A nurse in an urgent care center is assessing a client who reports a sudden onset of irregular palpitations, fatigue, and dizziness. The nurse assesses a rapid and irregular heart rate with a significant pulse deficit. Which dysrhythmia does the nurse expect to find on the cardiac monitor?

The dysrhythmia on the cardiac monitor is Atrial Fibrillation (AFib). Here is why: Irregular Rhythm: In AFib, the atria are quivering (fibrillating) rather than contracting effectively. This leads to an "irregularly irregular" ventricular response. There is also no distinct P waves. The R-R intervals are variable Pulse Deficit: This is the hallmark of AFib. It occurs when the heart contracts so rapidly or ineffectively that some beats don't pump enough blood to produce a palpable peripheral pulse. If you feel the radial pulse while listening to the apical heart sound, you’ll notice the apical rate is higher than the radial rate. Sudden Palpitations and Dizziness: The loss of the "atrial kick" (which normally contributes about 20–30% of cardiac output) causes a sudden drop in blood pressure and oxygenation, leading to fatigue and lightheadedness.