How should the nurse interpret the electrocardiogram (ECG) of a patient which shows an atrial rate of 300-600 bpm, ventricular rate of 100-180 bpm, irregularly irregular rhythm, variable P:QRS, and PR interval that cannot be measured?
A) Atrial flutter
B) Atrial fibrillation
C) Paroxysmal supraventricular tachycardia
D) Sinus tachycardia
B) Atrial fibrillation
Explanation: A) The ECG in atrial flutter shows atrial rate of 240-360 bpm; ventricular rate depends on degree of atrioventricular block and usually is <150 bpm; atrial rhythm, regular; ventricular rhythm, usually regular; P:QRS: 2:1, 4:1, 6:1; PR interval: not measured; QRS complex: 0.6-0.10 sec.
B) In atrial fibrillation, the ECG reveals an atrial rate of 300-600 bpm, a ventricular rate of 100-180 bpm, an irregularly irregular rhythm, a variable P:QRS, and a PR interval that cannot be measured.
C) In paroxysmal supraventricular tachycardia, the ECG reveals a rate of 100-280 bpm (usually 150-200 bpm), regular rhythm; P waves often not identifiable; PR interval not measured, QRS complex 0.6-0.10 sec.
D) In sinus tachycardia, the ECG reveals a rate of 101-150 bpm; regular rhythm; 1:1 P:QRS; PR interval 0.12-0.20 sec., QRS complex 0.6-0.10 sec.
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