Question

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).

Answer 1

The nurse interprets the patient's ECG tracing as indicating a third-degree atrioventricular (AV) block, a condition where atrial and ventricular activities are completely dissociated, as seen on the electrocardiogram. This form of heart arrhythmia can be severe and may necessitate the use of an artificial pacemaker for rhythm correction.

Step-by-step explanation:

The patient's ECG tracing, as described, indicates a heart rhythm that a nurse would interpret as a third-degree atrioventricular (AV) block. In this condition, there is no correlation between the atrial activity, represented by the P wave, and the ventricular activity, represented by the QRS complex. This separation means that electrical signals from the atria do not reach the ventricles, which then beat at their own rate, independent of the atrial rhythm. Third-degree AV block is also known as a complete heart block and is evidenced on an electrocardiogram (ECG) by the complete dissociation of the P waves and QRS complexes. Heart arrhythmias, like the third-degree AV block, can be life-threatening and may require intervention such as the implantation of an artificial pacemaker to maintain an effective heart rhythm. The heart arrhythmias are a result of problems with the heart's electrical conduction system, which can be diagnosed with tools such as the ECG or a Holter monitor.