Neonatal Nurse Practitioner Practice Exam

What should a nurse do if a neonate receiving IV calcium gluconate for symptomatic hypocalcemia develops bradycardia?

1. Recognize this as a transient effect

2. Slow the rate of administration

3. Stop the infusion immediately

4. Monitor the patient's heart rate closely

The correct answer is: Stop the infusion immediately

In the scenario where a neonate receiving IV calcium gluconate for symptomatic hypocalcemia develops bradycardia, stopping the infusion immediately is the appropriate course of action due to the potential serious implications of this arrhythmia. Calcium gluconate can cause bradycardia, particularly if infused too quickly or in high doses, which can compromise the neonate's cardiac function and overall stability. Bradycardia in neonates can be indicative of underlying complications or adverse reactions to medications. By halting the infusion, the nurse is addressing both a potential immediate safety concern and preventing further complications related to calcium administration. Continuing treatment without addressing the bradycardia could place the infant at risk for more severe cardiac issues, including prolonged bradycardia or cardiac arrest. After stopping the infusion, the healthcare team should closely monitor the neonate's heart rate and overall condition while considering further management options for hypocalcemia based on the patient's response. While close monitoring and potentially other interventions may also be valuable, the immediate priority is to ensure patient safety by stopping the infusion of calcium gluconate in light of the bradycardia.