During a CPR class a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response?
"Cardioversion is always attempted before defibrillation because it has fewer risks."
"The difference is the timing of the delivery of the electric current."
"Cardioversion is done on fast rhythms with a pulse; defibrillation is done on all rhythms without a pulse."
"Defibrillation is synchronized with the electrical activity of the heart but cardioversion is not."
The Correct Answer is B
A. “Cardioversion is always attempted before defibrillation because it has fewer risks.”: Cardioversion is not always attempted first; the choice depends on the client’s rhythm and pulse status. Defibrillation is required immediately for pulseless shockable rhythms, and cardioversion is used only when a pulse is present.
B. “The difference is the timing of the delivery of the electric current.”: Cardioversion delivers a synchronized shock on the R wave to avoid inducing ventricular fibrillation, while defibrillation delivers an unsynchronized shock at any point in the cardiac cycle. This timing difference is the key distinguishing feature between the two.
C. “Cardioversion is done on fast rhythms with a pulse; defibrillation is done on all rhythms without a pulse.”: While cardioversion is used for tachyarrhythmias with a pulse, defibrillation is only for specific pulseless rhythms such as ventricular fibrillation and pulseless ventricular tachycardia, not all pulseless rhythms.
D. “Defibrillation is synchronized with the electrical activity of the heart but cardioversion is not.”: Cardioversion is synchronized to avoid shocking during the vulnerable T wave, while defibrillation is unsynchronized because pulseless rhythms lack organized activity to time the shock to.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Right-sided weakness with a hyper-awareness of deficits: Right-sided weakness occurs with left hemisphere strokes, not right-sided strokes. Clients with right-brain strokes typically have left-sided motor deficits. Hyper-awareness of deficits is more characteristic of left-brain stroke.
B. Slow to perform with a tendency to be impulsive: Slow, cautious behavior is more typical of left-brain stroke. Impulsivity is associated with right-brain stroke, but this option does not include the expected motor deficits on the left side.
C. Left-sided hemiplegia and a tendency to be impulsive: Right hemisphere strokes often result in left-sided weakness or paralysis (hemiplegia) and can impair judgment, spatial perception, and attention, leading to impulsivity and poor safety awareness. This combination accurately reflects common deficits seen in right-brain strokes.
D. Left-sided hemiplegia with hyper-awareness of deficits: Clients with right-brain strokes usually have diminished awareness of deficits (anosognosia) rather than hyper-awareness. Hyper-awareness is more common in left-brain strokes, making this option inaccurate for right-sided stroke.
Correct Answer is A
Explanation
A. Diltiazem: Diltiazem is a calcium channel blocker that slows conduction through the AV node, reducing ventricular response in atrial fibrillation. The client’s pulse is 188, indicating a rapid ventricular rate that can compromise cardiac output. Administering diltiazem first helps control heart rate and stabilize hemodynamics.
B. Atropine: Atropine is used to increase heart rate in bradycardic rhythms, not for tachyarrhythmias like atrial fibrillation. Administering it to a client with a pulse of 188 would worsen tachycardia and could lead to hemodynamic instability.
C. Epinephrine: Epinephrine is used primarily for cardiac arrest or severe hypotension, not for rate control in atrial fibrillation. Its use in this scenario would increase heart rate and myocardial oxygen demand, potentially exacerbating the tachyarrhythmia.
D. Nicardipine: Nicardipine is a calcium channel blocker used primarily for hypertension management. While it can lower blood pressure, it is not typically used for acute rate control in atrial fibrillation. Diltiazem is preferred in this context for controlling the ventricular rate.
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