A patient whose heart monitor shows sinus tachycardia, rate 132, ...

[sammy]

A patient whose heart monitor shows sinus tachycardia, rate 132, is apneic and has no palpable pulses. What is the first action that the nurse should take?
 
  a. Perform synchronized cardioversion.
  b. Start cardiopulmonary resuscitation (CPR).
  c. Administer atropine per agency dysrhythmia protocol.
  d. Provide supplemental oxygen via non-rebreather mask.

Question 2

A patient who is on the progressive care unit develops atrial flutter, rate 150, with associated dyspnea and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?
 
  a. Obtain a 12-lead electrocardiogram (ECG).
  b. Notify the health care provider of the change in rhythm.
  c. Give supplemental O2 at 2 to 3 L/min via nasal cannula.
  d. Assess the patient's vital signs including oxygen saturation.

[peter]

Answer to Question 1

ANS: B
The patient's clinical manifestations indicate pulseless electrical activity and the nurse should immediately start CPR. The other actions would not be of benefit to this patient.

Answer to Question 2

ANS: C
Because this patient has dyspnea and chest pain in association with the new rhythm, the nurse's initial actions should be to address the patient's airway, breathing, and circulation (ABC) by starting with oxygen administration. The other actions also are important and should be implemented rapidly.