A patient's cardiac monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious and pulseless. Which action should the nurse take first?
a. Perform immediate defibrillation.
b. Give epinephrine (Adrenalin) IV.
c. Prepare for endotracheal intubation.
d. Give ventilations with a bag-valve-mask device.
ANS: A
The patient's rhythm and assessment indicate ventricular fibrillation and cardiac arrest; the initial action should be to defibrillate. If a defibrillator is not immediately available or is unsuccessful in converting the patient to a better rhythm, the other actions may be appropriate.
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