Question

case study 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?

Answer 1

Ans. Other asessment findings , i may anticipate finding include , low blood pressure , altered mental status , pale skin that is cool to touch, nausea , diziness and headache.

Ans . During defecation a person may strain or bear down this then causes inhaling , closing the glottis, and tightening of chest and abdominal muscles. These bodily actions increase the intra abdminal pressure that assists with colon evacuation, but also increases intrathoracic pressure and produces the decrease in cerebral blood flow and cerebral perfusion. This is even more predominant in patients with cardiovascular disease.

Ans. If the patient is stable , treatment includes identification and treatment of the underlying cause , if the patient has any of these symptoms and the underlying cause cannot be determined. The treatment is to administer drug therapy with atropine 0.5mg IV, increase intravascular volume , IV fluids, and apply oxygen Drugs that may be causing the bradycardia are also discontinued. If the issue is not solved by doing the previous interventions, the patient may need permanent pacemaker implantation. The first intervention that I would implement would be to look at the medical administration record and see if any of the medications the patient is taking may be causing the issue. If none of them seem to have those side effects, I would administer the atropine and oxygen.

Ans. The drug treatment and dosage for symptomatic bradycardia is atropine 0.5mg IV. The atropine results in modifications of the heart rate. A moderate dose generally results in heart acceleration by the elimination of reflex bradycardia, and the reduction of the vagal tone and arterial hypertension .