Page 1691 - Saunders Comprehensive Review For NCLEX-RN

posterior position, and placement directly over breast
tissue should be avoided.

E. Automated external defibrillator (AED)

1. An AED is used by laypersons and emergency medical
technicians for prehospital cardiac arrest.
2. Place the client on a firm, dry surface.
3. Turn on the AED and follow the voice prompts.
4. Place the electrode patches in the correct position on
the client’s chest.
5. Stop CPR.
6. Ensure that no one is touching the client to avoid
motion artifact during rhythm analysis.
7. The machine will advise whether a shock is necessary.
8. Shocks are recommended for pulseless VT or VF only
(usually 3 shocks are delivered).
9. If unsuccessful, CPR is continued for 1 minute and
then another series of shocks is delivered.
F. Automated implantable cardioverter-defibrillator (AICD)
1. Description

2. Client education

a. An AICD monitors cardiac rhythm and
detects and terminates episodes of VT
and VF by delivering 25 to 30 joules up
to 4 times, if necessary.
b. An AICD is used in clients with
episodes of spontaneous sustained VT
or VF unrelated to an MI or in clients
whose medication therapy has been
unsuccessful in controlling life-
threatening dysrhythmias.
c. Transvenous electrode leads are placed
in the right atrium and ventricle in
contact with the endocardium; leads
are used for sensing, pacing, and
delivery of cardioversion or
defibrillation.
d. The generator is most commonly
implanted in the left pectoral region.
e. Instruct the client in the basic functions
of the AICD.
f. Know the rate cutoff of the AICD and
the number of consecutive shocks that
it will deliver.
g. Wear loose-fitting clothing over the
AICD generator site.

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