ECG Question #23
A client has confirmed second degree type II AV block (Mobitz II) and heart rate of 45 bpm. The nurse expects the following treatment for the condition: (Select all that apply.)
- Atropine for bradycardia
- Temporary pacemaker
- Digoxin to improve conduction
- Adenosine 6 mg IV
Both temporary pacing and administration of atropine will increase cardiac output. A permanent pacemaker will most likely follow. Mobitz type II block is considered to be more serious since it has the potential to develop into a 3rd degree (complete heart block). The client may feel dizzy, have palpitations, and feel skipped beats. Mobitz type II block reveals some P waves that are not conducted to the ventricles. This type of conduction problem occurs from MI, heart surgery, infections, and at times from hyperkalemia. If left untreated, electrical impulses may not reach the ventricles to produce a contraction. Digoxin and adenosine are not indicated in the treatment of this heart rhythm.