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A 20-year-old has a mandatory electrocardiogram (ECG) before participating on a college soccer team and is found to have sinus bradycardia, rate 52. The students blood pressure is 119/76 and denies any health issues. Which action by the nurse is most appropriate?

A.

Tell the student to stop playing immediately if any dyspnea occurs.

B.

Refer the student to a cardiologist for further diagnostic testing.

C.

Allow the student to participate on the soccer team.

D.

Obtain more detailed information about the student's family health history.

Answer and Explanation

The Correct Answer is C

A. It is appropriate to monitor for symptoms of bradycardia, but the student is currently asymptomatic.

B. Referral to a cardiologist is not necessary unless the student develops symptoms or other concerning signs.

C. Sinus bradycardia can be normal in young, healthy athletes, especially those who engage in regular physical activity. Since the student is asymptomatic, with no signs of dyspnea, chest pain, or other concerning symptoms, there is no reason to restrict participation in sports.

D. Family history may be helpful, but this is not the immediate priority when the student is asymptomatic.


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Related Questions

Correct Answer is D

Explanation

A. Increasing IV fluids would exacerbate the client's fluid overload and worsen heart failure symptoms.

B. Trendelenburg positioning is typically used for shock management, but this client’s fluid overload needs to be addressed first.

C. Monitoring is important but does not address the immediate need to manage fluid overload.

D. The client's elevated CVP, PAWP, and BNP levels indicate fluid overload and heart failure with reduced ejection fraction. The priority is to reduce fluid overload by administering IV diuretics, which will help reduce the pressure in the heart and lungs, improving oxygenation and decreasing the risk of pulmonary edema.

Correct Answer is C

Explanation

A. This is an underestimation due to a miscalculation of the dose rate.

B. This is an overestimation due to a miscalculation of the dose rate.

C. 1. Calculate the desired dose of dobutamine:

Desired dose (mcg/min) = Dose per kg (mcg/kg/min) x Weight (kg)

Desired dose (mcg/min) = 12 mcg/kg/min x 75 kg = 900 mcg/min

2. Convert mcg/min to mg/hr:

900 mcg/min x 60 min/hr = 54,000 mcg/hr

54,000 mcg/hr ÷ 1000 mcg/mg = 54 mg/hr

3. Calculate the concentration of dobutamine in the solution:

Concentration (mg/mL) = Total amount of dobutamine (mg) / Total volume (mL)

Concentration (mg/mL) = 1000 mg (1 g) / 250 mL = 4 mg/mL

4. Calculate the infusion rate (mL/hr):

Infusion rate (mL/hr) = Desired dose (mg/hr) / Concentration (mg/mL)

Infusion rate (mL/hr) = 54 mg/hr / 4 mg/mL = 13.5 mL/hr

5. Round to the nearest whole number:

Infusion rate (mL/hr) = 14 mL/hr

Therefore, the IV pump should be programmed for 14 mL/hr.

D. This is an overestimation due to a miscalculation of the dose rate.

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