How would the nurse document the heart rhythm shown on this EKG strip?
Explanation & Rationale
A. Atrial flutter: The baseline shows a rapid, regular, and "saw-tooth" pattern of atrial activity. These are referred to as F-waves (flutter waves). Atrial flutter is characterized by rapid, regular atrial depolarizations with a consistent ventricular response. The rhythm is usually regular or regularly irregular depending on the AV conduction ratio. B. Supraventricular Tachycardia: Supraventricular tachycardia (SVT) is a rapid, regular rhythm originating above the ventricles, often with a narrow QRS, but it does not display the characteristic sawtooth flutter waves seen in atrial flutter. SVT documentation would be incorrect if the flutter waves are clearly visible. C. Atrial fibrillation: Atrial fibrillation presents with an irregularly irregular rhythm and absence of distinct P waves, replaced by chaotic fibrillatory waves. Unlike atrial flutter, atrial fibrillation does not show organized, repetitive atrial activity, making this label inaccurate for the described EKG. D. Sinus rhythm: Sinus rhythm is defined by a normal P wave before each QRS complex with consistent rate and rhythm. Atrial flutter deviates from normal sinus activity due to abnormal atrial depolarizations and cannot be documented as sinus rhythm.