Final Answer:
The nurse should anticipate the insertion of a pacemaker as the priority treatment for a patient with persistent third-degree heart block and recurrent syncope. Thus the correct option is (4) Insertion of an implantable cardioverter defibrillator (ICD).
Step-by-step explanation:
In a persistent third-degree heart block, there is a complete blockage of electrical impulses between the atria and ventricles, leading to a severe disruption in the heart's conduction system. This results in a slow and unreliable heartbeat, causing symptoms such as dizziness, fatigue, and, in severe cases, syncope (fainting). The priority in managing third-degree heart block is to re-establish a stable and regular heart rate Thus the correct option is (4) Insertion of an implantable cardioverter defibrillator (ICD).
Inserting a pacemaker is the most appropriate intervention in this case. A pacemaker is a device that regulates the heart's rhythm by emitting electrical impulses, ensuring a consistent and adequate heartbeat. Unlike other interventions, such as atropine or epinephrine, which may be used in specific circumstances, a pacemaker provides a continuous and controlled pacing mechanism. This is crucial for patients with third-degree heart block as it addresses the underlying conduction issue and helps prevent syncope by maintaining an appropriate heart rate.
In summary, the insertion of a pacemaker is the most effective and direct approach to managing persistent third-degree heart block, as it directly addresses the conduction abnormality, providing a reliable and controlled heartbeat. This intervention is essential for improving the patient's symptoms and preventing further episodes of syncope, ultimately promoting better cardiovascular health.