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The nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis: no visible P waves, P-R interval not measurable, ventricular rate 162, R-R interval regular, QRS complex wide and QRS duration 0.18 second. The nurse interprets the patient's cardiac rhythm as

A.

ventricular tachycardia.

B.

ventricular fibrillation.

C.

sinus tachycardia.

D.

atrial flutter.

Answer and Explanation

The Correct Answer is A

A. Ventricular tachycardia is characterized by a ventricular rate >100 bpm, regular rhythm, no visible P waves, and wide QRS complexes (>0.12 seconds). The findings described—ventricular rate of 162, regular R-R intervals, no visible P waves, and a QRS duration of 0.18 seconds—are consistent with ventricular tachycardia.
B. Ventricular fibrillation shows a chaotic, irregular rhythm with no identifiable QRS complexes, which is not the case here.
C. Sinus tachycardia would have visible P waves and a normal QRS duration.
D. Atrial flutter typically has "sawtooth" flutter waves and a more organized atrial rhythm with a distinct P wave pattern, which is absent in this scenario.


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Related Questions

Correct Answer is D

Explanation

A. Ventricular tachycardia is a run of three or more consecutive ventricular beats at a rapid rate, not every other beat.
B. Multifocal premature ventricular contractions (PVCs) arise from different ventricular foci and have different shapes, but this scenario describes uniform shape and consistent pattern.
C. Ventricular couplets are two consecutive PVCs, not a pattern where every other beat is abnormal.
D. Ventricular bigeminy is the correct term for a rhythm in which every other beat is a premature ventricular contraction (PVC). These PVCs typically have no visible P wave and a wide, bizarre QRS complex, matching the description given.

Correct Answer is A

Explanation

A. Epinephrine – Epinephrine is the first-line treatment for anaphylactic shock. It rapidly reverses airway constriction, hypotension, and swelling by stimulating alpha and beta-adrenergic receptors, leading to bronchodilation, vasoconstriction, and increased cardiac output.
B. Dobutamine – Dobutamine is a positive inotrope used to treat cardiogenic shock and may support cardiac output, but it does not address the airway or allergic component of anaphylaxis.
C. Methylprednisolone – This corticosteroid may be given to reduce inflammation and prevent delayed reactions, but it has a slower onset of action and is not the priority in emergency management.
D. Furosemide – This diuretic is used in fluid overload or pulmonary edema, not in the management of anaphylaxis.

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