The Emergency department

Scenario: Four hours after her arrival to the emergency department, the patient remains in second-degree type II heart block and her vital signs are stable. She is transferred to a telemetry unit to prepare for insertion of a permanent pacemaker later in the day.

When she gets out of bed to use the restroom, she felt faint and had to sit on the floor.

The nurse finds her sitting on the floor beside the commode; the patient is awake but somewhat confused.

The patient is assisted back to bed. The nurse notes that the ECG monitor shows that the patient’s heart rate is at 40 beats/minute and she is now in third degree heart block.

The Rapid Response team is called, and preparations are made for the immediate application of a transcutaneous pacemaker (TCP).

1. NGN Item Type: Extended Multiple Response

Based on the patient’s current treatment plan, the patient’s priority needs will be to prevent which of the following? Select all that apply.

_____ 1. Angina

_____ 2. Pneumothorax

_____ 3. Hypertension

_____ 4. Dislodged pacing electrodes

_____ 5. Pacemaker failure to pace

_____ 6. Infection of the incision site

_____ 7. Injury from falling due to syncope

_____ 8. Hypotension