A 65-year-old man arrives in the Emergency Department with heart palpitations. His BP is 148/84, respirations are 18 per min., temperature is 98.6o F, and his heart rate is fast (ECG strip). H

A 65-year-old man arrives in the Emergency Department with heart palpitations. His BP is 148/84, respirations are 18 per min., temperature is 98.6o F, and his heart rate is fast (ECG strip). He says he feels as though his heart were racing. He had a similar episode during the last year and says that, by using the Valsalva maneuver (bearing down), he was able to slow his heart rate on his own.
He is not taking any medications and has no prior medical history other than degenerative joint disease requiring a right total knee replacement 2 years ago. Once in the ED, the ECG monitor is applied.
1. What do you interpret this ECG as?
2. What is your initial treatment for this patient?
3. What further assessment would you perform?
4. Following the appropriate assessment, the rhythm shows on the monitor as:
5. The patient’s vital signs are still stable except for the fast heart rate. Your next appropriate treatment choice for this patient is..?
6. Following the appropriate treatment in question 5, the rhythm shows on the monitor as:
7. The patient is still responsive and stable, but after 1-2 minutes this above rhythm shows on the monitor. Your next appropriate treatment for this patient is to:
8. Following the appropriate treatment in question 7, this rhythm shows on the monitor:
9. After 2 minutes the rhythm still shows on the monitor. Now your most appropriate treatment choice is to:
10. Following the appropriate treatment, the rhythm on the monitor is:
11. After about 30 minutes the patient feels calm and has a temperature of 98.6o F, respirations are 12 per minute and a BP of 130/80 mm Hg. His rhythm is: