The health care provider orders: Epinephrine 0.25 mg IV stat Pharmacy provides: Epinephrine 0.1 mg/mL. How many mL will the nurse prepare to administer? (Round to one decimal place.)

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.

A. Hypercalcemia (Calcium > 10.5 mg/dL) can lead to shortened QT intervals, not prolonged ones, and is unlikely to cause Torsades de Pointes.

B. A magnesium level of 3.1 mEq/L is slightly elevated and would not contribute to QT prolongation or Torsades de Pointes. In fact, magnesium supplementation is a treatment for this condition.

C. Hypokalemia (Potassium < 3.5 mEq/L) can prolong the QT interval and contribute to dysrhythmias, but it is less commonly a direct cause of Torsades de Pointes compared to hypomagnesemia. A potassium level of 2.6 mEq/L is low but would not typically result in Torsades without coexisting hypomagnesemia.

D. Hypomagnesemia (Magnesium < 1.5 mEq/L) disrupts the heart's electrical activity, prolonging the QT interval and increasing the risk of polymorphic ventricular tachycardia, like Torsades de Pointes. Magnesium is critical for stabilizing myocardial electrical conduction, and a value of 1.1 mEq/L indicates significant deficiency, consistent with this dysrhythmia.