Question

The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and there are no discernible P waves. The ventricular rate is 90 beats per minute, and the patient is hemodynamically stable. The nurse realizes that the patient's rhythm is:

a. atrial fibrillation.
b. atrial flutter.
c. atrial flutter with rapid ventricular response.
d. junctional escape rhythm.

Answer 1

The heart rhythm described by the student is atrial fibrillation, due to the lack of P waves and an irregular ventricular rate of 90 beats per minute while the patient remains hemodynamically stable.

Step-by-step explanation:

The student's question describes a cardiac rhythm that is extremely irregular without discernible P waves, with a ventricular rate of 90 beats per minute, and the patient is hemodynamically stable. This description fits with a diagnosis of atrial fibrillation. Atrial fibrillation is characterized by a rapid and chaotic electrical activity in the atria, leading to an irregular and often rapid ventricular rate. The absence of discernible P waves on the cardiac monitor is a classic indication of atrial fibrillation, as the atria are not contracting in a coordinated manner. In contrast, atrial flutter would show a more organized rhythm with 'flutter' waves, and a junctional escape rhythm would have a slower rate and a regular rhythm. Since the patient's ventricular rate is 90 beats per minute, which is faster than would be seen with a junctional escape rhythm (30-40 beats per minute), and the patient is stable, this further supports the diagnosis of atrial fibrillation.