Bradycardia

Clinical Picture

-HR <60 bpm
-Nausea & vomitting, dizziness or lighteadedness.
-Sign- Altered LOC, Chest pain, Short of breath(SOB), Hypotension, pulmonary congestion, &/@ cyanosis

Immediate Interventions

-Have a patient sit or lie down in bed
-Administer supplemental oxygen
-Assess BP
-Notify physician or NP
-Obtain a 12-lead ECG
-Check for patient IV access
-Document patient's status,phone call to physician or NP, & physician @ NP response.

Focused Assessment

-Assess level of consciousness & orientation
-Assess BP & HR
-Assess respirations rate & effort; assess SaO2 if readily available
-Assess skin for colour, moistness, & temprature. Assess for associated symptoms (chest pain, SOB, hypotension)
-If patient on telemetry or cardiac monitor, assess ECG

Stabilizing & Monitoring

-Monitor VS
-Set up cardiac monitoring & monitor rate & rhythm
-Assess recent laboratory results
-Chart patient status & convey status to physician or NP

Be Prepared To

-Administer oral or IV medications as ordered
-Obtain or order laboratory tests
-Titrate oxygen to SaO2 >90%
-Obtain IV access if none available
-Assist with external pacing
-Transfer to ICU or telemetry unit

Possible Etiologies

-Medication toxicity
-Vasovagal response
-Hyperkalemia
-Hypothermia
-Hyperthyroidism
-Sepsis
-Severe infection
-Hypoglycemia
-Excellent physical condition (athletes)
-Myocardial infarction
-Shock