Which heart rhythm should the nurse report if a client exhibits three P waves for each QRS complex with a rate of 240 beats per minute?

The scenario described involves a rhythm where there are three P waves for each QRS complex and a rapid heart rate of 240 beats per minute. This is characteristic of atrial flutter, a type of supraventricular tachycardia.

In atrial flutter, the atrial electrical activity results in a rapid and organized but abnormal firing of impulses, leading to multiple P waves (often described as "sawtooth" patterns) for every QRS complex. The rapid heart rate is due to the increased atrial activity and the consequent conduction of these impulses through the AV node into the ventricles, resulting in a significantly elevated heart rate.

The presence of three P waves for every QRS complex clearly indicates that there are more atrial contractions than ventricular contractions, which aligns with the electrocardiogram findings typically seen in atrial flutter. Monitoring and reporting this rhythm is crucial because it can lead to complications such as thromboembolism due to stagnant blood flow in the atria, thus requiring appropriate medical intervention.

In contrast, other options represent different arrhythmias that do not match the specific characteristic of three P waves per QRS complex at such a high rate. Sinus tachycardia would normally have a 1: