A patient has a radial pulse of 52 beats per minute. What is the most appropriate initial nursing action?

• A. Immediately administer atropine
• B. Assess for symptoms, monitor rhythm, review medications, and notify clinician if symptomatic
• C. Ignore the pulse rate
• D. Document it as normal

Answer: (B)

When a pulse is lower than normal, the priority is to assess the patient’s condition and determine stability before acting. A rate of 52 beats per minute is bradycardia, but you don’t treat it immediately with a drug or ignore it—you first gather information. Check how the patient feels (dizziness, lightheadedness, syncope, chest pain, confusion), measure blood pressure and oxygen saturation, and monitor the heart rhythm. Review current medications for agents that slow the heart rate (such as beta-blockers or certain calcium channel blockers, digoxin, or antiarrhythmics) to identify possible causes. If the patient is symptomatic or unstable, notify the clinician promptly and be prepared for potential interventions like atropine or pacing. If the patient is asymptomatic and stable, continue close monitoring and reassessment. Jumping to treatment or labeling it as normal isn’t appropriate; the best initial action is a thorough assessment to guide the next steps.