What would be the priority intervention for the care of the client who is pulseless and has the following rhythm on the monitor?
Amiodarone 300mg IV bolus, Amiodarone 150mg bolus if needed
CPR
Cardioversion
Defibrillation
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The best response is to educate the client about the cause of Prinzmetal angina. It occurs due to spasm in the coronary arteries, which is different from the plaque buildup seen in traditional coronary artery disease. This response addresses the client's concern in an accurate and reassuring manner.
B. While healthy eating is important, Prinzmetal angina is not typically caused by cholesterol or plaque buildup. This response could increase the client's anxiety.
C. While acknowledging the client's emotions is important, this response does not address the underlying concern or provide an accurate explanation of Prinzmetal angina.
D. Offering reassurance without providing accurate information about the condition does not help the client understand the cause of their symptoms and could leave them confused or anxious.
Correct Answer is C
Explanation
A. Mild hyponatremia (Sodium < 135 mEq/L) typically does not produce distinctive ECG changes. This value is unlikely to correlate with the presence of U waves.
B. Hyperkalemia (Potassium > 5.0 mEq/L) is associated with peaked T waves, widened QRS complexes, and flattened or absent P waves, not U waves.
C. Hypokalemia (Potassium < 3.5 mEq/L) is the primary cause of U waves. A potassium level of 2.1 mEq/L is significantly low and can result in ECG changes, including U waves, ST segment depression, and prolonged QT intervals. These changes reflect altered ventricular repolarization.
D. Hypermagnesemia (Magnesium > 2.5 mEq/L) can cause ECG changes such as prolonged PR and QRS intervals, bradycardia, and heart block. However, such an extreme magnesium level of 18 mEq/L would cause severe toxicity and is not associated with U waves.
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