A client is to receive Synthroid 25 mcg PO daily. Synthroid unit dose available is 0.05 mg/ tablet. How many tablets (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero)

A. calculate the number of small squares between one QRS complex and the next one and divide by 1500: This method provides an accurate heart rate calculation, but it is more time-consuming and typically used when precision is needed. It is not the quickest method for rapid bedside estimation of rate.

B. use the 3 second markers to count the number of QRS complexes in 6 seconds and multiply by 10: This is the fastest and most commonly used method for quickly estimating heart rate on an ECG strip. By counting the QRS complexes in a 6-second interval and multiplying by 10, the nurse gets an approximate beats-per-minute rate.

C. count the number of large squares in the R-R interval and divide by 300: This method also provides a quick estimate of heart rate but is best suited for regular rhythms. If the rhythm is irregular, this approach can yield inaccurate results.

D. print a 1-minute ECG strip and count the number of QRS complexes: While accurate, this method is inefficient for quick bedside estimation and is rarely used in practice for rapid assessment due to the time it takes to obtain and interpret a full-minute strip.

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.