A client is to receive LR 1000 ml over 8 hours. The IV tubing drop rate is 60 gtts/ml. What is the correct rate (gtts/min)? DOCUMENT ANSWER AS: RATE gtts/min (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

A. The P-P and R-R distances are equal and regular: Equal and regular spacing between P-P and R-R intervals indicates that both atrial and ventricular rhythms are regular. This is a fundamental aspect of rhythm interpretation, helping to distinguish between regular and irregular rhythms such as atrial fibrillation or sinus arrhythmia.

B. The rhythm rate using a 3-second strip: Assessing the heart rate using a 3-second or 6-second ECG strip helps determine whether the rhythm is bradycardic, tachycardic, or within normal limits, which is crucial for accurate rhythm classification.

C. The duration of the U waves: U waves are typically small and follow the T wave. Although their presence can suggest conditions like hypokalemia, they are not routinely assessed in basic rhythm identification. Evaluating U wave duration is more relevant in electrolyte imbalance analysis than in identifying rhythm type.

D. There is a QRS complex after each P wave: A consistent QRS following every P wave indicates effective conduction from the atria to the ventricles. Each atrial depolarization (P wave) should be followed by a ventricular depolarization (QRS complex) if the signal is being conducted properly through the AV node. This finding supports a diagnosis of sinus rhythm and helps rule out AV blocks, where conduction may be delayed or blocked entirely.

E. P waves are present, upright and rounded: P waves that are upright and rounded in lead II suggest the electrical impulse is originating from the SA node. Their presence and morphology are essential criteria for identifying sinus rhythm and differentiating it from atrial arrhythmias like flutter or fibrillation.

A. Atria is taking longer to depolarize and contract: This would be indicated by a prolonged or abnormal P wave, not a normal PR interval. The rhythm strip shows clearly visible, normal-appearing P waves followed by QRS complexes, ruling this out as the correct interpretation.

B. Conduction time is slowed from the SA node to the ventricles: A slowed conduction time would result in a PR interval longer than 0.20 seconds, characteristic of first-degree AV block. The PR interval on this strip measures within the standard range (0.12–0.20 seconds), so this is not accurate.

C. The PR interval is within the normal time limits: The PR interval on the ECG strip spans about 3 to 4 small boxes (0.12–0.16 seconds), which is within the normal range of 0.12 to 0.20 seconds. This indicates normal conduction from the atria through the AV node to the ventricles.

D. Ventricular repolarization is delayed: Delayed ventricular repolarization refers to a prolonged QT interval, not an abnormality in the PR interval. The PR interval evaluates atrial conduction, not ventricular repolarization, so this is an incorrect association.