The patient is brought to the emergency room after briefly losing consciousness. He states, “I feel like my heart has been racing for days now. I just assumed it was stress, but now it feels so much worse.” He is pale, diaphoretic, and tachypneic. His heart rate is 118 bpm and his blood pressure is 86/52 mmHg. An electrocardiogram shows an irregularly irregular RR interval without distinct P waves. The nurse prepares the patient for which intervention?

Question

The patient is brought to the emergency room after briefly losing consciousness. He states, &ldquo;I feel like my heart has been racing for days now. I just assumed it was stress, but now it feels so much worse.&rdquo; He is pale, diaphoretic, and tachypneic. His heart rate is 118 bpm and his blood pressure is 86/52 mmHg. An electrocardiogram shows an irregularly irregular RR interval without distinct P waves. The nurse prepares the patient for which intervention?

Accepted Answer

Direct current electrocardioversion. The patient with atrial fibrillation with rapid ventricular response (as evidenced by ECG that shows irregularly irregular RR interval without distinct P waves and a ventricular rate greater than 110 bpm) and signs of shock (hypotension and pallor) must be cardioverted with direct current electrocardioversion. Adenosine is used for supraventricular tachycardia. Transesophageal pacing can be used to treat supraventricular tachycardia in children. Amiodarone is used for ventricular arrhythmias.

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