random fact throwing: PCCN/CCRN edition

[turnforthenurse]

I know the random fact throwing thread is very popular on here and I wanted to start a PCCN/CCRN edition to help those who are planning on taking the PCCN/CCRN study :)

Hyperacute (tall) T waves that are localized in the absence of hyperkalemia could be an early sign of ischemia.

Ischemia: ST depression and/or T wave inversion in >/ 2 contiguous leads

Injury: ST-segment elevation >/ 1mm in >/ 2 contiguous limb or >/ 2mm in precordial leads

Infarction: pathological Q waves (>0.04sec wide, >25% amplitude of the R wave)

NSTEMI: subendocardial damage (doesn't go all the way through). Normal R wave progression, ST-segment depression, normal Q.

STEMI: transmural damage, loss of R wave progression, ST elevation with abnormal Q wave

Anterior MI (LCD, LAD)

- leads V3, V4

- tachycardia, pulmonary edema (dyspnea, orthopnea)

Inferior MI (RCA)

- leads II, III, aVF (these leads are also at the bottom or inferior part on a printed 12-lead EKG which helps me remember)

- bradycardia, hypotension

- **do a right-sided EKG because there is a chance a patient with an inferior MI will have a RVMI.

Lateral MI (LCA, Circumflex)

- Leads V5, V6, I, aVL

- ventricular dysrhythmias, heart failure, AV blocks

Septal MI

- Leads V1, V2

- Tachycardia, atrial fibrillation, septal rupture

Posterior MI (LCA, Circumflex, RCA)

- Pathological R waves in V1-V4

- ST depression in V1, V2

- You need to look through the heart for reciprocal changes

- Bradycardia, junctional rhythms

RVMI

- As mentioned above, you need to do a right-sided EKG in a patient with an inferior MI, incidence is about 40%!

- Lead V4R

- Hypotension, bradycardia, absence of pulmonary edema in a true RVMI (clear lungs!)

Cardiogenic pulmonary edema (more common)

- increase in hydrostatic pressure (push) within the pulmonary-capillary bed due to heart failure. Third-spacing occurs in the INTERSTITIUM.

- bibasilar rales, vascular prominence, bilateral infiltrates

Non-cardiogenic pulmonary edema: third spacing into the ALVEOLI

- ARDS

[Stormy8]

Great thread. I'm about to start studying for the CCRN.

[SwansonRN]

I love it!!! Printing this out.

[megan9107]

Love this thread. Is there a way to print from here?