I recognize this as A-fib, which is a fairly “stable” arrhythmia it may be cheating in a FAQ for new RNs to say that I, the old guy, already recognize the rhythm, but we learn by example, right?
The ventricular rate is not too fast. This is a very important concept in grasping the significance of arrhythmias: speed matters -usually we’re talking about ventricular speed here. Ventricles beating at a rate of 200 bpm have no time to physically fill up with blood therefore they don’t have much blood in them to pump out therefore cardiac output and blood pressure fall, and other bad things like death may ensue. Too slow a rate may have the same result sure, the ventricles have all the time they need to fill, but at such a slow rate, the cardiac output is still too low to maintain a blood pressure. What’s the ventricular rate in the strip above 70, we said. Sounds good to me. If the ventricular rate is kept around this range, the patient will probably do fine. A helpful basic concept: the ventricles do most of the pumping in generating a blood pressure. The rule is, no matter what else is happening, if the ventricular rate is somewhere near the normal range of sinus rhythm
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