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.
Case Study Analysis-Patient with Bradycardia
The case involves a 60-year-old male patient admitted with chest pain. The patient has undergone electrocardiography to reveal bradycardia. Other assessments include troponin, magnesium level, electrolyte level, thyroid function tests, glucose level, toxicologic screening, blood pressure test, and calcium levels (Hafeez & Grossman, 2022). In addition, the patient’s results showed hypoglycemia, high blood pressure, elevated troponin levels, electrolyte imbalance, and normal thyroid levels. A physical examination reveals shortness of breath, low heart rate, decreased level of consciousness, and cyanosis. Do your need help in your nursing assignment?
The patient’s bradycardia is probably drug-induced since the patient is diaphoretic. Elderly patients are at a higher risk of suffering from cardiovascular disorders managed with drugs such as calcium channel blockers that can induce bradycardia (Chakraborty & Hamilton, 2022). A 60-year-old is also at a high risk of suffering from sick sinus syndrome. Treatment of arrhythmias such as dysrhythmias is based on the heartbeat. The heartbeat can show tachycardia or bradycardia, which is seen in this patient. The patient’s slow heart rate needs treatment since it causes significant symptoms such as chest pain. The first intervention to implement is to ensure the patient is hemodynamically stable, administer supplemental oxygen, and ensure cardiac monitoring.
Symptomatic bradycardia is treated using intravenous or intramuscular atropine (Hafeez & Grossman, 2022). The dosage of intravenous atropine is administered at 0.5mg or 1mg. The dosage of intravenous atropine can also be calculated as 0.04mg/kg and administered every five minutes. The dosage of intravenous atropine should not exceed 3mg. Two to three times, the intravenous dose of atropine is diluted in 3 to 5 ml of water for injection or normal saline. Atropine is cholinergic, increasing the heart rate through antimuscarinic action and competitive inhibition of acetylcholine at muscarinic receptors (McLendon & Preuss, 2022).
References
Chakraborty, R.K., & Hamilton, R.J. (2022). Calcium Channel Blocker Toxicity. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK537147/.
Hafeez, Y., & Grossman, S.A. (2022). Sinus Bradycardia. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK493201/.
McLendon, K., & Preuss, C.V. (2022). Atropine. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470551/.