In addition to bradycardia, you may anticipate the following assessment findings:

• Decreased blood pressure
• Pale, cool, and clammy skin
• Decreased level of consciousness
• Confusion
• Restlessness
• Anxiety
• Syncope (fainting)

Why does this patient probably have bradycardia?

The patient’s bradycardia is likely due to a vasovagal response. A vasovagal response is a reflex reaction that occurs when the vagus nerve is stimulated. The vagus nerve is a long nerve that controls many different bodily functions, including heart rate and blood pressure.

A vasovagal response can be triggered by a variety of factors, including:

• Pain
• Emotional distress
• Dehydration
• Standing for a long period of time
• Straining to have a bowel movement

Does this dysrhythmia need treatment? Why or why not?

Whether or not a vasovagal response needs treatment depends on the severity of the symptoms. If the patient is symptomatic, such as having shortness of breath, dizziness, or lightheadedness, then treatment is necessary.

What intervention would you implement first?

The first intervention you should implement is to place the patient in a supine position with the head of the bed elevated 30-60 degrees. This will help to increase blood flow to the brain and improve the patient’s symptoms.

If the patient is still symptomatic, you may need to administer oxygen. In severe cases, you may need to administer atropine, which is a medication that blocks the effects of the vagus nerve.

What is the drug treatment and dosage of choice for symptomatic bradycardia? How does this drug increase heart rate?

Atropine is the drug treatment of choice for symptomatic bradycardia. The typical dosage is 0.5-1.0 mg IV every 3-5 minutes until the desired heart rate is achieved.

Atropine works by blocking the effects of the vagus nerve on the heart. The vagus nerve slows down the heart rate. By blocking the effects of the vagus nerve, atropine increases the heart rate.

Additional Information

Here is some additional information on vasovagal responses and bradycardia:

Vasovagal Responses

Vasovagal responses are common. They are most likely to occur in young people, but they can occur at any age. Vasovagal responses are usually not serious, but they can be frightening.

To prevent a vasovagal response, it is important to stay hydrated and to avoid standing for long periods of time. If you feel like you are going to have a vasovagal response, sit or lie down and take deep breaths.

Bradycardia

Bradycardia is a heart rate that is slower than normal. A normal resting heart rate for adults is 60-100 beats per minute. Bradycardia is defined as a heart rate that is less than 60 beats per minute.

Bradycardia can be caused by a variety of factors, including:

• Vasovagal responses
• Heart disease
• Thyroid problems
• Medications
• Infections

Bradycardia is not always a sign of a problem. However, if you have bradycardia and you are also experiencing symptoms such as shortness of breath, dizziness, or lightheadedness, you should see a doctor.

Conclusion

A vasovagal response is a common and usually not serious condition. However, it can be frightening and may require treatment if the patient is symptomatic. Atropine is the drug treatment of choice for symptomatic bradycardia.