An emergency indication for a pacemaker is

A. piloerection, diaphoresis of lower extremities, hypertension: While hypertension is present, piloerection and lower-extremity diaphoresis are less prominent and not the hallmark manifestations. Sweating is usually above the level of the spinal lesion rather than below.

B. hypertension, throbbing headache, nasal congestion: These are classic signs of autonomic dysreflexia. The sudden, severe hypertension triggers a throbbing headache, facial flushing, and nasal congestion due to baroreceptor-mediated reflexes. This combination reflects the acute, life-threatening nature of the syndrome.

C. hypotension, throbbing headache, piloerection: Hypotension is not associated with autonomic dysreflexia; the condition is characterized by sudden severe hypertension. Including hypotension in the manifestations is inaccurate and would mislead assessment.

D. hypertension, limb spasticity, sweating of forehead: Although hypertension occurs, limb spasticity is not a primary manifestation, and sweating typically occurs above the level of injury rather than just on the forehead. This combination does not fully represent the classic presentation of autonomic dysreflexia.

A. Maintain adequate cardiac output: Adequate cardiac output ensures that oxygen and nutrients are delivered to vital organs and tissues, which is essential for survival. Cardiac dysrhythmias can compromise cardiac output, leading to hypotension, organ dysfunction, or shock. Prioritizing interventions to maintain perfusion addresses the most immediate risk.

B. Maintain normal cardiac structure: While preserving cardiac structure is important for long-term cardiac health, it is not the immediate priority in managing a dysrhythmia. Structural issues are chronic concerns, whereas maintaining perfusion through adequate cardiac output is an urgent, life-sustaining goal.

C. Maintain adequate control of chest pain: Controlling chest pain is important for client comfort and can prevent further myocardial stress, but it does not directly ensure tissue perfusion or prevent hemodynamic compromise. Pain management is supportive rather than the primary goal in dysrhythmia care.

D. Maintain a resting heart rate below 70 bpm: Targeting a specific heart rate is not the priority unless the heart rate is causing compromised cardiac output or symptoms. Focusing on a numerical goal without assessing perfusion may not adequately address the client’s immediate physiologic needs.