A client admitted to the telemetry unit with a diagnosis of syncopal episodes has a sitting blood pressure of 80/50 mm Hg, a regular apical pulse, and a cardiac rhythm as shown on the monitor. The nurse should prepare the client for which procedure?

Rationale: A. Transcutaneous pacing: The ECG rhythm demonstrates a third-degree (complete) heart block. This results in severe bradycardia and hypotension (80/50 mm Hg), placing the client at risk for syncope and cardiac arrest. Transcutaneous pacing is the immediate intervention to maintain cardiac output until a permanent pacemaker can be placed. B. Mechanical ventilation: Although hypotension and bradycardia can lead to hypoxia, the client’s issue is primarily electrical conduction failure, not respiratory compromise. Ventilatory support would not correct the underlying cause of hemodynamic instability. C. Chest tube insertion: Chest tube insertion is indicated for pneumothorax or hemothorax, not cardiac conduction abnormalities. There is no evidence of respiratory distress or pleural injury requiring this intervention. D. Synchronized cardioversion: Cardioversion is used for tachydysrhythmias such as atrial fibrillation or supraventricular tachycardia. It is contraindicated in complete heart block, where electrical pacing not shock is required to restore effective cardiac rhythm and perfusion