Question

A patient develops sinus bradycardia at a rate of 32 beats/minute, has a BP of 80/36 mm Hg, and is complaining of feeling faint. Which action should the nurse take?

a. Continue to monitor the rhythm and BP.

b. Apply the transcutaneous pacemaker (TCP).

c. Have the patient perform the Valsalva maneuver.

d. Give the scheduled dose of diltiazem (Cardizem).

Answer 1

The nurse should apply the transcutaneous pacemaker to the patient with symptomatic bradycardia and low blood pressure, as this intervention can stabilize the patient's hemodynamic status.

Step-by-step explanation:

In the case of a patient with sinus bradycardia at a rate of 32 beats/minute, a BP of 80/36 mm Hg, and symptoms of feeling faint, the nurse should take immediate action. This condition suggests that the heart is not providing sufficient oxygenated blood to the tissues, manifesting as significant symptoms due to the slow heart rate. The nurse's priority should be to stabilize the patient's hemodynamic status and therefore, applying the transcutaneous pacemaker (TCP) is the most appropriate action. TCP is an emergency intervention that provides temporary pacing through the skin until a more permanent solution, such as an implantable pacemaker, can be considered.

Continuing to only monitor the patient's rhythm and BP would not be adequate given the symptomatic bradycardia. The Valsalva maneuver is inappropriate in this case as it may temporarily further slow the heart rate. Additionally, administering a scheduled dose of diltiazem (Cardizem), a calcium channel blocker, should be avoided as it could exacerbate bradycardia.