A nurse is caring for a client who has developed a heart rate of 38/min and reports tremors and feeling faint. Which of the following medications should the nurse anticipate administering?
A.
Magnesium sulfate
B.
Digoxin
C.
Atropine sulfate
D.
Diltiazem
The Correct Answer and Explanation is:
The correct answer is C. Atropine sulfate.
Explanation:
The client’s symptoms—bradycardia (heart rate of 38/min), tremors, and feeling faint—suggest a case of severe bradycardia, which can be associated with various conditions including vagal stimulation, heart block, or medication side effects. Bradycardia, defined as a heart rate below 60 beats per minute, can lead to inadequate blood flow to vital organs, causing symptoms like dizziness, fainting, and tremors.
Atropine sulfate is the medication of choice for treating symptomatic bradycardia. Atropine is an anticholinergic agent that works by blocking the effects of the vagus nerve on the heart, thereby increasing the heart rate. It inhibits the action of acetylcholine on muscarinic receptors in the heart, which counters the parasympathetic stimulation responsible for bradycardia. Typically, atropine is administered intravenously in cases of acute bradycardia to rapidly improve heart rate and reduce symptoms like dizziness and fainting.
Here’s why the other options are less appropriate in this scenario:
A. Magnesium sulfate: This medication is primarily used to manage magnesium deficiency and conditions such as preeclampsia or torsades de pointes, a type of abnormal heart rhythm associated with prolonged QT interval. It is not indicated for acute symptomatic bradycardia.
B. Digoxin: Digoxin is used to treat heart failure and certain types of arrhythmias, particularly atrial fibrillation. However, digoxin can also cause bradycardia as a side effect, and its use would not be appropriate in the case of acute symptomatic bradycardia.
D. Diltiazem: This is a calcium channel blocker used to manage hypertension and certain types of arrhythmias such as atrial fibrillation or flutter. It can actually cause bradycardia as a side effect, making it inappropriate for treating acute symptomatic bradycardia.
In summary, atropine sulfate is the correct medication to address the immediate concern of symptomatic bradycardia by increasing the heart rate and alleviating symptoms related to insufficient cardiac output.