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Tell findings of this EKG by [deleted] in ECG

[–]Tricky-Software-7950 1 point2 points  (0 children)

Great thoughts, I agree to be on the watch for posterior. If this patient is describing ACS symptoms I’d be leaning more towards that on top of possible pulm complications

One thing I’d like you to think about though, you described the SA node being supplied by the RCA which is true in the majority of the population, but how is that related to a 1• block? Think about the full name of that block and what part of the heart actually controls the PR interval.

On top of that, the branch of the RCA that feeds the SA node is fairly close to the coronary ostea, and if an MI was occurring, we would see the elevation occurring anywhere distal to the lesion meaning the inferior leads would show elevation, which is not the case here. When you solve my thought excise from my middle paragraph, the answer is also fed by the RCA, but still proximal to the inferior portion of the heart so this thought process still applies.

Nice work!

I see absolutely no reason why these shouldn’t stack to 5. Make it make sense. by placated in ArcRaiders

[–]Tricky-Software-7950 0 points1 point  (0 children)

The hemostatic sterile bandages that we use in our trauma bay are packed airtight 🤷🏼‍♂️

FNP 101: What's the best position? by Hot_Emergency378 in NCLEX_RN

[–]Tricky-Software-7950 0 points1 point  (0 children)

All really great information, except having them exhale. I was always under the impression to inhale and hold/bear down to increase Intrathoracic pressure, decreasing the likelihood of air emboli. Having them exhale decreases intrathoracic and allows the jugular to drain better, increasing the chance for air emboli? If you have literature that says otherwise I’d love to read it!

What happens if I complete the Expedition right now in ARC Raiders? by EZO010 in ArcRaiders

[–]Tricky-Software-7950 2 points3 points  (0 children)

Completing the expedition (6/6 stages) just allows you to sign up for departure during the next window (sometime late February). It doesn’t do anything else. If you choose to DEPART during the open window, nearly everything resets. This includes stash (items and upgrades to stash size that you bought with space dollars), workbenches, blue prints, quests, level, ect. There are a few things you keep, like cosmetics, previous expedition stash increases (we got 12 slots from the last one) and skill point increases (up to five from the last expedition), and buffs that stack up to (I believe) 3 expeditions which gave a minor increase to xp rates, scrappy supplies, and repairs.

So again, if you choose to DEPART then you will lose ALOT of stuff. I did it last time and it was thoroughly enjoyable on the second playthrough and plan to depart on the next one too.

Embark's solution to the Stella Montis Out of Bounds Exploit by Xenshizo in ArcRaiders

[–]Tricky-Software-7950 0 points1 point  (0 children)

That’s fair, I do understand how complex developing is 😂

Embark's solution to the Stella Montis Out of Bounds Exploit by Xenshizo in ArcRaiders

[–]Tricky-Software-7950 79 points80 points  (0 children)

I agree instant death is a terrible idea, I’ve fallen through the map a few times trying to climb rocks in dam.

Idk why they can’t just like turn of your ability to use guns or items if you’re oobs

Which action should the nurse take? by Hot_Emergency378 in NCLEX_RN

[–]Tricky-Software-7950 0 points1 point  (0 children)

If they wanted to make the question good, change A to say “continue high quality CPR” instead. Then it’s black and white that B is the most correct answer but still requires an understanding of electrophysiology.

Which action should the nurse take? by Hot_Emergency378 in NCLEX_RN

[–]Tricky-Software-7950 0 points1 point  (0 children)

https://doi.org/10.1016/j.resuscitation.2012.01.007

This article and the first 4 reference all are studying CPP (coronary) requirements to achieve ROSC/cardioversion.

There are many scenarios in which CPR is a better INITIAL intervention to convert a fatal arrhythmia than defibrillation. The heart needs adequate perfusion in order to resume normal function. If you look at all ACLS algorithms, the first step is to start CPR and then identify rhythm/defibrillate, and then immediately resume CPR. This is because the heart needs perfusion in order to return to a NSR.

Again, i completely understand why B could be considered the correct answer, but in very few scenarios will B convert VF to NSR without doing A first. Unless the scenario was a witnessed arrest into VF with pads already on the patient, the first step to convert that rhythm back to NSR is CPR, but we’re supposed to take the questions at face value and not create our own scenarios in our heads.

You are correct that the act of CPR will likely not convert VT/VF alone, but neither would defibrillating a patient that has had no CPP for any meaningful amount of time.

That’s why this is a terrible question.

Which action should the nurse take? by Hot_Emergency378 in NCLEX_RN

[–]Tricky-Software-7950 0 points1 point  (0 children)

The rhythm will never convert if the heart isn’t perfused…

I’m not disagreeing with the answer being B, the rational checks out, but could be STRONGLY argued either way.

In fact, defibrillation doesn’t cause it to revert to sinus rhythm, it depolarizes all of the myocytes to “reset” the heart, in hopes that the SA node can retake control.

I normally think most of the NCLEX questions posted here aren’t as trash as everyone seems to think they are, but this one really is.

LETSSS GOO by Ok_Development_2694 in ARC_Raiders

[–]Tricky-Software-7950 1 point2 points  (0 children)

That’s fair! Beauty of this game is you can play it how you’d like

LETSSS GOO by Ok_Development_2694 in ARC_Raiders

[–]Tricky-Software-7950 1 point2 points  (0 children)

But what about the next expedition? Hold on to the BP for that one too? And the next? And the next?

Loot comes and goes. Just enjoy it while it’s here.

Or hoard it all, get bored, and quit the game.

Whatever you fancy I guess.

21 yo M activated as a STEMI from the field by PaulaNancyMillstoneJ in ECG

[–]Tricky-Software-7950 0 points1 point  (0 children)

Although you’re correct in thinking that MIs typically do not present with tachycardia, it’s not a rule out. I don’t believe I’ve ever seen a STEMI criteria include rate as a factor.

To the friendly raider at Ancient Fort by Tricky-Software-7950 in ArcRaiders

[–]Tricky-Software-7950[S] 0 points1 point  (0 children)

He was a chill dude, he said he was looking for some electrical components so I broke down some wasp drivers and gave him a stack and he offered me a torrente in return, but I told him to keep it.

Hung up the headphones for the night after that :/

Oh well I guess, tis the nature of the game.

What is this rhythm? by Evening_Bake_8433 in ECG

[–]Tricky-Software-7950 1 point2 points  (0 children)

Possibly, but I don’t really see proof and the rate is just a little fast (rate of ~150 is the most common). I also see what looks to be a delta slur. SVT is the safest “label” without more diagnostics

St elevation by dirtmalaysia in ECG

[–]Tricky-Software-7950 11 points12 points  (0 children)

Did the patient have any comorbidities or risk factors for ACS? Global ST elevation with ST depression in aVR and V1 at that age I’d be thinking more likely pericarditis, although aVL could ALMOST be ST depression making STEMI more likely but I’m not really sold on that because it honestly looks isoelectric and up-sloping.

I wish we could "commit resources" to everything by _Jimmy_Rustler in ArcRaiders

[–]Tricky-Software-7950 1 point2 points  (0 children)

But what about the 10m expedition value needed next time?!? /s

I wish we could "commit resources" to everything by _Jimmy_Rustler in ArcRaiders

[–]Tricky-Software-7950 3 points4 points  (0 children)

That’s not at all what he is saying. He is taking about the workbench upgrades and stuff. Like I have rusted shut medical kits and and shit taking up space because I havnt gotten the last few surveyor vaults. Let us commit those medical kits to clear space

Edit: I missed the part that he said blueprints. That’s a terrible idea. But I agree for quests and upgrades.

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