A patient with pericarditis is being evaluated for dizziness and shortness of breath. His heart rate on the monitor demonstrates supraventricular tachycardia. Which of the following interventions is most appropriate in this situation?
a. Administer a vasopressor medication, such as epinephrine
b. Have the patient perform the Valsalva maneuver
c. Give the patient 8 oz. of water to drink
d. Start CPR at a rate of 100 compressions per minute
b. Have the patient perform the Valsalva maneuver
rationale: "Have the patient perform the Valsalva maneuver" is correct. Supraventricular tachycardia (SVT) is a type of cardiac arrhythmia in which the heart beats rapidly. The rhythm originates in the atria of the heart and can cause a heart rate of up to 300 bpm. The patient becomes lightheaded and dizzy because his heart is not effectively pumping blood due to the rapid rate. The initial method of management is to ask the patient to "bear down", known as the Valsalva maneuver. The maneuver can also be achieved by having the patient close their mouth, pinch their nose and blow against closed airways. This causes increased intrathoracic pressure, blood pressure and heart rate shifts, and may convert the arrhythmia back into a normal rhythm.
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