A patient's heart rhythm shows a regular rate of 50 bpm. The P wave looks like an inverted notch and appears after the QRS complex. What should the nurse suspect as the reason for this patient's rhythm? Select all that apply.

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1. A junctional escape rhythm has a rate of 50, and the P wave looks like an inverted notch and occurs immediately after the QRS complex. This rhythm might be seen in patients taking digitalis.
2. A junctional escape rhythm has a rate of 50, and the P wave looks like an inverted notch and occurs immediately after the QRS complex. This rhythm is not associated with caffeine intake.
3. A junctional escape rhythm has a rate of 50, and the P wave looks like an inverted notch and occurs immediately after the QRS complex. This rhythm might be seen in patients with valvular disease, such as aortic regurgitation.
4. A junctional escape rhythm has a rate of 50, and the P wave looks like an inverted notch and occurs immediately after the QRS complex. This rhythm might be seen in patients recovering from cardiac surgery.
5. A junctional escape rhythm has a rate of 50, and the P wave looks like an inverted notch and occurs immediately after the QRS complex. This rhythm might be seen in patients with an acute myocardial infarction.

A Patient's Heart Rhythm Shows a Regular Rate of 50