A nurse is monitoring the electrocardiogram (EKG) of a patient in the intensive care unit (ICU). The monitor shows a regular P to P interval with intermittent QRS waves that have regular intervals when occurring, but are often missing. The EKG demonstrates no correlation between P waves and QRS waves. The nurse knows that this indicates which of the following heart rhythms?

Third-degree AV block


•Third-degree AV heart block is seen when no atrial electrical impulses can conduct past the AV node to the ventricles. 

•All QRS waves noted in third-degree AV block occur from intrinsic depolarization in the ventricles at a rate of less than 40 beats per minute.

•Since there is no "communication" between the atria and ventricles, the upper and lower heart chambers beat independently of each other instead of being "in sync."

•This condition almost always will require a pacemaker or death can occur if the ventricles stop depolarizing. 

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