Measure the client's blood pressure Sodium nitroprusside is a highly potent vasodilator (both venous and arteriolar). Temporary or permanent pacing is necessary to stabilize the client.ģ. Educational objective: Third-degree AV block results in disassociation of atrial and ventricular contraction due to blocked electrical conduction pathways. This type of AV block requires temporary or permanent pacing to restore electrical conduction and hemodynamic stability. On ECG, third-degree AV block presents as a regular rate and rhythm with disassociated P waves and QRS complexes. Third-degree AV block, or complete heart block, occurs when electrical conduction from the atria to the ventricles is blocked, causing decreased cardiac output (eg, dizziness, syncope, mental status changes, heart failure, hypotension, bradycardia). ![]() Ablation performed near the atrioventricular (AV) node can damage conduction, causing varying degrees of AV block. Notify the cardiologist and prepare for temporary pacing Radiofrequency ablation is performed through transvenous cardiac catheterization to ablate (ie, burn) electrical pathways causing supraventricular or ventricular tachydysrhythmias. The client with third-degree AV block requires a permanent pacemaker.Ĥ. Educational objective:Clients with third-degree atrioventricular (AV) block should be assessed immediately due to the potential for life-threatening consequences (eg, shock, syncope, asystole) caused by decreased cardiac output and severe bradycardia. The nurse can see the client as soon as possible or ask another nurse for help. However, severe pain does not take priority over third-degree AV block. (Option 3) The client experiencing severe postoperative pain should be assessed for surgical complications (eg, infection), and the pain should be treated (eg, with hydrocodone). ![]() The goal in this client population is to keep the oxygen saturation 88-92%. (Option 2) Clients with chronic obstructive pulmonary disease often have pulse oximetry readings that are lower than normal (eg, 91%). Administration of warfarin (a long-term anticoagulant) is important to prevent thrombus formation however, symptomatic third-degree AV block is a higher priority. (Option 1) Atrial fibrillation puts clients at risk for development of atrial thrombi, which can embolize and cause a stroke. Treatment includes administration of atropine and temporary pacing (eg, transcutaneous) until a permanent pacemaker can be placed. The client with third-degree AV block is a high priority, as the client may decompensate to cardiogenic shock and even periods of asystole (Option 4). client with third-degree heart block with a pulse of 42/min Third-degree atrioventricular (AV) block, or complete heart block, occurs when electrical conduction from the atria to the ventricles is blocked, causing decreased cardiac output (eg, dizziness, syncope, mental status changes, heart failure, hypotension, bradycardia).
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