Premature ventricular contractions (PVCs) occur while the nurse is suctioning a patient’s endotracheal tube. Which action by the nurse is best?
A.
Stop and ventilate the patient with 100% oxygen.
B.
Check the patient’s potassium level
C.
Give prescribed PRN antidysrhythmic medications.
D.
Decrease the suction pressure to 80 mm Hg.
The Correct Answer and Explanation is:
The correct answer is A. Stop and ventilate the patient with 100% oxygen.
Explanation:
Premature ventricular contractions (PVCs) are early heartbeats originating from the ventricles. They are often benign, especially if they occur infrequently. However, PVCs can sometimes be indicative of more serious underlying issues, particularly if they occur in a setting of stress or decreased oxygenation.
When PVCs occur during a procedure like suctioning of an endotracheal tube, it’s important to assess the possible causes. During suctioning, the patient may experience hypoxia (low oxygen levels) due to the interruption of ventilation. This hypoxia can trigger PVCs, which is why the priority should be to ensure adequate oxygenation.
Option A: Stop and ventilate the patient with 100% oxygen.
This action is the most appropriate response. By halting the suctioning and providing 100% oxygen, the nurse can address a potential cause of the PVCs—hypoxia. Ensuring the patient receives adequate oxygen can help stabilize the heart rhythm and reduce the frequency of PVCs.
Option B: Check the patient’s potassium level.
While electrolyte imbalances such as hypokalemia (low potassium) can contribute to PVCs, this is not an immediate priority during the suctioning procedure. Addressing immediate concerns related to oxygenation and ventilation is more critical in this context.
Option C: Give prescribed PRN antidysrhythmic medications.
Antidysrhythmic medications might be necessary for managing PVCs if they are frequent or symptomatic, but they should not be the first-line response during a procedure causing transient PVCs. Addressing the root cause (potential hypoxia) is more crucial before considering pharmacologic interventions.
Option D: Decrease the suction pressure to 80 mm Hg.
While adjusting suction pressure to minimize trauma and hypoxia is important, it does not address the immediate need to ensure adequate oxygenation. The primary concern during the procedure should be maintaining oxygenation, and adjusting the suction pressure alone may not be sufficient to manage the PVCs effectively.
In summary, during an episode of PVCs while suctioning, the best immediate action is to stop the suctioning and provide the patient with 100% oxygen to correct any potential hypoxia and stabilize the patient’s condition.