Which abnormal ECG wave is seen in a patient with hypothermia?

Appeared in: NORCET 8 Prelims-2025

Explanation

The Osborn wave and the J wave are two synonymous names for the same electrocardiogram (ECG) finding.
This wave is a characteristic positive deflection ('hump') seen at the J-point, which is the junction between the QRS complex and the ST segment.
It is a pathognomonic sign of hypothermia, typically appearing when the core body temperature drops below 32°C (90°F).
Because both 'Osborn wave' and 'J wave' are correct terms for the same phenomenon, the option that acknowledges both is the most complete and accurate answer.

Option A: This option is incomplete. While 'Osborn wave' is a correct term for the ECG finding in hypothermia, it is also known as the 'J wave'. Choosing this option alone fails to acknowledge the synonymous nature of the terms.
Option B: This option is incomplete. While 'J wave' is a correct term, the finding is also famously known as the 'Osborn wave'. The best answer choice acknowledges that both terms are used for the same wave.
Option D: This is incorrect because a very specific and well-documented ECG wave, the Osborn (or J) wave, is associated with hypothermia.

Clinical Relevance

Nursing practice connection: Use the key finding related to ECG interpretation in hypothermia to guide bedside assessment, documentation, and the next nursing action.
A nurse's ability to recognize the Osborn (J) wave on a cardiac monitor is a critical skill for the early identification of severe hypothermia, prompting immediate intervention.
When hypothermia is suspected, patients must be handled with extreme care (e.g., during transfers or turning) as rough movement can precipitate life-threatening arrhythmias like ventricular fibrillation.
The size of the Osborn wave is generally proportional to the degree of hypothermia; a decreasing wave size during rewarming is a positive prognostic sign.

How to Approach the Question

First, identify the core concept of the question, which is the specific ECG finding associated with hypothermia.
Recall the key pathognomonic sign for hypothermia on an ECG.
You should remember that this sign is called both the 'Osborn wave' and the 'J wave'.
Examine the options provided. Notice that Option A and Option B are both correct, individual names for the same wave.
Recognize that Option C combines both correct terms.
In test-taking, when two options are individually correct synonyms and a third option combines them or acknowledges their relationship, that combined option is usually the intended 'best' answer. Select the most comprehensive choice.

Concept Tested & Keywords

QjJNgKzLPIaNgnwRA1mj1P

E6 Medicine Harrison 22e Part 1 pp. 1916-1918, 1915-1917

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