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A client in an urgent care clinic is reports having heart palpitations, and occasional shortness of breath. A 12-lead electrocardiogram (ECG) shows regular P- waves in a sawtooth formation at a rate of 260 beats per minute, and a regular ventricular rate of 82 beats per minute. The nurse should understand that this ECG finding represents which of the following conditions?

A.

Atrial fibrillation

B.

Atrial flutter

C.

Unstable angina

D.

Premature atrial contractions

Answer and Explanation

The Correct Answer is B

A.    Atrial fibrillation is characterized by irregularly irregular rhythms with no distinct P-waves. Instead, it has a chaotic baseline with fibrillatory waves. The ventricular response can be irregular and variable. The description provided (regular P-waves in a sawtooth formation) does not match the typical appearance of atrial fibrillation, which lacks regular P-waves and has an irregular rhythm.
B.    Atrial flutter is characterized by regular, sawtooth-shaped P-waves known as "F-waves" or "flutter waves." The classic pattern is referred to as "F-waves" with a "sawtooth" appearance, often seen in the inferior leads (II, III, aVF). The atrial rate is typically between 240 to 340 beats per minute, which fits the rate of 260 beats per minute in the description. The ventricular rate can be regular or irregular, depending on the degree of AV node conduction. A
 
C.    Unstable angina is a clinical diagnosis of chest pain due to myocardial ischemia. It is not associated with specific ECG findings related to the P-wave morphology or rate. The ECG findings described do not correspond to unstable angina, which would typically present with ST-segment changes or other signs of myocardial ischemia rather than a specific P-wave pattern.
D.    Premature atrial contractions (PACs) are early beats originating from the atria that interrupt the normal rhythm. They usually present as a single early beat with a different morphology of the P-wave compared to the sinus P-waves, but do not result in a regular sawtooth pattern or a sustained rhythm at high rates like the one described.
 


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Related Questions

Correct Answer is ["50"]

Explanation

Flow rate in gtt/min = (Volume in mL * Drop factor) / Time in minutes.
The prescribed volume is 150 mL/hr. Since there are 60 minutes in an hour, the time for one hour would be 60 minutes. The drop factor is 20 gtt/mL.
(150 mL/hr * 20 gtt/mL) / 60 min/hr = 3000 gtt/hr / 60 min/hr = 50 gtt/min.
Therefore, the nurse should set the manual IV infusion to deliver 50 gtt/min.

Correct Answer is B

Explanation

A. Gallstones are formed in the gallbladder and are not directly related to PKD.

B. Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts can obstruct the flow of urine, making it easier for bacteria to grow and cause a urinary tract infection (UTI).
C. Hypotension is low blood pressure. While PKD can lead to kidney failure, which can cause hypotension, it is not a common complication.
D. Osteoporosis is a condition characterized by weak bones. While PKD can lead to kidney failure, which can affect calcium metabolism and contribute to osteoporosis, it is not a common complication.

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