The nurse is caring for a client with sinus bradycardia at a rate of 32 beats/min, blood pressure (BP) of 80/42 mm Hg, and reports feeling faint. Which is the appropriate action?
Give the scheduled dose of diltiazem (Cardizem).
Reposition the patient on the left side.
Have the patient perform the Valsalva maneuver.
Apply the transcutaneous pacemaker (TCP) pads
The Correct Answer is D
Sinus bradycardia with a heart rate of 32 beats/min and accompanying hypotension and symptoms of feeling faint indicates significant hemodynamic compromise. In such cases, the first-line intervention is to provide external cardiac pacing through transcutaneous pacemaker (TCP) pads. TCP can help increase the heart rate and improve cardiac output by delivering electrical impulses to the heart.
Administering the scheduled dose of diltiazem (Cardizem), a calcium channel blocker, is not appropriate in this situation. Diltiazem can further lower the heart rate and blood pressure, exacerbating the client's symptoms and potentially leading to adverse effects.
Repositioning the patient on the left side or having the patient perform the Valsalva maneuver are not effective interventions for treating sinus bradycardia with hemodynamic compromise. These actions may be used in specific situations, but in this case, the client requires immediate intervention to address the low heart rate and blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The procedure uses electrical energy to destroy areas of the conduction system: Catheter ablation is a minimally invasive procedure performed to treat abnormal heart rhythms, such as atrial flutter. During the procedure, a catheter is inserted into the heartand used to deliver electrical energy to specific areas of the heart tissue. This energy is used to destroy or ablate the abnormal conduction pathways that are causing the atrial flutter.
Let's go through the other options and explain why they are not accurate:
The procedure stimulates the growth of new pathways between the atria: Catheter ablation does not stimulate the growth of new pathways. Instead, it aims to eliminate or modify existing abnormal pathways in the heart to restore normal electrical conduction.
The procedure uses cold therapy to stop the formation of the flutter waves: Catheter ablation does not use cold therapy. It primarily utilizes radiofrequency energy or other sources of heat to ablate the targeted areas of the heart tissue.
The procedure prevents or minimizes the patient's risk for sudden cardiac death: While catheter ablation can be an effective treatment for certain arrhythmias, including atrial flutter, it is not primarily performed to prevent or minimize the risk of sudden cardiac death. Its main purpose is to restore normal heart rhythm and alleviate symptoms associated with the arrhythmia.
Correct Answer is C
Explanation
The most important finding to report to the health care provider would be the serum potassium level of 3.0 mEq. This is an extremely low potassium level (normal range is typically 3.5-5.0 mEq/L), which can indicate a potentially life-threatening condition called hypokalemia. Furosemide (Lasix) is a diuretic medication that can cause potassium loss in the urine, and a low potassium level can lead to serious cardiac and muscle abnormalities. It is crucial to report this finding promptly to the health care provider for appropriate intervention and monitoring.
Blood glucose level of 175 mg/dL: While an elevated blood glucose level can be a concern, especially for individuals with diabetes, it is not the most critical finding in this situation. The client's primary concern is hypertension, and the administration of IV furosemide is aimed at managing blood pressure. The elevated blood glucose level should still be addressed and monitored, but it is not as urgent as the low potassium level.
Orthostatic systolic BP decrease of 12 mm Hg: Orthostatic hypotension refers to a significant decrease in blood pressure upon standing up. While it is important to assess and manage orthostatic changes, a decrease of 12 mm Hg in systolic blood pressure alone may not be considered clinically significant. It could be a normal response for some individuals. However, if the client experiences symptoms such as dizziness or lightheadedness upon standing, further evaluation may be necessary. Nonetheless, it is not as urgent as the low potassium level.
Current blood pressure reading of 166/94 mm Hg: While this blood pressure reading indicates hypertension, it is not the most critical finding to report in this situation. The nurse is preparing to administer furosemide (Lasix), which is a medication commonly used to treat hypertension. It is expected that the blood pressure will be high before administering the medication. The goal is to monitor the blood pressure after the administration to assess the effectiveness of the medication.
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