A nurse is preparing for a cardioversion procedure for a client diagnosed with supraventricular tachycardia (SVT) who is alert and has a blood pressure of 110/66 mmHg. Which action should the nurse prioritize before implementing the cardioversion?
Ensure the synchronizer switch is in the "manual" mode to facilitate immediate defibrillation.
Turn the synchronizer switch to the "off" position to prevent unwanted shocks.
Inform the client that they will need to remain still during the procedure without sedation.
Administer a sedative agent before the cardioversion procedure is implemented.
The Correct Answer is D
A. The synchronizer switch should be on, not in manual mode, to ensure the shock is delivered during the R wave and avoid inducing ventricular fibrillation. Manual mode is used for defibrillation, not synchronized cardioversion.
B. Turning the synchronizer off is inappropriate for cardioversion, as the shock must be synchronized with the QRS complex.
C. Although the client should remain still, cardioversion is painful and generally requires sedation, so this alone is insufficient.
D. Clients undergoing elective synchronized cardioversion while alert require sedation to reduce pain and anxiety during the procedure. Administering a sedative is a priority nursing action before delivering the shock to ensure client safety and comfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Failure to sense occurs when the pacemaker does not recognize intrinsic cardiac activity, leading to inappropriate pacing, but pacer spikes are usually present.
B. Failure to pace is indicated when the pacemaker does not deliver electrical impulses, evidenced by the absence of pacer spikes on the rhythm strip. This explains the low heart rate and hypotension.
C. Failure to synchronize occurs with synchronized cardioversion, not in demand pacemakers.
D. Failure to capture occurs when pacer spikes are present but do not result in ventricular depolarization; in this case, pacer spikes are absent.
Correct Answer is C
Explanation
A. A CVP of 8 mmHg is within the upper normal range (2–8 mmHg) and is not immediately concerning.
B. SVR of 1000 dynes/sec/cm² is within a typical range for adults and does not indicate acute complications.
C. Inability to auscultate breath sounds on the side of catheter insertion suggests possible pneumothorax, a serious complication of subclavian CVP insertion that requires immediate attention.
D. Urine output of 30 mL/hour is acceptable and does not indicate acute renal compromise.
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