Sinus bradycardia (rate 56 beats per minute) is identified in a ...

[Mollykgkg]

Sinus bradycardia (rate 56 beats per minute) is identified in a sleeping patient on telemetry. What is the priority nursing action?
 
  1. Awaken the patient and see how the heart rate responds.
  2. Call the physician and report this dysrhythmia.
  3. Check the medication administration record and see if there is a PRN medication that will improve this rhythm.
  4. Call for an immediate 12-lead electrocardiogram (ECG).

Question 2

The nurse sees this rhythm on a patient's cardiac monitor. For which rhythm should the nurse begin care?
 
  1. ventricular fibrillation
  2. atrial flutter
  3. sinus tachycardia
  4. ventricular tachycardia

[rleezy04]

Answer to Question 1

Correct Answer: 1
The priority is to awaken the patient to determine how the heart rate is affected with activity as it normally should increase. The patient should be evaluated to determine how the dysrhythmia is affecting heart function. Many patients who are asymptomatic while in sinus bradycardia can be observed and require no further intervention. Common reasons for sinus bradycardia for the nurse to consider include athletic conditioning, sleep, or a conduction disorder. Notifying the physician without first assessing the patient's response would not be appropriate. Checking the medication administration is not the priority nursing action. Ordering an ECG requires a physician's prescription.

Answer to Question 2

Correct Answer: 1
Ventricular fibrillation is too rapid to count and is grossly irregular; P:QRS shows no identifiable P waves; the PR interval is absent, and the QRS interval is bizarre and varies in shape and direction. It is important to identify this rhythm since it is a medical emergency and is known as cardiac arrest since the heart is not pumping. Death will follow if this situation is not resolved within four minutes. This rhythm is not atrial flutter, sinus tachycardia, or ventricular tachycardia.