A 47-year-old female client tells the nurse that her heart feels as th

A 47-year-old female client tells the nurse that her heart feels as though it is racing. The client’s pulse is 160 beats per minute.

The nurse knows that a vagal response will stimulate the parasympathetic nervous system to slow the heart rate and instructs the client to:
1. Bear down as though she is having a bowel movement
2. Take a hot shower
3. Take a cold bath
4. Hold her breath

ANSWER

ANS: 1
Paroxysmal supraventricular tachycardia is a sudden rapid onset of tachycardia originating above the AV node. It often begins and ends spontaneously. Sometimes excitement, fatigue, caffeine, smoking, or alcohol use precipitates paroxysmal supraventricular tachycardia. When needed, treatment includes vagal stimulation such as carotid sinus massage or Valsalva maneuver to de-crease the ventricular response. A hot shower would cause the heart to beat faster in order to cool down the body. A cold bath could cause additional stress and would not be appropriate. Holding the breath will increase the heart rate as it compensates for the lack of oxygen intake and buildup of carbon dioxide.