What should a nurse administer to a client experiencing sinus bradycardia and acute chest pain?

• A. Establish intravenous access
• B. External pacing if needed
• C. Administer atropine
• D. Obtain baseline CBC and electrolytes

Answer: (C)

In the context of a patient experiencing sinus bradycardia accompanied by acute chest pain, administering atropine is the most appropriate action. Atropine is an anticholinergic medication that effectively increases the heart rate by blocking vagal influences on the heart. In the case of sinus bradycardia, where the heart rate is abnormally low, atropine can facilitate a more adequate cardiac output and improve perfusion, which is crucial given the client’s chest pain that may indicate ischemia or reduced oxygen delivery to the heart.

Establishing intravenous access, while important for further medication administration and potential fluid resuscitation, is not a direct intervention to address the immediate bradycardia or chest pain. Similarly, external pacing is generally reserved for severe bradycardia or cases where atropine is ineffective. Obtaining baseline CBC and electrolytes, although valuable for assessing other underlying issues or contributors to the patient’s symptoms, does not provide immediate relief in this acute scenario. Thus, administering atropine directly addresses the primary concerns of low heart rate and accompanying acute chest pain.