. What would be the best immediate treatment for this patient.
A 30-year-old male with a history of paroxysmal (from time to time) atrial dysrhythmias reports to the emergency room complaining of shortness of breath, dizziness, and intermittent heart palpitations. He holds a somewhat stressful job as an accountant with a local accounting firm, lives alone, and participates regularly in physical activities, playing in a local amateur soccer league. The patient reports that he is taking quinidine to control his dysrhythmias, and that he has been stable on this medication for about 2 years without any episodes, but that he occasionally misses doses when he gets busy.
The patient undergoes a physical assessment and is given an ECG. The results of the examination and ECG are as follows:
Neurological: AAOx3 (patient is awake, aware, and oriented to place, time, and person)
Pulmonary: Normal, with slightly increased respiratory rate
Gastrointestinal: Normal bowel sounds, but patient complains of intermittent nausea
Genitourinary: Normal, no patient complaints
Cardiovascular: Rapid, irregular pulse; patient complains of chest pain and occasional heart palpitations
Vitals: HR 152 and irregular; respiratory rate 29/min; BP 100/52; Temp 36.8 C; O2 saturation 96%
Medications: Quinidine 400mg 3xday; multivitamin; aspirin 80mg/day
Labs: Na+ 135 mEq/L; K+ 2.9 mEq/L; BUN 27; creatinine 1.4 mg/dL; fasting blood glucose 99 mg/dL
ECG- abnormal
1. What type of dysrhythmia does this patient have?
2. What are the characteristics of this type of dysrhythmia, as compared to a normal ECG?
3. What is the most likely cause of this dysrhythmia? (refer to the lab results above)
4. What would be the best immediate treatment for this patient.
5. Does this patient have a good or a poor prognosis (long-term outlook)? Explain your answer fully.