Problem: The nurse provides care for a client with a history of mitral valve stenosis on a telemetry unit. The nurse notes new onset of atrial fibrillation on the monitor. Assessment of the client reveals a heart rate of 180 beats per minute and blood pressure 59/30 mm Hg, and the client is not arousable to verbal stimuli. Which action will the nurse take first? 1. Administer an IV bolus of 70 units/kg heparin. 2. Assess the client's lung sounds. 3 Prenare for immediate sunchronized cardioversion 4. Request a transesophageal echocardiogram. Need Assignment Help?