An unconscious client is demonstrating pulseless ventricular tachycardia (PVT).The nurse checks the client's pulse and begins cardiopulmonary resuscitation (CPR). The defibrillator and crash cart arrive at the bedside and the client is shocked. Which action should the nurse implement next?
Administer epinephrine IV push.
Recharge the defibrillator and give one shock.
Resume CPR, beginning with compressions.
Administer amiodarone IV push.
The Correct Answer is C
Rationale:
A. Administer epinephrine IV push: Epinephrine is administered after the next cycle of CPR if pulseless ventricular tachycardia persists following defibrillation. It increases coronary perfusion and enhances the likelihood of successful defibrillation but is not given immediately after the first shock.
B. Recharge the defibrillator and give one shock: Consecutive shocks without performing CPR in between reduce perfusion and worsen outcomes. Current resuscitation guidelines emphasize immediate chest compressions after each shock before reanalyzing the rhythm or delivering another shock.
C. Resume CPR, beginning with compressions: After a defibrillation attempt, the priority is to resume high-quality CPR starting with chest compressions to maintain cerebral and coronary perfusion. CPR should continue for 2 minutes before reassessing the cardiac rhythm or administering medications.
D. Administer amiodarone IV push: Amiodarone is indicated for refractory ventricular fibrillation or pulseless ventricular tachycardia after multiple shocks and epinephrine have failed. It is not part of the immediate post-shock action sequence but follows continued CPR and rhythm reassessment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Monitor the client every 1 hour for changes in the GCS score: Frequent monitoring is important, but a sudden drop from 13 to 6 indicates significant neurological deterioration that requires immediate reporting rather than just continued observation.
B. Prepare the family for the client's imminent death: While family support is important, it is premature to focus on end-of-life discussions before stabilizing the client and notifying the healthcare provider of acute neurological decline.
C. Notify the healthcare provider of the GCS score: A GCS of 6 represents severe brain injury and indicates that the client may require urgent interventions, such as airway protection, imaging, or neurosurgical evaluation. Immediate notification of the healthcare provider is the priority action.
D. Begin cardiopulmonary resuscitation (CPR): CPR is indicated only if the client is pulseless or apneic. A GCS of 6 reflects decreased consciousness but does not necessarily indicate cardiopulmonary arrest, so CPR is not immediately warranted.
Correct Answer is ["0.3"]
Explanation
Calculation
Ordered Dose (D): 3 mg
Available Concentration (H): 30 mg / 3 mL
= 10 mg/mL
- Calculate the Volume (mL) to Administer
Amount to Administer (mL) = (Ordered Dose (D) / Dose on Hand (H)) x Quantity (Q)
= (3 mg / 10 mg) x 1 mL
= 0.3 x 1 mL
= 0.3 mL
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