Your patient is a 55-year-old male who is in moderate distress and complaining of chest pain. He states that he experienced an acute onset of left-sided crushing chest pain while playing basketball with his grandson. He complains of weakness and near-syncope with exertion. His skin is pale, cool, and diaphoretic. HR = 40, BP = 72/40, RR = 20, SaO₂ = 95%. The monitor shows a third-degree AV block. Which of the following is most appropriate?

Question

Quizplus · Accepted Answer

The patient is exhibiting signs of cardiogenic shock, most likely due to acute myocardial infarction. The third-degree AV block can be a complication of this, and the patient is also experiencing near-syncope with exertion. Transcutaneous pacing is the best immediate intervention to stabilize the patient's heart rate and support cardiac output. Sedation may be used to make the patient more comfortable during the procedure. Atropine is not appropriate in third-degree AV block, and dopamine may increase the patient's heart rate, exacerbating the AV block. Aspirin, nitroglycerin, and morphine should be administered if a myocardial infarction is suspected, but should not be the initial intervention in this case.

Your Patient Is a 55-Year-Old Male Who Is in Moderate