Sinus bradycardia (rate 56 beats per minute) is identified in a sleeping patient

1. Awaken the patient and see how the heart rate responds.

 2 and 4 were automatically out because as a nurse you should access and evaluate before notifying when you do not have an adequate reason or response to give. 3 is not taking any action to identify the issue nor should you just give out a medication without a Dr's order.

The priority is to awaken the patient to determine how the heart rate is affected with activity as it normally should increase. The patient should be evaluated to determine how the dysrhythmia is affecting heart function. Many patients who are asymptomatic while in sinus bradycardia can be observed and require no further intervention. Common reasons for sinus bradycardia for the nurse to consider include athletic conditioning, sleep, or a conduction disorder. Notifying the physician without first assessing the patient’s response would not be appropriate. Ordering an ECG requires a physician’s prescription.