Page 1687 - Saunders Comprehensive Review For NCLEX-RN

cardiac output.
c. VF is fatal if not successfully resolved
within 3 to 5 minutes.
d. Client is unconscious with no pulse, BP,
respirations, or heart sounds.

2. Interventions

a. Initiate CPR until a defibrillator is
available.
b. The client is defibrillated immediately
with 120 to 200 joules (biphasic
defibrillator) or 360 joules (monophasic
defibrillator); check the entire length of
the client 3 times to make sure no one
is touching the client or the bed; when
clear, proceed with defibrillation.
c. CPR is continued for 2 minutes, and the
cardiac rhythm is reassessed to
determine the need for further
countershock.
d. Administer oxygen as prescribed.
e. Administer antidysrhythmic therapy as
prescribed.
H. Guidelines for performing adult CPR
1. Follow CAB (compressions, airway, breathing)
guidelines. If a victim is noted not breathing or only
gasping, activate the emergency response system and
obtain an automated external defibrillator (AED) or
monophasic or biphasic defibrillator depending on
the setting and equipment available.
2. Check the carotid pulse for a maximum of 10 seconds.
3. If no pulse is felt, begin chest compressions (100 to 120
per minute) at a depth of 2 inches (5 cm) for 2 minutes
or 5 cycles of 30 compressions to 2 ventilations using
a barrier device or bag valve mask.
4. To provide ventilations, the head-tilt chin-lift
maneuver, or jaw thrust technique is used if neck
injury is suspected.
5. Check rhythm and for presence of a pulse every 2
minutes or after 5 cycles (depending on the setting
and equipment available, deliver a shock if indicated).
6. Switch compression and ventilation roles if another
rescuer is available, to avoid fatigue.
7. Continue this process until the victim gains
consciousness, starts breathing, or has a pulse.
8. If the victim has a pulse but is not breathing, continue
with rescue breathing until help arrives and advanced
cardiovascular life support measures are instituted.

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