Question

A client on a telemetry unit demonstrates a regular sinus rhythm (RSR) with an occasional premature atrial contraction (PAC). What action should the nurse take?

1. Continue to monitor the client.

2. Notify the health care provider.

3. Ensure that a defibrillator is close by.

4. Administer lidocaine intravenously as per protocol.

Answer 1

The nurse should continue to monitor the client with a regular sinus rhythm and occasional premature atrial contractions, as these are usually benign. Further intervention may be needed if PACs become frequent or symptomatic.

Step-by-step explanation:

The appropriate action for a nurse who observes a client with a regular sinus rhythm (RSR) and occasional premature atrial contractions (PACs) is to continue to monitor the client (Option 1). PACs can be common and often benign, particularly if they are infrequent and the patient's overall rhythm is regular and stable. Monitoring the client is crucial to ensure that there are no significant changes in the heart rhythm that could indicate a worsening condition.

Although a PAC is an early electrical impulse originating in the atria causing premature contraction, it generally does not warrant immediate intervention unless it significantly affects cardiac output or is symptomatic. Lidocaine and defibrillators are tools used for more serious arrhythmias, such as ventricular tachycardia or ventricular fibrillation, and are not typically used for isolated PACs in a stable, regular sinus rhythm. However, the healthcare provider should be notified if PACs become frequent or are associated with symptoms.