Question

A 45-year-old woman with a history of palpitations develops light-headedness and palpitations. She has received adensoine 6mg IV for the rhythm shown here (SVT), without conversion of the rhythm. She is now extremely apprehensive. Her blood pressure si 128/70mm Hg. What is the next appropriate intervention?

Answer 1

The next appropriate intervention for a 45-year-old woman with SVT after an unsuccessful first dose of adenosine is a second, larger dose of adenosine (12mg IV push), continuous monitoring, reassurance, and preparation for potential cardioversion if needed.

Step-by-step explanation:

The question pertains to the next appropriate intervention for a 45-year-old woman with a history of palpitations who has developed light-headedness and palpitations after an initial dose of adenosine 6mg IV for supraventricular tachycardia (SVT) did not convert the rhythm.

Considering that the patient is extremely apprehensive and the first dose has failed, the next step in managing SVT, according to Advanced Cardiac Life Support (ACLS) guidelines, is to administer a larger second dose of adenosine. The initial recommended dose is 6mg IV push followed by a 12mg dose if the first fails. It is critical, however, to also ensure continuous monitoring of the patient's vital signs, providing reassurance to alleviate anxiety, and preparing for alternative therapies such as synchronized cardioversion if pharmacological measures are ineffective and the patient's condition worsens.