Medical Surgical EKG #4

Question

A nurse is caring for a client who complained of sudden weakness, palpitations, and shortness of breath. The following electrocardiogram (ECG) is depicted below:

The nurse identifies the ECG as:

Answers

  1. Ventricular tachycardia
    • Rationale:

      This answer is not correct because ventricular tachycardia (VT) is an unusually fast heartbeat. It is defined as at least 3 or more heart beats of more than 100 bpm that originates from the ventricles. If VT lasts more than a couple of seconds at a time, it can be life-threatening. Atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm. Symptoms of weakness, dizziness, shortness of breath, palpitations, and chest pain may occur.

  2. Atrial flutter
    • Rationale:

      This answer is not correct because atrial flutter causes saw-toothed P waves between the QRS complexes. Atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm. The quivering atria may place the client at risk for thrombus formation. Symptoms of weakness, dizziness, shortness of breath, palpitations, and chest pain may occur.

  3. Atrial fibrillation
    • Rationale:

      This answer is correct because atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm. The quivering atria may place the client at risk for thrombus formation. Symptoms of weakness, dizziness, shortness of breath, palpitations, and chest pain may occur.

  4. First-degree heart block
    • Rationale:

      This answer is not correct because a first-degree atrioventricular (AV) block on an ECG strip shows a prolonged PR interval. This indicates a slowed conduction through the nodes to the ventricles. Atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm. The quivering atria may place the client at risk for thrombus formation. Symptoms of weakness, dizziness, shortness of breath, palpitations, and chest pain may occur.

Overview

Symptoms of weakness, dizziness, and shortness of breath are most associated with atrial fibrillation. Atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm.

Explanation

Learning Outcomes

Atrial fibrillation consists of multi-foci impulses, which are disorganized, usually without discernable P waves, and may have a rapid atrial rate of 350 – 600 bpm. The quivering atria may place the client at risk for thrombus formation. Symptoms of weakness, dizziness, shortness of breath, palpitations, and chest pain may occur.

Test Taking Tip

This may be a way to remember the look of atrial fibrillation: In atrial fibrillation, there is a rhythm that seems normal except for between the QRS and there are shaky looking lines, like if a person was shaking while writing, like they were nervous and shaking. The “LL” of fibrillation can help the student remember, “Lie, Lie”. When a person is lying, they are nervous and will be shaking (like the look of the rhythm between QRSs).

Video Rationale