Page 1735 - Saunders Comprehensive Review For NCLEX-RN

sitting in a chair

▪ Use of prescribed medications
▪ Dietary measures, including the avoidance of saturated fats and cholesterol and
the use of salt

▪ Resumption of sexual intercourse on the advice of the primary health care
provider or cardiologist after exercise tolerance is assessed (usually, if the client
can walk 1 block or climb 2 flights of stairs without symptoms, she or he can
resume sexual activity safely)

FIG. 52-5 Normal sinus rhythm. Both atrial and ventricular rhythms are essentially regular
(a slight variation in rhythm is normal). Atrial and ventricular rates are both 83 beats per
minute. There is one P wave before each QRS complex, and all P waves are of a
consistent morphology, or shape. The PR interval measures 0.18 seconds and is constant;
the QRS complex measures 0.06 seconds and is constant.

FIG. 52-6 Each segment between the dark lines (above the monitor strip) represents 3
seconds when the monitor is set at a speed of 25 mm/second. To estimate the ventricular
rate, count the QRS complexes in a 6-second strip and then multiply that number by 10 to
estimate the heart rate for 1 minute. In this example, there are 9 QRS complexes in 6
seconds. Therefore, the heart rate can be estimated as 90 beats per minute.

Box 52-3

Determination of Heart Rate Using 6-Second Strip
Method

▪ The method can be used to determine heart rate for regular and irregular
rhythms.
▪ To determine atrial rate, count the number of P waves in 6 seconds and multiply
by 10 to obtain a full minute rate.
▪ To determine ventricular rate, count the number of R waves or QRS complexes
in 6 seconds and multiply by 10 to obtain a full minute rate.

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