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School

Walden University *

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Course

6521

Subject

Nursing

Date

Nov 24, 2024

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pdf

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1

Uploaded by SuperHumanFrogMaster1106

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MSC: NCLEX: Physiological Integrity 20. The nurse notices ventricular tachycardia on the heart monitor. When the patient is assessed, the patient is found to be unresponsive with no pulse. The nurse should take what action immediately? a. Treat with intravenous amiodarone or lidocaine. b. Begin cardiopulmonary resuscitation and advanced life support. c. Provide electrical cardioversion. d. Ignore the rhythm since it is benign. ANS: B Ventricular tachycardia (VT) is a rapid, life-threatening dysrhythmia originating from a single ectopic focus in the ventricles. Determine whether the patient has a pulse. If no pulse is present, provide emergent basic and advanced life-support interventions, including defibrillation. If a pulse is present and the blood pressure is stable, the patient can be treated with intravenous amiodarone or lidocaine. Cardioversion is used as an emergency measure in patients who become hemodynamically unstable but continue to have a pulse. It also may be used in nonemergency situations, such as when a patient has asymptomatic VT. DIF: Cognitive Level: Analysis OBJ: Describe appropriate interventions for common dysrhythmias. TOP: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity 21. The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex. The nurse should take what action immediately? a. Defibrillate the patient immediately. b. Initiate basic life support. c. Initiate advanced life support. d. Assess the patient and the electrical leads. ANS: D Ventricular fibrillation (VF) is a chaotic rhythm characterized by a quivering of the ventricles, which results in total loss of cardiac output and pulse. VF is a life-threatening emergency, and the more immediate the treatment is, the better the survival will be. VF produces a wavy baseline without a PQRST complex. Because a loose lead or electrical interference can
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