A patient has a history of syncope and dizziness associated with nausea. The nurse records an EKG which shows complete heart block (a.k.a. third-degree heart block), a ventricular rate of 40 beats/minute, and intermittent sinus pauses. What is the immediate management indicated in this patient?
Explanation
Answer: D - A pacemaker is the immediate management indicated for this patient. Complete heart block associated with an abnormal pulse, inadequate escape rhythm, or a block below the atrioventricular node, evidence of cardiac ischemia, or hypotension should be treated immediately with a pacemaker or pacing agent. Individuals diagnosed with complete heart block should be on bed rest to avoid further complications. Drugs such as atropine and isoproterenol hydrochloride can be used as temporizing measures to treat complete heart block, but a pacemaker placement is standard.
