NCLEX RN Quiz # 1001

NCLEX Examination.

Practice Question # 1001.

 

nclex examination

 

Cardioversion involves the delivery of a “timed” electrical current to terminate a tachydysrhythmia. In cardioversion, the defibrillator is set to synchronize with the ECG on a cardiac monitor so that the electrical impulse discharges during ventricular depolarization (QRS complex). Because there may be a short delay until recognition of the QRS, the discharge buttons must be held down until the shock has been delivered. The synchronization prevents the discharge from occurring during the vulnerable period of repolarization (T wave), which could result in VT or ventricular fibrillation. When the synchronizer is on, no electrical current will be delivered if the defibrillator does not discern a QRS complex. Sometimes the lead and the electrodes must be changed for the monitor to recognize the patient’s QRS complex. If the cardioversion is elective, anticoagulation for a few weeks before cardioversion may be indicated. Digoxin is usually withheld for 48 hours before cardioversion to ensure the resumption of sinus rhythm with normal conduction. The patient is instructed not to eat or drink for at least 8 hours before the procedure.

 

Gel-covered paddles or conductor pads are positioned front and back (anteroposteriorly) for cardioversion. Before cardio- version, the patient receives intravenous sedation as well as an analgesic medication or anesthesia. Respiration is then supported with supplemental oxygen delivered by a bag-mask-valve device with suction equipment readily available. Although patients rarely require intubation, equipment is nearby if it is needed. The amount of voltage used varies from 25 to 360 joules, depending on the defibrillator’s technology and the type of dysrhythmia. If ventricular fibrillation occurs after cardioversion, the defibrillator is used to defibrillate the patient (sync mode is not used).

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