Cardiac Medicine Certification (CMC) Practice Exam

What initial steps should be taken for symptomatic bradycardia?

1. Administer nitroglycerin

2. Give oxygen and prepare for transcutaneous pacing

3. Increase fluid intake

4. Monitor heart rate continuously

The correct answer is: Give oxygen and prepare for transcutaneous pacing

In cases of symptomatic bradycardia, the initial steps are focused on ensuring patient safety and addressing the underlying issue that is causing the bradycardia. Providing oxygen and preparing for transcutaneous pacing is a critical step because symptomatic bradycardia can lead to inadequate perfusion and potentially serious complications such as syncope or even cardiac arrest. Administering oxygen helps to ensure that the body receives adequate oxygenation, which is vital in cases where the heart rate is insufficient to meet the metabolic needs of the patient. Additionally, transcutaneous pacing serves as an immediate temporary measure to increase the heart rate and restore adequate cardiac output while further evaluation and definitive treatment are considered. In contrast, other options like administering nitroglycerin can actually worsen hypotension and is contraindicated in cases where the heart rate is already low, while increasing fluid intake may not directly address the underlying issue of bradycardia. Continuous heart rate monitoring is important for all patients with bradycardia but is not a direct intervention for symptomatic cases. Therefore, combining oxygen administration with preparations for pacing effectively targets the urgent needs of the patient.