Question

identify this rhythm
question 3 of 25
atrial pacing
av (dual) pacing with undersensing, notify chain of command, rn, charge, provider, prepare for 12-lead, probable pacemaker interrogation
ventricular pacing
av pacing

Explanation:

Analyze the pacing spikes and complexes

The ECG strip shows pacing spikes preceding both P waves and QRS complexes, indicating AV (dual-chamber) pacing. However, there are also pacing spikes occurring inappropriately, such as a ventricular pacing spike falling directly on the T wave of the fourth complex. This indicates a failure of the pacemaker to sense intrinsic cardiac activity (undersensing).

Evaluate the clinical management options

When pacemaker malfunctions like undersensing are identified, appropriate clinical management includes notifying the chain of command (RN, Charge, provider), obtaining a diagnostic 12-lead ECG, and preparing for pacemaker interrogation to adjust the sensitivity settings.

Answer:

• (A) Atrial pacing
• (B) AV (dual) pacing with undersensing, notify chain of command, RN, Charge, provider, prepare for 12-lead, probable pacemaker interrogation (Correct answer)
• (C) Ventricular pacing
• (D) AV pacing