Question

The nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves, no definable QRS complexes, and coarse wavy lines of varying amplitude. How should the nurse correctly interpret this rhythm?

1.Asystole
2.Atrial fibrillation
3.Ventricular fibrillation
4.Ventricular tachycardia

Answer 1

The described ECG changes indicate ventricular fibrillation, a life-threatening condition where the heart displays erratic and ineffective electrical activity. It's not ventricular tachycardia, as the ECG would show regular, fast QRS complexes instead.

Step-by-step explanation:

The clinical scenario described suggests the client experienced a premature ventricular contraction (PVC) that falls on the T wave, potentially triggering a dangerous form of arrhythmia. Upon observing the change in rhythm to one without P waves, definable QRS complexes, and coarse, irregular wavy lines, this is indicative of ventricular fibrillation (VFib). VFib is a life-threatening emergency characterized by erratic electrical activity in the ventricles, leading to ineffective quivering instead of synchronized contractions.

In ventricular fibrillation, there is no effective cardiac output, which can rapidly lead to cardiac arrest if not treated immediately with advanced life support measures like defibrillation and cardiopulmonary resuscitation (CPR). The description given doesn't match ventricular tachycardia, which is characterized by regular and fast QRS complexes, nor does it align with the other forms of heart block or atrial fibrillation where distinct abnormalities are present but maintain a form of rhythm.