Michelle S.

Esteban BSN3A NCM112LEC: Case Study Cardio 0923/22

Imagine you are an intern nurse in a doctor’s office. Your job is to enter patient information

into their digital medical records. The patient whose information you are entering now

came in with a heart rate of 50 bpm, technically bradycardia.

A. Which of the following could be reasons for this patient’s low heart rate and why?

(Choose all that apply)

1. The patient has high blood pressure and high afterload due to specific

medications, thickened heart tissue or certain injury. (Mitton,2021)

2. The patient is an athlete due to the heart adapting to the physical

stresses that it is put under by the physical activity.

3. The patient is a child due to the sinus node firing at a slow rate which

called sinus bradycardia that is usually normal in children.

4. The patient has damage to their SA node due to surgery, drugs,

congenital heart defect or other causes that makes the SA node to

inability consistently pace in a regular pattern (sick sinus syndrome).

(Kang, Clayton, Wojcik, 2022)

You look back at the previous visits in the medical record and find that until about a year

ago the patient had average resting heart rates in the 70–80 bpm range. So, you

hypothesize that the bradycardia is new and caused by some recent event.

A. Which symptoms is the patient most likely experiencing?

The symptoms of the patient that most likely experiencing are change of ADL,

heart surgery, or some certain medication that alter the heart rate such as
Michelle S. Esteban BSN3A NCM112LEC: Case Study Cardio 0923/22

maintenance for high blood pressure and other arrhythmias or abnormal

heartbeats.

The office has a portable ECG and was able to capture a few minutes of ECG tracing.

A. What is the most likely abnormality and why?

1. Missing P Waves- a lack of sinus beats which may occur with

sinus dysfunction such as sinus arrest, and sinoatrial axit

block.

2. Long T-Q segments- irregular heart rhythm that reflects a

disturbance in how the heart’s bottom chamber (ventricles)

send signals. This is usually caused by a faulty gene inherited

from a parent, also certain medicines that can trigger this such

as antibiotics.

3. Short PR interval- when the electrical signal takes less time than

normal to get from the top of the heart to the bottom, seen in

conditions like Wolff-Parkinson-White (WPW) syndrome.

4. Long ST segment- prolonged interval between ventricular

depolarization and repolarization that cause myocardial

ischemia or infarction. (Burns, Buttner, 2022)

Michelle S. Esteban BSN3A NCM112LEC: Case Study Cardio 0923/22

REFERENCES:
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