Answer:
When a client is exhibiting ventricular tachycardia (VT) and is pulseless, it is considered a life-threatening emergency known as pulseless ventricular tachycardia (PVT) or ventricular fibrillation (VF). In this situation, the nurse should prepare for immediate defibrillation.
The nurse should follow the established emergency protocols, which typically involve the following steps:
Call for help: Alert the healthcare team, including calling for a Code Blue or requesting assistance from other healthcare providers experienced in cardiac arrest management.
Assess and confirm pulselessness: Verify that the client has no detectable pulse. This can be done by checking for carotid or femoral pulses for a maximum of 10 seconds.
Initiate cardiopulmonary resuscitation (CPR): Begin high-quality CPR, starting with chest compressions. Provide compressions at a rate of 100 to 120 compressions per minute, with adequate depth and complete chest recoil between compressions.
Obtain a defibrillator: Retrieve a defibrillator or automated external defibrillator (AED) and apply the electrodes or pads to the client's chest according to the manufacturer's instructions.
Clear for defibrillation: Ensure that everyone, including the nurse, is clear of the client before delivering the shock. Analyze the rhythm to confirm it is shockable (VT or VF).
Deliver the shock: If a shockable rhythm is identified, deliver a direct-current (DC) shock. Follow the specific protocols and guidelines of the healthcare facility regarding energy levels and subsequent rhythm assessment.
Resume CPR immediately after the shock: Provide immediate chest compressions following the shock, without delay, to maintain circulation.
Continue the cycle: Repeat the steps of CPR, rhythm analysis, and defibrillation as necessary, following the advanced cardiac life support (ACLS) algorithm and guidelines.
It's important to note that the specific protocols and interventions may vary depending on the healthcare setting, ACLS guidelines, and the nurse's level of training and certification. Immediate defibrillation is a critical intervention to restore normal cardiac rhythm and improve the chances of survival in a client experiencing pulseless VT or VF.
Step-by-step explanation: