The nurse obtains a rhythm strip on a patient who has had a ...

[theo]

The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis:
 
  no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, and QRS complex wide and distorted, QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as
  a. atrial flutter.
  b. sinus tachycardia.
  c. ventricular fibrillation.
  d. ventricular tachycardia.

Question 2

A patient has a junctional escape rhythm on the monitor. The nurse will expect the patient to have a heart rate of _____ beats/minute.
 
  a. 15 to 20
  b. 20 to 40
  c. 40 to 60
  d. 60 to 100

[kilada]

Answer to Question 1

ANS: D
The absence of P waves, wide QRS, rate >150 beats/minute, and the regularity of the rhythm indicate ventricular tachycardia. Atrial flutter is usually regular, has a narrow QRS configuration, and has flutter waves present representing atrial activity. Sinus tachycardia has P waves. Ventricular fibrillation is irregular and does not have a consistent QRS duration.

Answer to Question 2

ANS: C
If the sinoatrial (SA) node fails to discharge, the atrioventricular (AV) node will automatically discharge at the normal rate of 40 to 60 beats/minute. The slower rates are typical of the bundle of His and the Purkinje system and may be seen with failure of both the SA and AV node to discharge. The normal SA node rate is 60 to 100 beats/minute.