Question

The patient's heart rate is 165 beats per minute. His cardiac monitor shows a rapid rate with narrow QRS complexes. The P waves cannot be seen, but the rhythm is regular. The patient's blood pressure has dropped from 124/62 to 78/30. His skin is cold and diaphoretic and he is complaining of nausea. The nurse prepares the patient for:

a. administration of beta-blockers.
b. administration of atropine.
c. transcutaneous pacemaker insertion.
d. emergent cardioversion.

Answer 1

The patient exhibits signs of a supraventricular tachycardia with instability, necessitating immediate intervention. The most appropriate preparation is for emergent cardioversion to restore a normal heart rate and stabilize the patient's condition.

Step-by-step explanation:

The patient described in the question has a heart rate (HR) of 165 beats per minute, indicating tachycardia with a rapid rate and narrow QRS complexes. The regular rhythm and absence of visible P waves suggest a type of supraventricular tachycardia (SVT), possibly atrial fibrillation or atrial flutter. Coupled with symptoms of hypotension (blood pressure dropping to 78/30), cold and diaphoretic skin, nausea, and the risk of syncope, the patient requires immediate stabilization.

The nurse should prepare the patient for emergent cardioversion. This rapid treatment option is necessary to convert the patient's rhythm back to a normal heart rate, as pharmacological interventions might be too slow or insufficient given the patient's unstable hemodynamics. Cardioversion is often the preferred treatment in emergency settings for unstable patients with supraventricular tachycardia symptoms when medication alone might not be effective or timely enough.