the culprit?
What is the circumflex artery
300

What is the next expected evolution in the acute MI after the T waves have inverted?

What is ST segment elevation

300

This is how frequently ECG electrodes should be changed

Daily/Q24

300
These three EKG changes may occur with hypokalemia
What are ~ T wave flattening, ST depression, and appearance of U waves
300
This 'wave' is indicative of myocardial necrosis
What is the Q wave
300
If your patient is experiencing an inferior MI, what coronary artery do you expect to be the culprit?
What is the RCA (in 85% of the population)
400

This change frequently occurs in the last stage of the evolving MI, frequently with the Q wave formation

What is T wave inversion

400

When should you check BP when administering NTG

what is prior to each administration

400
Patients presenting with acute apical ballooning will likely have ST elevation in what leads
What is anterior leads or V1-V4
400
This category of ACS requires immediate repurfusion therapy
What is a NSTEMI
400
Your patient has just experienced an anterior MI, name 2 complications specific to this type MI that you are going to monitor for
What are complete heart block, bundle branch block, reduced EF and heart failure symptoms
500

These 2 parameters must be met for the Q wave to be considered significant

What are the Q wave must be greater than 0.04 seconds in duration, and the depth of the Q wave must be at least 1/3 the height of the R wave in the same QRS complex

500

This is what you should do with the electrodes if the tele strip is showing low voltage and triggering a asystole/vfib alarm 

Move the lower leads up and the upper leads down (in closer to the heart)

500
Hypothemic EKG changes sometimes include this distintive wave
What is the Osborn or J wave
500
If your patient is experiencing unstable angina, what do you expect his troponin level to be?
What is negative or nondiagnostic/indeterminate range (o.06, 0.19, ect...)
500
Your patient has just experienced a large anterior/septal MI, what complication, specific to the septal involvement, are you going to monitor for?
What is ventricular septum rupture