Final answer:
The initial priority for a patient with end-stage renal disease and frequent PVCs is to check the potassium level to determine if there is an electrolyte imbalance causing the arrhythmias. Defibrillation and administration of medications may follow based on the potassium level results and a physician's orders.
Step-by-step explanation:
The priority intervention for a patient with end-stage renal disease experiencing frequent PVCs on the cardiac monitor is to check the patient's latest potassium level. Potassium imbalances can significantly affect cardiac function, and patients with renal disease are at high risk for electrolyte disturbances, including hyperkalemia or hypokalemia, both of which can cause cardiac arrhythmias like premature ventricular contractions (PVCs). Checking the potassium level is a critical step in guiding appropriate interventions.
Defibrillation may be necessary if the patient progresses to ventricular fibrillation, a life-threatening condition where the heart beats in an uncontrolled manner. However, initiating defibrillation is not the first step unless the PVCs lead to a more severe arrhythmia that is immediately life-threatening. Similarly, administration of antiarrhythmic medications such as IV lidocaine (Xylocaine) or potassium channel blockers like amiodarone would follow confirmation of the underlying electrolyte disturbance and under direction of a physician. If the potassium levels are found to be abnormal, treatments might include IV delivery of potassium for hypokalemia or other interventions for hyperkalemia. Immediate contact with a doctor is important for any significant changes in patient status, including severe or frequent arrhythmias, but gathering critical information like the potassium level is a key step before alerting the physician.