A client’s telemetry monitor indicates ventricular fibrillation (VF). Which action should the nurse implement immediately?
A.
Defibrillate with one shock.
B.
Prepare for external pacing.
C.
Administer atropine IV.
D.
Give a dose of amiodarone IV.
The correct answer and Explanation is :
Correct Answer: A. Defibrillate with one shock.
Explanation:
Ventricular fibrillation (VF) is a life-threatening cardiac rhythm disturbance characterized by rapid, erratic electrical impulses in the ventricles, which leads to the heart’s inability to pump blood effectively. The heart quivers instead of contracting in a coordinated manner, and this results in a complete loss of cardiac output and a lack of perfusion to vital organs, particularly the brain. Immediate intervention is required to prevent death.
Immediate Defibrillation:
The priority action for a client in ventricular fibrillation is immediate defibrillation, as this is the only definitive treatment that can restore an organized rhythm. Defibrillation delivers an electric shock to the heart, which depolarizes the myocardial cells and allows the heart’s natural pacemaker (the sinoatrial node) to potentially regain control and reestablish a normal rhythm. Delay in defibrillation significantly decreases the likelihood of survival, as for every minute that defibrillation is delayed, the chance of survival drops by approximately 7-10%.
- B. Prepare for external pacing: External pacing is used for bradyarrhythmias (slow heart rhythms), not for VF. Ventricular fibrillation is a chaotic rhythm that cannot be corrected by pacing.
- C. Administer atropine IV: Atropine is an anticholinergic medication used primarily to increase heart rate in conditions like symptomatic bradycardia. It has no role in treating ventricular fibrillation, as the issue is not slow conduction but chaotic electrical activity.
- D. Give a dose of amiodarone IV: Amiodarone is an antiarrhythmic medication used to treat life-threatening ventricular arrhythmias. While it may be used after the first shock if defibrillation fails, it is not the first-line immediate treatment.
In summary, for a client in VF, the nurse must immediately defibrillate, as this is the best chance of restoring a normal heart rhythm and saving the client’s life.