Author Question: A client with a heart rate of 40 who is experiencing shortness of breath and nausea is diagnosed ... (Read 98 times)

Anajune7 · **on:** Jun 25, 2018

A client with a heart rate of 40 who is experiencing shortness of breath and nausea is diagnosed with second-degree AV block type II. Which of the following will be included in this client's treatment? (Select all that apply.)

1. Administer digoxin
2. Administer antiemetic
3. Administer atropine sulfate
4. Insert external pacemaker
5. Decrease intravenous fluids
6. Lower the head of the bed

Question 2

A client is recovering from insertion of a pacemaker to pace the activity of the ventricles. At which point on the electrocardiogram tracing will the nurse assess pacer spikes?

1. Before the QRS complex
2. Before the P wave
3. After the QRS complex
4. After the P wave

dawsa925 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

3, 4
For second-degree AV block type II, treatment will almost always consist of external pacemaker insertion. Atropine sulfate may be used to increase the heart rate until the pacemaker can be inserted. Digitalis toxicity can cause this heart rhythm so digoxin should not be administered to this client. An antiemetic will not solve the client's underlying problem. The client may or may not need additional fluids. Lowering the head of the bed could compromise this client's respiratory status and should not be done.

Answer to Question 2

1
If the ventricles are being paced, there will be a pacer spike just prior to the QRS complex. If the atria are being paced, there will be a pacer spike just before the P wave. Pacer spikes that occur after the QRS complex or P wave would indicate pacemaker malfunction and should be addressed immediately.