A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client?
Test the equipment by delivering a smaller shock at 50 J.
Administer 2 mg of intravenous epinephrine.
Make sure that the defibrillator is set to the synchronous mode.
Ensure that everyone is clear of contact with the client and the bed.
The Correct Answer is D
A. Testing the equipment with a smaller shock is unnecessary when preparing to defibrillate in an emergency.
B. Epinephrine is used in cases of cardiac arrest with no pulse, particularly in asystole or pulseless electrical activity (PEA), not immediately before defibrillation in ventricular fibrillation.
C. Synchronous mode is used for cardioversion, not for defibrillation. Defibrillation should be delivered in unsynchronized mode.
D. Before delivering a shock, it is essential to ensure that everyone, including the nurse, is clear of the client and any conductive surfaces like the bed. This prevents injury from the electrical shock.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Mild hyponatremia (Sodium < 135 mEq/L) typically does not produce distinctive ECG changes. This value is unlikely to correlate with the presence of U waves.
B. Hyperkalemia (Potassium > 5.0 mEq/L) is associated with peaked T waves, widened QRS complexes, and flattened or absent P waves, not U waves.
C. Hypokalemia (Potassium < 3.5 mEq/L) is the primary cause of U waves. A potassium level of 2.1 mEq/L is significantly low and can result in ECG changes, including U waves, ST segment depression, and prolonged QT intervals. These changes reflect altered ventricular repolarization.
D. Hypermagnesemia (Magnesium > 2.5 mEq/L) can cause ECG changes such as prolonged PR and QRS intervals, bradycardia, and heart block. However, such an extreme magnesium level of 18 mEq/L would cause severe toxicity and is not associated with U waves.
Correct Answer is D
Explanation
A. Amiodarone is an antiarrhythmic used to treat ventricular arrhythmias like monomorphic VT, but it is not the first-line treatment for a pulseless patient. Defibrillation should be performed immediately, and amiodarone can be administered after defibrillation if the rhythm persists.
B. CPR is essential for maintaining circulation in a pulseless patient, but defibrillation should be the first priority for monomorphic VT. CPR should be continued if defibrillation is not immediately available, but the most effective intervention is defibrillation to attempt to restore normal rhythm.
C. Cardioversion is used for stable, regular arrhythmias, but for a pulseless client in monomorphic VT, defibrillation is the appropriate first intervention. Cardioversion is typically used when the patient is conscious or stable and is not a priority for pulseless VT.
D. For a pulseless client with monomorphic ventricular tachycardia, defibrillation is the priority intervention. Defibrillation delivers an electric shock to the heart, which may terminate the abnormal rhythm and allow the heart to return to normal sinus rhythm. This is the most effective and immediate treatment for a pulseless client in ventricular tachycardia.
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