A 38-year-old female is brought to the Emergency Department with complaints of her "heart beating out of her chest". She is diaphoretic, tachypneic and
... [Show More] her BP is 70/40. The cardiac monitor shows supraventricular tachycardia. Valsalva maneuvers and three doses of Adenosine have not been successful. The nurse should immediately:
a.) prepare the patient for synchronized cardioversion.
b.) give Epinephrine 1 mg IV and repeat in 3 minutes.
c.) give Adenosine 6 mg IV per protocol.
d.) perform unilateral carotid massage. - answera.) prepare the patient for synchronized cardioversion.
Prior to discharge from the Emergency Department, the nurse prints a rhythm strip on a patient and notices that the P wave cannot be detected and the QRS complex is 0.24 seconds. This is a change in the patient's condition. What is the best action for the nurse to take?
a.) Measure the PR interval.
b.) Prepare the patient for discharge.
c.) Notify the physician of this abnormal strip.
d.) Continue to monitor for abnormalities. - answerc.) Notify the physician of this abnormal strip.
Rationale:
c.) is correct because notifying the physician of the abnormal rhythm would be the most appropriate response. The patient has experienced a rhythm change and requires further treatment.
a.) is not correct for measuring the PR would not be possible as there is no P wave present. Since the QRS interval and other parameters given are abnormal, discharging the patient would not be appropriate at this point.
b.) is not correct as discharging the patient is not appropriate or safe practice.
d.) is not correct because continuing to monitor the patient without any other actions would be inappropriate as the patient has experienced a change in condition.
A patient is to have synchronized cardioversion for treatment of atrial flutter. He has received Heparin 500 units subcutaneously. Which of the following interventions should now be performed?
a.) Assist the MD in intubating the patient to stabilize airway.
b.) Sedate the patient with Versed 2 mg IV push per protocol. [Show Less]