The nurse on the telemetry unit responds to the cardiac monitor alarm on a patie
ID: 125446 • Letter: T
Question
The nurse on the telemetry unit responds to the cardiac monitor alarm on a patient recovering from a myocardial infarction. Upon entering the room, the nurse notes the rhythm on the monitor appears to be bradycardia with a heart rate of 32 bpm.
a. What action should the nurse take first?
b. How will the nurse determine if the patient has signs and symptoms of poor perfusion?
c. What factors contribute or may lead to a bradycardic rhythm?
d. What medications and treatments are used for patients with bradycardia?
Explanation / Answer
The medical term for a low heart rate is bradycardia. Sometimes a low heart rate is defined as below 60 beats per minute, but it would maybe below 50 beats per minutes.
If a patient is on monitoring while recovering from myocardial infarction, are more prone to sinus bradycardia arises from suppression of the sinus node.
Bradycardia is a sign of a problem with the heart's electrical system. It means that the heart's natural pacemaker isn't working right or that the electrical pathways of the heart are disrupted. In severe forms of bradycardia, the heart beats so slowly that it doesn't pump enough blood to meet the body's needs. This can cause symptoms and can be life-threatening.
And after applying the pacemaker, capture the heart rate. If the patient is in cardiac arrest with bradycardia or an asystolic rhythm, the pacing should be initiated at the maximum current output to ensure that capture is achieved as soon as possible.
As MI case there is damaging of the heart's electrical system.
Medicines for treating heart problems or high blood pressure, such as beta-blockers may be the cause.
There are three medications used in case of bradycardia:
Atropine, Epinephrine, and Dopamine.
Atropine is the first drug used to treat bradycardia.
It is classified as an anticholinergic drug and increases working of the SA Node by blocking the action of the vagus nerve on the heart resulting in an increased heart rate.
Epinephrine and Dopamine
Epinephrine and dopamine are second-line drugs for bradycardia.
They both are used as infusions in case of bradycardia if atropine is ineffective.
Note: The goal of therapy is to improve the patient’s clinical status rather than target an exact heart rate.