The client's telemetry reading shows a "P" wave before each QRS complex and has a heart rate of 70. Which action would the nurse implement?

A. Document this as normal sinus rhythm: A P wave preceding each QRS complex with a heart rate of 60–100 beats per minute indicates normal sinus rhythm. This reflects appropriate electrical conduction from the sinoatrial node through the atria and ventricles, and no immediate interventions are required beyond routine monitoring.

B. Prepare to administer intravenous atropine: Atropine is indicated for symptomatic bradycardia or heart block, not for a heart rate of 70 bpm with normal sinus rhythm. Administering atropine in this situation is unnecessary and could cause tachycardia or other complications.

C. Request a 12-lead electrocardiogram: While a 12-lead ECG can provide a more comprehensive assessment, it is not required for documentation of uncomplicated normal sinus rhythm in a stable client. Telemetry reading alone is sufficient to identify NSR in this context.

D. Assess the client's cardiac enzymes: Cardiac enzymes are indicated for suspected myocardial injury or infarction. Normal sinus rhythm with a heart rate of 70 does not suggest myocardial ischemia, so evaluating cardiac enzymes is not warranted based solely on the telemetry reading.

A. Tell me more about your concerns about the surgery: This response uses therapeutic communication by encouraging the client to express feelings and fears. It is open-ended, acknowledges the client’s anxiety, and allows the nurse to assess specific concerns.

B. Would you like to speak with a chaplain prior to surgery: While spiritual support may be helpful, this option changes the focus away from exploring the client’s expressed fear. The nurse should first assess the client’s concerns before offering additional resources.

C. What support systems do you have to assist you: This question may be appropriate later, but it does not directly address the client’s immediate fear of dying. The priority is to explore the expressed anxiety.

D. This is a routine surgery and the risk of death is very low: Providing false reassurance dismisses the client’s feelings and may undermine trust. Emergent aortic aneurysm repair is a high-risk surgery, so minimizing the risk is inappropriate and nontherapeutic.