As a nurse, when a patient presents with chest pain and subsequently develops shortness of breath and diaphoresis while on the commode, it is important to anticipate other possible assessment findings. These may include decreased oxygen saturation, increased respiratory rate, and an increase in the patient’s blood pressure. The patient may also complain of dizziness, lightheadedness, or feeling faint.
Bradycardia is a slower than normal heart rate, which is typically defined as a heart rate less than 60 beats per minute. In this patient, the bradycardia may be due to a variety of causes, including vagal stimulation from the act of defecation, medication side effects, or underlying cardiac disease such as an atrioventricular (AV) block.
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This dysrhythmia needs treatment if the patient is symptomatic. Symptoms of bradycardia may include dizziness, syncope, hypotension, or heart failure. In this case, the patient is symptomatic with shortness of breath and diaphoresis, so intervention is necessary. The first intervention would be to assist the patient back to bed and administer oxygen to improve oxygenation.
The drug treatment of choice for symptomatic bradycardia is atropine. The dosage for atropine is 0.5 mg IV bolus, which may be repeated every 3 to 5 minutes as needed, up to a total dose of 3 mg. Atropine works by blocking the action of the parasympathetic nervous system, which leads to an increase in heart rate.
In conclusion, when a patient presents with chest pain and subsequently develops shortness of breath and diaphoresis while on the commode, it is important to anticipate other possible assessment findings. The patient may have bradycardia due to various reasons. If the patient is symptomatic, treatment is necessary. The first intervention would be to assist the patient back to bed and administer oxygen to improve oxygenation. The drug treatment of choice for symptomatic bradycardia is atropine, which works by blocking the action of the parasympathetic nervous system, leading to an increase in heart rate.
