Final answer:
D. Apply transcutaneous pacemaker pads. The first action a nurse should take when admitting a client with a complete heart block and signs of hemodynamic instability is to apply transcutaneous pacemaker pads, as this will provide temporary stabilization.
Step-by-step explanation:
In the scenario where a client has a complete heart block as shown on an ECG with a heart rate of 34/min and a blood pressure of 83/48 mm Hg, while also being lethargic and unable to complete sentences, the first action a nurse should perform is D. Apply transcutaneous pacemaker pads. This is an emergency measure to stabilize the client's condition by temporarily pacing the heart until a permanent solution, such a permanent pacemaker insertion, can be arranged. It is crucial to act quickly in this situation, as the client's low heart rate and blood pressure, along with their lethargic state, indicate hemodynamic instability and insufficient cardiac output.
The first action the nurse should perform is to apply transcutaneous pacemaker pads. A complete heart block is a serious condition that can result in a dangerously low heart rate. Applying transcutaneous pacemaker pads can provide temporary pacing until the client can receive a permanent pacemaker insertion.Transporting the client to the cardiovascular laboratory or preparing for a permanent pacemaker insertion may be necessary, but the first priority is to stabilize the client's heart rate and blood pressure. Obtaining a signed informed consent form for a pacemaker is not the first priority in this situation because immediate intervention is needed to address the client's unstable condition.