Page 1684 - Saunders Comprehensive Review For NCLEX-RN

regular.

b. Atrial and ventricular rates are

less than 60 beats per minute.
c. PR interval and QRS width are within
normal limits.
d. Treatment may be necessary if the
client is symptomatic (signs of
decreased cardiac output).
e. A low heart rate may be normal for
some individuals, such as athletes.

2. Interventions

a. Attempt to determine the cause of sinus
bradycardia; withhold medication
suspected of causing the bradycardia
and notify the PHCP.
b. Administer oxygen as prescribed for
the symptomatic client.
c. Administer atropine sulfate as
prescribed to increase the heart rate to
60 beats per minute.
d. Be prepared to apply a noninvasive
(transcutaneous) pacemaker initially if
the atropine sulfate does not increase
the heart rate sufficiently.
e. Avoid additional doses of atropine
sulfate, because this will induce
tachycardia.
f. Monitor for hypotension and administer
fluids intravenously as prescribed.
g. Depending on the cause of the
bradycardia, the client may need a
permanent pacemaker.
C. Sinus tachycardia
1. Description
a. Atrial and ventricular rates are

100 to 180 beats per minute.
b. Atrial and ventricular rhythms are
regular.
c. PR interval and QRS width are within
normal limits.
2. Interventions
a. Identify the cause of the tachycardia.
b. Decrease the heart rate to normal by
treating the underlying cause.

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