The nurse is reviewing a patient's electrocardiogram (ECG) tracing. Which of the following are characteristics of normal sinus rhythm (NSR?

QRS interval less than or equal to 0.10 seconds

Heart rate 50-100 bpm

P waves are rounded and inverted, and follow each QRS complex

PR interval 0.34 to 0.43 seconds

Answer and Explanation

The Correct Answer is B

A.   The QRS interval may vary but is typically less than 0.12 seconds in normal sinus rhythm.
B.   Normal sinus rhythm typically has a heart rate between 50 and 100 beats per minute.
C.   In normal sinus rhythm, P waves are typically upright and precede each QRS complex.
D.   The PR interval may vary but is typically between 0.12 and 0.20 seconds in normal sinus rhythm.

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Correct Answer is C

Explanation

A. Sinus bradycardia may not require immediate intervention if the patient is asymptomatic and stable.
B. Asymptomatic premature atrial contractions may not require immediate attention unless they are associated with significant symptoms or hemodynamic instability.
C. Dyspnea in a patient with atrial fibrillation may indicate heart failure or other complications and requires prompt assessment and intervention.
D. Sinus tachycardia may not require immediate intervention if the patient is asymptomatic and stable.

A. "The pain occurs as a residual pain from cholecystitis." B. "The pain results from lying in one position too long during surgery." C. "The pain is caused from the nitrous dioxide injected into the abdomen." D. "The pain will dissipate if you ambulate frequently."

Correct Answer is D

Explanation

A. Postoperative pain typically resolves after a laparoscopic cholecystectomy since the surgery removes the gallbladder
B. While positioning during surgery can cause discomfort, isolated right shoulder pain is more commonly attributed to the diaphragmatic irritation from residual nitrous oxide in the abdomen.

C. Nitrous dioxide used during laparoscopic procedures is not associated with referred pain to the right shoulder. The pain is due to carbon dioxide gas used during the procedure resulting in the irritation of the diaphragm.
D. This pain is often due to the carbon dioxide used to inflate the abdomen during surgery, which can irritate the diaphragm and refer pain to the shoulder. Ambulation helps to absorb the gas more quickly.

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