A nurse is caring for a client in a cardiac unit. Using the five criteria for ECG analysis information, the nurse interprets the client's ECG as which of the following rhythm interpretations?Heart Rate: 59 bpmRhythm: RegularPresence of P waves: One P wave for every QRS complexPR interval: 0.20 secondsQRS complex duration: 0.10 seconds
Ventricular tachycardia
Sinus tachycardia
Sinus bradycardia
Normal sinus rhythm
The Correct Answer is C
A) Ventricular tachycardia: Ventricular tachycardia is characterized by a rapid heart rate exceeding 100 bpm, typically arising from abnormal ventricular activity. In this case, the heart rate is 59 bpm, which does not support this interpretation. Additionally, ventricular tachycardia usually presents with wide QRS complexes and no discernible P waves, neither of which is true in this scenario.
B) Sinus tachycardia: Sinus tachycardia is defined by a heart rate exceeding 100 bpm originating from the sinoatrial (SA) node, with a regular rhythm and normal P waves. The heart rate of 59 bpm in this client is too low for a diagnosis of sinus tachycardia, making this option incorrect.
C) Sinus bradycardia: Sinus bradycardia occurs when the heart rate is less than 60 bpm, with a regular rhythm and a normal PR interval and QRS duration. The provided data shows a heart rate of 59 bpm, a regular rhythm, one P wave for every QRS complex, a PR interval of 0.20 seconds, and a QRS duration of 0.10 seconds, which aligns perfectly with the criteria for sinus bradycardia.
D) Normal sinus rhythm: Normal sinus rhythm typically presents with a heart rate of 60-100 bpm, a regular rhythm, and appropriate P waves for each QRS complex. Given the heart rate of 59 bpm, this does not meet the criteria for normal sinus rhythm, as it falls below the acceptable range.
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Correct Answer is C
Explanation
A) Ventricular tachycardia: Ventricular tachycardia is characterized by a rapid heart rate exceeding 100 bpm, typically arising from abnormal ventricular activity. In this case, the heart rate is 59 bpm, which does not support this interpretation. Additionally, ventricular tachycardia usually presents with wide QRS complexes and no discernible P waves, neither of which is true in this scenario.
B) Sinus tachycardia: Sinus tachycardia is defined by a heart rate exceeding 100 bpm originating from the sinoatrial (SA) node, with a regular rhythm and normal P waves. The heart rate of 59 bpm in this client is too low for a diagnosis of sinus tachycardia, making this option incorrect.
C) Sinus bradycardia: Sinus bradycardia occurs when the heart rate is less than 60 bpm, with a regular rhythm and a normal PR interval and QRS duration. The provided data shows a heart rate of 59 bpm, a regular rhythm, one P wave for every QRS complex, a PR interval of 0.20 seconds, and a QRS duration of 0.10 seconds, which aligns perfectly with the criteria for sinus bradycardia.
D) Normal sinus rhythm: Normal sinus rhythm typically presents with a heart rate of 60-100 bpm, a regular rhythm, and appropriate P waves for each QRS complex. Given the heart rate of 59 bpm, this does not meet the criteria for normal sinus rhythm, as it falls below the acceptable range.
Correct Answer is C
Explanation
A) Vitamin A: While vitamin A can affect various bodily functions, it is not known to have a direct interaction with warfarin. Therefore, it is not considered incompatible with warfarin therapy.
B) Alprazolam: This medication, a benzodiazepine, is primarily used to treat anxiety and does not have a significant interaction with warfarin. Thus, it is not incompatible with warfarin therapy.
C) Vitamin K: This vitamin is a critical consideration when a client is on warfarin therapy. Warfarin works by inhibiting vitamin K-dependent clotting factors, so an increased intake of vitamin K can counteract the effects of warfarin, making this the correct answer. Clients on warfarin should maintain a consistent intake of vitamin K to prevent fluctuations in their INR levels.
D) Furosemide: This loop diuretic is used to manage conditions such as heart failure and edema. While it may affect electrolyte levels, it does not have a direct interaction that would render it incompatible with warfarin. It can be safely used alongside warfarin with appropriate monitoring.