The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

2nd degree Mobitz Il

Atrial flutter

Sinus bradycardia

1st degree AV block

Answer and Explanation

The Correct Answer is D

A.   This type of AV block is characterized by a progressively lengthening PR interval until a QRS complex is dropped (a blocked beat). A PR interval of 0.28 seconds could be seen in 2nd degree Mobitz I (Wenckebach), not Mobitz II, which has a more irregular pattern of dropped beats
B.   Atrial flutter: Atrial flutter is a type of arrhythmia characterized by rapid atrial rates (typically around 250-350 beats per minute) with a sawtooth pattern of P-waves. It does not relate to the PR interval, but rather the atrial rhythm.
C.   Sinus bradycardia: Sinus bradycardia is characterized by a slower-than-normal heart rate (less than 60 beats per minute), but this does not affect the PR interval directly. A normal PR interval (0.12-0.20 seconds) can still be seen in sinus bradycardia, so the prolonged PR interval in this case makes sinus bradycardia less likely.
D.   1st degree AV block: In 1st degree AV block, the PR interval is consistently prolonged, usually more than 0.20 seconds, but it is still a constant, non-variable delay in the conduction between the atria and ventricles. A PR interval of 0.28 seconds (which is longer than normal but consistent) is characteristic of a first-degree AV block, making it the correct answer.

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Correct Answer is D

Explanation

A. A value of 119 seconds would indicate a therapeutic or even elevated level of heparin, as it is much higher than the normal aPTT range.
B. A value of 98 seconds is still above the normal aPTT range, suggesting that the heparin level is therapeutic, or even too high, but not sub-therapeutic.
C. This is just slightly above the normal range and might be considered a therapeutic range for someone
on heparin, but it’s not sub-therapeutic.
D. This aPTT value is above the normal range but likely not high enough to indicate therapeutic heparin levels, which should typically be between 1.5 to 2.5 times the normal aPTT. A sub-therapeutic level could be indicated with a lower value.

A. Second degree AV block- Mobitz II B. Sinus bradycardia with first degree AV block C. Second degree AV block- Mobitz I D. Third degree heart block

Correct Answer is C

Explanation

A. Mobitz II is a type of second-degree AV block characterized by constant PR intervals and sudden dropped QRS complexes (i.e., the PR interval does not lengthen progressively). This is a more serious block because the dropped beats are unpredictable and could lead to complete block.
B. Sinus bradycardia is a slower-than-normal heart rate (usually less than 60 beats per minute) that originates from the sinus node. First-degree AV block is characterized by a prolonged PR interval, but unlike second-degree block, there are no dropped QRS complexes.
C. Mobitz I (Wenckebach) is a second-degree AV block where the PR interval gradually lengthens with each successive beat until a QRS complex is dropped. After the dropped beat, the cycle repeats. This is a relatively benign block and often resolves without intervention, though it requires monitoring.
D. Third-degree heart block (also known as complete heart block) occurs when there is no communication between the atria and ventricles. The atria and ventricles beat independently of each other. There are no relationship between the P waves and QRS complexes, and the ventricular rate is typically slower than the atrial rate.

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			Male: 14- 17.3 g/dL
Hematocrit	26%	24%	Female: 36%-48% Male: 42%-52%
Platelets	35,000mm3	20,000mm3	150,000- 450,000mm3
RBC	4.5 mm3	3mm3	Female: 4.01-5.51 million/mm3 Male: 4.51-

The nurse notes that the client's rhythm strip indicates a PR-interval of 0.28 seconds. What is the nurse's analysis of this problem?

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