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1. Question
The nurse is monitoring a client’s cardiac rhythm when an abnormal rhythm occurs. Which of the following cardiac rhythms does the ECG strip (see image) indicate?
Correct
Option C is the correct answer:
Rationale: The irregular rhythm is an atrial fibrillation, which is characterized by a rapid, very irregular pulse with an atrial rate of 300 to 600 and ventricular rate of 120 to 200. Because the beats are rapid and ineffectual, the atria do not empty adequately, so blood begins to pool, increasing risk of thrombus formation and emboli. Because stroke volume decreases, cardiac output decreases, leading to myocardial ischemia and palpitations.
Incorrect
Option C is the correct answer:
Rationale: The irregular rhythm is an atrial fibrillation, which is characterized by a rapid, very irregular pulse with an atrial rate of 300 to 600 and ventricular rate of 120 to 200. Because the beats are rapid and ineffectual, the atria do not empty adequately, so blood begins to pool, increasing risk of thrombus formation and emboli. Because stroke volume decreases, cardiac output decreases, leading to myocardial ischemia and palpitations.
Atrial Fibrillation. Atrial fibrillation causes a rapid, disorganized, and uncoordinated twitching of atrial musculature. It is the most common dysrhythmia that causes patients to seek medical attention. It may start and stop suddenly. Atrial fibrillation may occur for a very short time (paroxysmal), or it may be chronic. Atrial fibrillation is usually associated with advanced age, valvular heart disease, coronary artery disease, hypertension, cardiomyopathy, hyperthyroidism, pulmonary disease, acute moderate to heavy ingestion of alcohol (“holiday heart” syndrome), or the aftermath of open heart surgery. Sometimes it occurs in people without any underlying pathophysiology (termed lone atrial fibrillation).
