Assessment of Symptomatic Bradycardia
A 60-year-old male patient is admitted with chest pain to the telemetry unit where you work. While having a bowel movement on the bedside commode, the patient becomes short of breath and diaphoretic. The ECG waveform shows bradycardia.
- What other assessment findings should you anticipate?
- Why does this patient probably have bradycardia?
- Does this dysrhythmia need treatment? Why or why not? What intervention would you implement first?
- What is the drug treatment and dosage of choice for symptomatic bradycardia? How does this drug increase heart rate?
Please use complete sentences to answer the questions. Ensure that you are using correct grammar. In additions, support your answers by using your textbooks, scholarly journals, and credible Internet sources. All citations must be in APA format.
Assessment findings that should be anticipated in this patient include a decrease in blood pressure, a decrease in oxygen saturation levels, and a decrease in respiratory rate. These symptoms may suggest that the patient is experiencing cardiovascular compromise.
The patient may have bradycardia due to a variety of causes, including medication side effects, coronary artery disease, or aging-related changes in the electrical system of the heart. In some cases, the patient may have an underlying medical condition that affects the conduction system of the heart, such as atrioventricular block or sick sinus syndrome.
Symptomatic bradycardia typically requires treatment because it can lead to decreased cardiac output and organ failure. The first intervention would be to ensure that the patient has a patent airway and is receiving adequate oxygenation. If the patient’s blood pressure is low, intravenous fluids or vasopressors may be necessary to improve perfusion. If the patient is experiencing chest pain or other signs of myocardial infarction, urgent reperfusion therapy may be required.
Atropine is the drug treatment of choice for symptomatic bradycardia. The recommended dose is 0.5 to 1.0 mg IV, with repeat doses every 3 to 5 minutes as needed, up to a maximum total dose of 3.0 mg. Atropine works by blocking the parasympathetic nervous system, which allows the sympathetic nervous system to increase heart rate. If atropine is ineffective, other medications such as dopamine or epinephrine may be used. In extreme cases, temporary pacing may be necessary.
