Rhythm Strip
A client comes to the emergency department (ED) complaining of a "racing heart and nervousness." The client's blood pressure is 106/60. The cardiac monitor displays the rhythm below. Which nursing action should be performed first?
Prepare the client for electrical cardioversion
Perform a carotid massage on the client.
Administer lidocaine 1mg/hour.
Ask the client if they drank a caffeinated beverage
The Correct Answer is B
A. Prepare the client for electrical cardioversion: Electrical cardioversion is reserved for unstable patients (e.g., hypotension, altered mental status, chest pain, or signs of shock). This client, while tachycardic, has a blood pressure of 106/60, which indicates relative stability. Cardioversion is not the first-line intervention in stable supraventricular tachycardia (SVT).
B. Perform a carotid massage on the client: Carotid sinus massage is a vagal maneuver used to slow conduction through the AV node and can terminate paroxysmal supraventricular tachycardia (PSVT). It is a non-invasive, first-line intervention for a stable patient with narrow-complex tachycardia, as shown on the ECG strip.
C. Administer lidocaine 1 mg/hour: Lidocaine is an antiarrhythmic used primarily to treat ventricular arrhythmias, such as ventricular tachycardia or fibrillation. It is not indicated for atrial or supraventricular tachycardias and would not address the underlying rhythm.
D. Ask the client if they drank a caffeinated beverage: While excessive caffeine intake can contribute to tachycardia, asking about caffeine use does not address the acute arrhythmia or guide immediate treatment. It may be part of history-taking but is not a priority intervention in this situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["35"]
Explanation
Calculate the total infusion time in minutes.
Infusion time in minutes = 2 hours × 60 minutes/hour
= 120 minutes
Calculate the total number of drops to be infused.
The total volume remaining is 350 mL
Drip factor is 12 gtts/mL.
Total drops = Total volume (mL) × Drop factor (gtts/mL)
Total drops = 350 mL × 12 gtts/mL
= 4200 gtts
Calculate the IV flow rate in drops per minute (gtts/min).
IV rate (gtts/min) = Total drops / Total infusion time (minutes)
= 4200 gtts / 120 minutes
= 35
=35 gtts/min
Correct Answer is ["0.5"]
Explanation
Convert milligrams to micrograms.
1 mg = 1000 mcg.
0.05 mg × 1000 mcg/mg = 50 mcg
Desired dose = 25 mcg
Available dose = 50 mcg/tablet
Calculate the number of tablets.
Number of tablets = Desired dose / Available dose per tablet
= 25 mcg / 50 mcg/tablet
= 0.5
The nurse should administer 0.5 tablet.
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