Chemical cardioversion is prescribed for a client in atrial fibrillation. The nurse prepares which of the following medications specifically for chemical cardioversion?

A. Have the client lie flat in bed with leg straight: After a cardiac catheterization, especially via the femoral artery, it is critical to keep the affected leg straight and the patient supine to prevent bleeding or hematoma formation at the puncture site. This positioning minimizes stress on the arterial access site and supports proper hemostasis during the immediate post-procedure period.

B. Keep the affected leg slightly flexed: Flexing the leg can increase pressure on the arterial puncture site, potentially causing bleeding, hematoma, or pseudoaneurysm formation. Maintaining the leg in a straight position is essential for vascular integrity and patient safety.

C. Elevate the head of the bed 45°: Elevating the head too early can increase hydrostatic pressure at the catheter insertion site, raising the risk of bleeding. Initial post-catheterization care requires a flat position until hemostasis is secure and vascular stability is confirmed.

D. Keep the client NPO for 4 hr: NPO status is typically not required after cardiac catheterization unless sedation or contrast-related concerns exist. Early resumption of oral intake is often safe and encouraged once the patient is alert and stable, as prolonged fasting is unnecessary and may cause discomfort.

A. Defibrillation: Defibrillation is used for pulseless ventricular tachycardia or ventricular fibrillation. Since the client has symptomatic VT but still has a pulse, defibrillation is not appropriate, as it is reserved for patients without effective cardiac output.

B. Radiofrequency catheter ablation: Catheter ablation is a long-term treatment for recurrent or refractory VT, but it is not the immediate intervention for an acute symptomatic episode. Acute stabilization takes priority before considering procedural interventions.

C. Cardioversion: Synchronized cardioversion is the treatment of choice for symptomatic VT with a pulse. It delivers a timed electrical shock to the ventricles, terminating the arrhythmia while minimizing the risk of inducing ventricular fibrillation, and restores a stable sinus rhythm promptly.

D. CPR: Cardiopulmonary resuscitation is indicated for cardiac arrest when there is no pulse. Since this patient has symptomatic VT with a pulse, CPR is not immediately necessary and would not address the underlying arrhythmia effectively.