John Smith presents to the emergency department with complai…
John Smith presents to the emergency department with complaints of palpitations, shortness of breath, and fatigue over the past 24 hours. He reports feeling lightheaded and having intermittent chest discomfort. Nurses’ Notes 0730-John Smith, a 65 year-old male presents to the emergency department with complaints of palpitations, shortness of breath, and fatigue over the past 24 hours. He reports feeling lightheaded and having intermittent chest discomfort. Past medical history includes hypertension, Diabetes Type 2, and hyperlipedema. He is a 1 pack/day smoker for 40 years. Drinks socially 1-2 drinks a month. Lungs sounds are clear to auscultation bilaterally. He is A & O x 4. 1+ edema noted to bilateral ankles. Peripheral pulses are palpable. His home medications include Metformin, Lisinopril and Atrovastatin. Vital signs: b/p 150/90 mmHg, HR 120 bpm and irregular, RR 20 breaths/min, Temp 98.6 F , O2 sat is 95% on room air. Patient is connected to the cardiac monitor. Then nurse is reviewing the patient’s ECG tracing on the cardiac monitor and notices there is not recognizable or discernible P waves and no PR interval. QRS complexes are consistent in shape and normal in duration but are present at an irregular rate. What dysrhythmia is Mrs. Smith most likely experiencing?