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Easy way to remember EKG changes with Electrolyte imbalances?


Specializes in Currently: Certified School Nurse.

Depressed T wave, prominent U wave......arghhh!

Any suggestions? TIA

hypocaffeinemia, BSN, RN

Specializes in Critical Care.

Depressed T wave, prominent U wave......arghhh!

Any suggestions? TIA

I'm a long-time monitor tech finishing up nursing- I've yet to come across any sort of decent mnemonic device for this. The best thing I can tell you is to just rote memorize them.

Maybe apply what the electrolyte does at a physiological level to predict its effects on an EKG tracing.

For instance, calcium is critical for contraction- a deficiency would lead to prolonged QT segment and possibly dysrhythmias.

Potassium is essential for repolarization, so a deficiency would lead to depressed T waves, while an excess would lead to quick, tall, peaked T-waves.

I suggest reviewing your A&P book regarding cardiac conduction for hints.


One other thing, as it's a personal battle of mine: if you only see changes in several leads and not universally, you need to consider something that affects just the area of the heart demonstrating changes.

For instance, tall, peaked T waves in only the inferior leads (II, III, AVF) is not an indicator of hyperkalemia, but may be the early warning sign for an acute MI in that region.

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