The RN should administer amiodarone (Cordarone) to treat which of the following arrhythmias?

A. Low-sodium diet: A low-sodium diet is often prescribed for cardiac patients to help control fluid retention and blood pressure. This prescription is appropriate and does not interfere with pacemaker function.

B. MRI of the chest: Many permanent pacemakers are not MRI-compatible due to the risk of lead heating, device malfunction, or movement of the generator. Ordering an MRI of the chest after pacemaker insertion requires clarification to prevent serious device-related complications. Alternative imaging modalities or MRI-compatible devices should be confirmed first.

C. Physical therapy: Early mobilization and physical therapy are typically encouraged post-pacemaker insertion to maintain overall function and prevent deconditioning. Precautions regarding the affected arm may apply, but physical therapy is generally safe and appropriate.

D. Serum cardiac enzyme levels: Monitoring cardiac enzymes can help assess for perioperative myocardial injury, particularly if the patient had underlying cardiac disease or post-procedural complications. This prescription is safe and does not conflict with pacemaker care.

A. Atropine: Atropine is used to treat symptomatic bradycardia by increasing heart rate through vagal inhibition. It has no role in pulseless ventricular tachycardia (VT) and would not address the life-threatening arrhythmia, making it inappropriate in this context.

B. Amiodarone: Amiodarone is a class III antiarrhythmic indicated for refractory ventricular tachycardia or ventricular fibrillation unresponsive to initial defibrillation and epinephrine. It works by prolonging the action potential and refractory period in cardiac tissue, helping to stabilize ventricular conduction and increase the likelihood of return of spontaneous circulation.

C. Dopamine: Dopamine is a vasoactive agent used to support blood pressure and cardiac output in hypotension or shock. It does not terminate pulseless VT and would not be effective in restoring a perfusing rhythm, so it is not appropriate as the next step in this scenario.

D. Adenosine: Adenosine is effective for terminating supraventricular tachycardias by transiently blocking AV nodal conduction. It is ineffective for ventricular arrhythmias such as pulseless VT and could delay appropriate life-saving therapy if used in this situation.