A nurse is caring for a 72-year-old client who suddenly becomes weak and lightheaded. The cardiac monitor shows second-degree AV block Type II. The client is pale and diaphoretic with a blood pressure of 82/48 mm Hg and a heart rate of 42 beats per minute. Which collaborative intervention should the nurse anticipate implementing?

Choice A reason: Furosemide is a diuretic used for fluid overload in heart failure, not for second-degree AV block Type II, which causes bradycardia and hypotension. Administering it could worsen hypotension by reducing preload, making it inappropriate for this client’s acute conduction issue. Choice B reason: Thrombolytic medications are used for acute myocardial infarction or stroke to dissolve clots. Second-degree AV block Type II is a conduction disorder, not a thrombotic event, so thrombolytics are irrelevant and could cause harmful bleeding in this scenario. Choice C reason: Second-degree AV block Type II causes intermittent failure of atrial impulses to conduct, leading to bradycardia and hypotension. Transcutaneous pacing restores heart rate and cardiac output, stabilizing the client’s hemodynamics, making it the most appropriate intervention for this life-threatening rhythm disturbance. Choice D reason: Synchronized cardioversion is used for tachyarrhythmias like atrial fibrillation or ventricular tachycardia. Second-degree AV block Type II is a bradyarrhythmia, so cardioversion is inappropriate. Pacing is needed to increase heart rate and address the client’s symptoms effectively.