A nurse is assisting with care for a group of clients on a telemetry unit. Which of the following images should the nurse identify as ventricular fibrillation?

This scenario requires identifying different cardiac rhythms from descriptive textual waveforms on a telemetry unit. Knowledge of cardiac electrophysiology, normal sinus rhythm, atrial flutter, ventricular tachycardia, and the chaotic characteristics of ventricular fibrillation must be applied to make an accurate interpretation. Choice A rationale Normal sinus progression with regular P waves and QRS complexes represents a normal sinus rhythm. This indicates that the electrical impulse originates from the sinoatrial node and conducts normally through the atria and ventricles without arrhythmia. Choice B rationale Ventricular fibrillation is characterized by rapid, chaotic, completely irregular electrical activity within the ventricles. The muscle quivers without contracting, resulting in no discernible P waves, QRS complexes, or T waves, leading to zero cardiac output. Choice C rationale A sawtooth pattern of flutter waves with a regular ventricular response is characteristic of atrial flutter. This supraventricular tachycardia is caused by a rapid, regular re-entrant circuit in the atria, with a functional atrioventricular block. Choice D rationale A regular, wide-complex tachycardia at a rate of 180 beats per minute describes monomorphic ventricular tachycardia. This rhythm originates from an ectopic focus within the ventricles, displaying uniform, wide QRS complexes due to abnormal conduction.