Question

. MetroPCS LTE 1:16 AM E A dl-mail.ymail.com 2. The nurse on the telemetry unit responds to the cardiac monitor alarm on a patient recovering from a myocardial infarction. Upon entering the room, the nurse notes the rhythm on the monitor appears to be ventricular tachycardia. (Learning Objective 4) a. What action should the nurse take first? b. The nurse notes the patient has no pulse, and tells someone to get the code cart and another to call the hospital's code team. Upon arrival of the code cart, the nurse prepares the defibrillator for use. At what energy level does the nurse set the biphasic defibrillator for the first shock? c. After defibrillation, the nurse assesses the patient, finds him pulseless, and initiates cardiopulmonary resuscitation. The code team has arrived, and epinephrine is administered. What is the rationale for this medication in this emergency situation? d. What is the difference between monophasic and biphasic defibrillators?

Answer 1

2.a.

• Alert the team for code blue
• Administer oxygen as patient may have
• Precordial thump method can be done until the team arrives
• Defibrilate immediately to regain patients heart beat
• To initiate CPR in case of no response

b.The biphasic defibrillator has to be set at 120 to 200 joules as per the ACLS guidelines.The standard rate to treat ventricular fibrillation is at 200J

c.Epinephrine is a vasocontrictor which has the capability to increase the blood flow to vital organs like brain and heart prevent any major damage .This has to be done because brain will be permanently damaged if there is no supply of blood for about 3 minutes.

d.Difference

Monophasic	Biphasic
has one pad Shock us given in one direction Needs more energy Moderately effective For VT 360J to be delivered	has two pads Shock is given in reversible directions Needs very minimal energy Very effective For VT 200J has to be delivered