QOD 052: Adult 3rd degree heart block (Physiological adaptation)

The telemetry nurse is reviewing a rhythm strip for a client with a 2nd degree type II heart block. The nurse notes a QRS complex of 0.16 seconds, no measurable PR interval, and a regular R to R and P to P interval. There is not a 1:1 ratio of QRS:P. The nurse assesses the client and determines the client is responsive but dizzy with a pulse rate of 50 bpm. Which action by the nurse is most appropriate?

• Continue to monitor
• Have the client perform a vagal maneuver
• Call a code blue
• Prepare the client for pacemaker insertion