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A client is admitted to the coronary care unit; the client's EKG shows atrial fibrillation with a rapid ventricular rate. The nurse prepares to assist the physician with the cardioversion procedure. To overcome the potential danger of inducing ventricular fibrillation during the procedure, the nurse should ensure that the

A.

Maintain continuous monitoring of the client's blood pressure.

B.

Administer sedation to the client prior to the procedure.

C.

Confirm that the synchronizer switch is in the "on" position.

D.

Ensure that the defibrillator is set to a higher energy level.

Answer and Explanation

The Correct Answer is C

A. Continuous blood pressure monitoring is important for safety but does not prevent ventricular fibrillation during cardioversion.
B. Administering sedation improves client comfort but does not address the risk of inducing arrhythmias.
C. Confirming that the synchronizer switch is in the "on" position ensures the shock is delivered during the R wave of the QRS complex, which prevents delivery during the vulnerable T wave and reduces the risk of ventricular fibrillation.
D. Setting the defibrillator to a higher energy level is not a preventive measure for arrhythmias and may increase the risk of myocardial injury.


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Related Questions

Correct Answer is C

Explanation

A. Congestive heart failure can develop after MI but is more likely to occur later, depending on the extent of myocardial damage.
B. Papillary muscle rupture is a rare mechanical complication that usually occurs 2–7 days post-MI.
C. Dysrhythmias are the most common and immediate life-threatening complication in the first 24 hours post-MI, requiring continuous monitoring.
D. Pericarditis may develop after MI but typically occurs several days later, not within the first 24 hours.

Correct Answer is D

Explanation

A. Biologic valves do not contain metal, so clients generally do not need special precautions when passing through metal detectors.
B. Routine prophylactic anticoagulation is not required for dental procedures with biologic valves; prophylactic antibiotics may be needed depending on the situation.
C. Papillary muscle rupture is a rare, acute complication of myocardial infarction, not a routine concern after biologic valve replacement.
D. Clients with biologic valve replacements typically require short-term anticoagulation for three to six months post-operatively to prevent thromboembolic events, making this the most important discharge teaching point.

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