Page 1686 - Saunders Comprehensive Review For NCLEX-RN

prescribed in the case of acute
myocardial ischemia or MI.

For the client experiencing PVCs, notify

the PHCP or cardiologist if the client complains of
chest pain or if the PVCs increase in frequency, are
multifocal, occur on the T wave (R-on-T), or occur in
runs of ventricular tachycardia.
F. Ventricular tachycardia (VT; Fig. 52-9)

1. Description

a. VT occurs because of a repetitive firing
of an irritable ventricular ectopic focus
at a rate of 140 to 250 beats per minute
or more.
b. VT may present as a paroxysm of 3 self-
limiting beats or more, or may be a
sustained rhythm.
c. VT can lead to cardiac arrest.

2. Stable client with sustained VT (with pulse

and no signs or symptoms of decreased cardiac
output)
a. Administer oxygen as prescribed.
b. Administer antidysrhythmics as
prescribed.

3. Unstable client with VT (with pulse and signs

and symptoms of decreased cardiac output)
a. Administer oxygen and
antidysrhythmic therapy as prescribed.
b. Prepare for synchronized cardioversion
if the client is unstable.
c. The PHCP may attempt cough
cardiopulmonary resuscitation (CPR)
by asking the client to cough hard
every 1 to 3 seconds.
4. Pulseless client with VT: Defibrillation and CPR
G. Ventricular fibrillation (VF; Fig. 52-10)

1. Description

a. Impulses from many irritable foci in the
ventricles fire in a totally disorganized
manner.
b. VF is a chaotic rapid rhythm in which
the ventricles quiver and there is no

1686