Which of the following ECG findings alerts the nurse that the client needs an antiarrhythmic?
A. Normal sinus rhythm
B. Sinus bradycardia
C. Sinus arrhythmia
D. Frequent ventricular ectopy
Correct Answer: D. Frequent ventricular ectopy
Ventricular ectopy can be a life-threatening arrhythmia; therefore, the client needs an arrhythmic. Frequent ventricular ectopy is a common clinical presentation in patients suffering idiopathic ventricular outflow tract arrhythmias. These are focal arrhythmias that generally occur in patients without structural heart disease and share a predilection for characteristic anatomic sites of origin Other choices are not arrhythmias that need to be treated.
Option A: Normal sinus rhythm is defined as the rhythm of a healthy heart. It means the electrical impulse from the sinus node is being properly transmitted. In adults, normal sinus rhythm usually accompanies a heart rate of 60 to 100 beats per minute.
Option B: Sinus bradycardia can be defined as a sinus rhythm with a resting heart rate of 60 beats per minute or less. However, few patients actually become symptomatic until their heart rate drops to less than 50 beats per minute. Patients should have continuous cardiac monitoring and intravenous access. In patients with sinus bradycardia secondary to therapeutic use of digitalis, beta-blockers, or calcium channel blockers, simple discontinuation of the drug, along with monitored observation, are often all that is necessary. Occasionally, intravenous atropine and temporary pacing are required.
Option C: Sinus arrhythmia is a commonly encountered variation of normal sinus rhythm. Sinus arrhythmia characteristically presents with an irregular rate in which the variation in the R-R interval is greater than 0.12 seconds. Additionally, P waves are typically monoform and in a pattern consistent with atrial activation originating from the sinus node. When present, sinus arrhythmia typically indicates good cardiovascular health.