EKG Question #6
The nurse analyzes the following strip and determines that the interpretation is:
- 2nd Degree Mobitz II
- Third Degree (Complete) Heart Block
- 1st Degree with BBB
- Atrial flutter
The ECG above reveals upright P waves with some buried (see the first impulse reveals a P wave buried in the ST segment), variable P-R interval, and a wide QRS of 0.14 sec. P waves and QRS complexes will be occurring at different rates. The QRS complexes may be coming from impulses in the HIS bundle or Purkinje. A wide bizarre QRS with a heart rate of < 40 may indicate that the Purkinje network is where the impulses are originating. There is a blockage that prevents electrical cardiac impulses in the atria from entering the ventricular conduction system. The atria and ventricles are electrically dissociated from each other.