Medical Surgical EKG #5

Question

The nurse admits a client to the cardiac floor for a scheduled intervention. The initial electrocardiogram depicts the following:

The nurse determines the rhythm is:

Answers

  1. Atrial fibrillation
    • Rationale:

      This answer is not correct because atrial fibrillation, although somewhat similar to atrial flutter, has an irregular, uncoordinated rhythm. Whereas, atrial flutter presents on the ECG as a fast, regular, coordinated rhythm but the atria appears as a characteristic saw-tooth pattern.

  2. Atrial flutter
    • Rationale:

      This answer is correct because atrial flutter presents on the ECG as a fast, regular, coordinated rhythm but the atria appears as a characteristic saw-tooth pattern. Atrial flutter is a heart arrhythmia where the atria (the heart’s upper chambers) beat too quickly.

  3. Sick Sinus Syndrome
    • Rationale:

      This answer is not correct because sick sinus syndrome (also known as sinus node dysfunction) is when the heart’s pacemaker (the SA node) does not produce a heart rate that meets the body’s perfusion needs. Sick sinus syndrome can cause various manifestations on the ECG, including sinus bradycardia, sinoatrial block, sinus arrest, and alternating patterns of tachycardia and bradycardia.

  4. Sinus Tachycardia
    • Rationale:

      This answer is not correct because sinus tachycardia is depicted by a regular sinus rhythm but the rate is greater than 100 bpm. It is most often caused by increased stress, anxiety, caffeine, and exercise.

Overview

Atrial flutter presents on the ECG as a fast, regular, coordinated rhythm but the atria appears as a saw-tooth pattern.

Explanation

Learning Outcomes

Atrial flutter is a heart arrhythmia where the atria (the heart’s upper chambers) beat too quickly. Atrial flutter is similar to atrial fibrillation except atrial flutter is less chaotic than atrial fibrillation. Atrial flutter presents on the ECG as a fast, regular, coordinated rhythm but the atria appears as a characteristic saw-tooth pattern. Some clients with atrial flutter are asymptomatic but some can experience serious complications such as stroke or heart failure. Treatment includes medication, synchronized cardioversion, or ablation.

Test Taking Tip

Atrial flutter has a very distinctive saw-tooth pattern. It can also look like a butterfly fluttering its wings, up and down, going from QRS to QRS.

Video Rationale