A nurse is caring for a client who returned from the catheterization laboratory (cath lab) to recover on the cardiac intermediate care unit status post radial approach transcatheter aortic valve replacement (TAVR). Which intervention would the nurse include in the client's care?

A. To detect and treat ventricular tachycardia: An AICD continuously monitors the heart’s rhythm and delivers an electrical shock or antitachycardia pacing when it detects life-threatening ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation. Its primary function is to prevent sudden cardiac death by restoring a normal rhythm during these events.

B. To detect and treat bradycardia: While some AICDs may have limited pacing capability, their main purpose is not to treat bradycardia. Bradycardia is more appropriately managed with a pacemaker rather than a defibrillating device.

C. To shock your heart if you have a heart attack at home: The AICD does not detect myocardial infarction itself. It responds to arrhythmias associated with sudden cardiac arrest, not the ischemic event of a heart attack, and cannot prevent or treat the infarction.

D. To monitor for normal sinus rhythm: Although the AICD continuously monitors the heart’s rhythm, its primary purpose is therapeutic intervention for dangerous arrhythmias, not passive rhythm monitoring. Monitoring is secondary to its life-saving function.

A. Take the client's blood pressure.: Measuring blood pressure is important for assessing perfusion, but it takes time and does not immediately assess the presence of a pulse or the client’s hemodynamic stability. In ventricular tachycardia (V-tach), rapid action is needed to determine if the client is perfusing before other interventions.

B. Check the client's peripheral pulses.: The first non-invasive priority is to assess whether the client has a palpable pulse, which determines if the V-tach is pulse-present (stable) or pulseless (unstable). This guides immediate interventions, such as preparing for synchronized cardioversion in a pulsed client or initiating CPR in a pulseless client. Assessing pulses quickly identifies life-threatening instability.

C. Administer adenosine intravenous push (IVP) to the client.: Adenosine is indicated for supraventricular tachycardia (SVT), not ventricular tachycardia. Administering adenosine in V-tach can worsen the arrhythmia or precipitate cardiac arrest.

D. Instruct the client to perform the Valsalva maneuver.: The Valsalva maneuver is used to terminate certain supraventricular tachycardias by increasing vagal tone. It is ineffective and unsafe for ventricular tachycardia, which originates in the ventricles and may rapidly deteriorate into ventricular fibrillation.