A patient reports dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains the following electrocardiographic (ECG) tracing
The nurse interprets this heart rhythm as
a. junctional escape rhythm.
b. accelerated idioventricular rhythm.
c. third-degree atrioventricular (AV) block.
d. sinus rhythm with premature atrial contractions (PACs).
ANS: C
The inconsistency between the atrial and ventricular rates and the variable P-R interval indicate that the rhythm is third-degree AV block. Sinus rhythm with PACs will have a normal rate and consistent P-R intervals with occasional PACs. An accelerated idioventricular rhythm will not have visible P waves.
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