Page 1689 - Saunders Comprehensive Review For NCLEX-RN

undesirable rhythm to a stable rhythm.
b. Cardioversion can be an elective
procedure performed by the PHCP for
stable tachydysrhythmias resistant to
medical therapies or an emergent
procedure for hemodynamically
unstable ventricular or
supraventricular tachydysrhythmias.
c. A lower amount of energy is used than
with defibrillation.
d. The defibrillator is synchronized

to the client’s R wave to avoid
discharging the shock during the
vulnerable period (T wave).

e. If the defibrillator is not

synchronized, it could discharge on the
T wave and cause VF.
2. Preprocedure interventions
a. If an elective procedure, ensure that
informed consent is obtained.
b. Administer sedation as prescribed.
c. If an elective procedure, hold digoxin
for 48 hours preprocedure as
prescribed to prevent
postcardioversion ventricular
irritability.

d. If an elective procedure for

atrial fibrillation or atrial flutter, the
client should receive anticoagulant
therapy for 4 to 6 weeks preprocedure,
and a transesophageal echocardiogram
(TEE) should be performed to rule out
clots in the atria prior to the procedure.

3. During the procedure

a. Ensure that the skin is clean and dry in
the area where the electrode
pads/hands-off pads will be placed.
b. Stop the oxygen during the procedure
to avoid a fire hazard.
c. Be sure that no one is touching the bed
or the client when delivering the
countershock (check the entire length
of the client 3 times).

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