A nurse is caring for a client that has been recently diagnosed with Guillian-Barre syndrome. What would the nurse consider to be common risk factors associated with Guillain-Barré syndrome (GB5)? (select all that apply)

A. Prepare for defibrillation: Defibrillation is the priority intervention for ventricular fibrillation, as it is the most effective treatment to terminate this life-threatening arrhythmia. Rapid defibrillation can restore a perfusing rhythm, which is critical for survival in a client who is unresponsive, pulseless, and apneic.

B. Atropine administration: Atropine is used to treat bradycardia or asystole but is not effective for ventricular fibrillation. In this scenario, defibrillation takes precedence over medication administration to restore a normal heart rhythm.

C. Prepare for synchronized cardioversion: Synchronized cardioversion is used for certain tachyarrhythmias when the client has a pulse. Ventricular fibrillation requires immediate unsynchronized defibrillation because the client is pulseless and unresponsive.

D. Amiodarone administration: Amiodarone is an antiarrhythmic drug that can be used after defibrillation and chest compressions to stabilize the heart rhythm. However, it is not the initial action in this emergency; defibrillation must occur first to terminate the arrhythmia and restore circulation.

Unstable Supraventricular Tachycardia: Synchronized Cardioversion

Unstable Bradycardia: Transcutaneous Pacing

Ventricular Fibrillation: Defibrillation

Ventricular Tachycardia with No Pulse: Defibrillation

Unstable Atrial Flutter: Synchronized Cardioversion

Rationales:

Unstable Supraventricular Tachycardia – Synchronized Cardioversion:

Synchronized cardioversion delivers a timed electrical shock to the heart during the R wave, avoiding the vulnerable T wave, which minimizes the risk of inducing ventricular fibrillation. This intervention is preferred for unstable SVT unresponsive to medications, as it restores normal sinus rhythm effectively.

Unstable Bradycardia – Transcutaneous Pacing:

Transcutaneous pacing provides electrical impulses to stimulate the heart when intrinsic conduction is insufficient. It is the recommended treatment for symptomatic bradycardia that does not respond to medications, ensuring adequate cardiac output while awaiting more definitive treatment.

Ventricular Fibrillation – Defibrillation:

Defibrillation delivers an unsynchronized shock to depolarize the entire myocardium, allowing the heart to reset and resume an organized rhythm. It is the first-line intervention for ventricular fibrillation, as the chaotic electrical activity makes the heart incapable of pumping blood.

Ventricular Tachycardia with No Pulse – Defibrillation:

Pulseless ventricular tachycardia requires defibrillation, as the rhythm is life-threatening and the absence of a pulse indicates the heart is not effectively pumping. This unsynchronized shock interrupts the abnormal rhythm, allowing normal sinus rhythm to potentially resume.

Unstable Atrial Flutter – Synchronized Cardioversion:

Synchronized cardioversion is used for unstable atrial flutter to restore sinus rhythm by delivering a precisely timed electrical shock. It is effective when pharmacological measures have not worked or are inappropriate, especially in cases of hemodynamic instability.