The nurse is analyzing a 6-second ECG rhythm strip with the following findings: P to QRS ratio is 1:1; four regular R waves were present; QRS width was 0.10 second; PR interval was 0.18 second. How should the nurse document this rhythm?

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1. An atrioventricular block of 2:1 ratio would mean that there are two atrial deflections (P waves) per one ventricular response (QRS), which is negated by the findings of a P to QRS ratio of 1:1.
2. The rate is 40 beats per minute and does not meet the criteria for tachycardia, which is a rate greater than 100 beats per minute. In addition, a junctional rhythm would have an inverted P wave, or it may be hidden in the QRS, which would alter the PR interval.
3. Complete heart block would have two separate rates for the atrial initiation of charge (P waves) at one rate and the ventricular initiation of a separate rate and cycle unrelated to the P waves. Therefore, no conduction is occurring between the atria and ventricles, and both have set up their escape rhythms to try to compensate.
4. Bradycardia is a heart rate below 60, which is validated by the 4 R waves in 3 slash marks = 4 times 10 or a rate of 40 per minute. The P to QRS ratio shows normal conduction between the atria and the ventricle. The QRS width and PR interval are both within normal limits. Therefore, the problem is just a slower than normal heart rate called bradycardia.

The Nurse Is Analyzing a 6-Second ECG Rhythm Strip with the Following