Monitoring a client's heart rhythm via central telemetry, which rhythm requires immediate nursing action?

• A. Normal sinus rhythm
• B. Atrial flutter
• C. Ventricular fibrillation
• D. Sinus tachycardia

Answer: (C)

When monitoring with central telemetry, the priority is rhythms that eliminate effective heart pumping and perfusion. Ventricular fibrillation fits that urgent scenario: the rhythm is chaotic and utterly disorganized, with no recognizable P waves or QRS complexes. There is no coordinated ventricular contraction, so cardiac output drops to almost nothing. This demands immediate nursing action—check for a pulse, initiate CPR, alert the code team, and prepare for defibrillation as soon as possible.

Normal sinus rhythm, by contrast, is regular with normal P waves and QRS complexes and typically indicates stable perfusion, so it does not require urgent intervention. Atrial flutter shows a rapid but organized atrial rhythm with sawtooth flutter waves; management focuses on rate control and rhythm conversion as appropriate, depending on stability. Sinus tachycardia is a fast but organized rhythm usually driven by reversible factors (pain, fever, dehydration, hypoxia); addressing those underlying causes is the main approach, unless the patient becomes unstable.