The nurse is reviewing a patient's electrocardiogram (ECG) tracing. Which of the following are characteristics of normal sinus rhythm (NSR?

QRS interval less than or equal to 0.10 seconds

Heart rate 50-100 bpm

P waves are rounded and inverted, and follow each QRS complex

PR interval 0.34 to 0.43 seconds

Answer and Explanation

The Correct Answer is B

A.   The QRS interval may vary but is typically less than 0.12 seconds in normal sinus rhythm.
B.   Normal sinus rhythm typically has a heart rate between 50 and 100 beats per minute.
C.   In normal sinus rhythm, P waves are typically upright and precede each QRS complex.
D.   The PR interval may vary but is typically between 0.12 and 0.20 seconds in normal sinus rhythm.

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Correct Answer is B

Explanation

A. Fatigue is a common symptom in patients with multiple myeloma but may not directly impact safety in the home environment as much as other factors.
B. An unsteady gait can increase the risk of falls and injuries, making it a priority for safety considerations in the home environment.
C. Back pain is common in multiple myeloma but may not directly affect safety in the home environment unless it significantly impairs mobility.

D. Dyspnea on exertion may limit physical activity but may not pose an immediate safety risk in the home environment unless it indicates a severe respiratory compromise.

A. 80-year-old male patient with a history of atrial fibrillation with rapid ventricular response whose cardiac monitor shows a heart rate of 92 B. 66-year-old female patient with a newly inserted permanent pacemaker whose cardiac monitor shows a heart rate of 50 C. 72-year-old male patient with an implantable cardiac defibrillator that delivered a shock 4 hours ago whose cardiac monitor shows normal sinus rhythm and a heart rate of 68 D. 78-year-old male patient with chronic atrial fibrillation who is prescribed metoprolol (Toprol) whose cardiac monitor shows a heart rate of 58.

Correct Answer is B

Explanation

A. While atrial fibrillation with a rapid ventricular response requires attention, it is not an immediate concern unless associated with symptoms such as chest pain, shortness of breath, or hemodynamic instability.
B. A heart rate of 50 in a patient with a newly inserted permanent pacemaker may indicate bradycardia, which could be a sign of pacemaker malfunction or lead dislodgement. This patient requires immediate assessment to rule out complications.
C. While recent implantable cardioverter-defibrillator (ICD) discharge warrants evaluation, the patient is currently in normal sinus rhythm with a heart rate of 68, suggesting stability. This patient's assessment can be prioritized after the patient with the pacemaker issue is seen.
D. A heart rate of 58 in a patient with chronic atrial fibrillation on beta-blocker therapy may not be immediately concerning if the patient is asymptomatic and hemodynamically stable. This patient can be assessed after addressing the more urgent pacemaker issue.

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The nurse is reviewing a patient's electrocardiogram (ECG) tracing. Which of the following are characteristics of normal sinus rhythm (NSR?

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