About
A procedure that involves application of electrodes and an external defibrillator to deliver a timed electrical current to help terminate abnormal cardiac rhythms. The defibrillator should be set to "synchronized" and will deliver the electrical current during ventricular depolarization. This procedure can help to terminate tachyarrhythmia's that can lead to death or deadly rhythms.
Assess
Telemetry, ECG, vitals, pulse-oximetry, level of consciousness, patient understanding of procedure, informed consent, medication history, airway
Complications
- Anesthesia reactions, impaired airway, failure to capture, arrhythmias, blood clots
Diagnosis
- Decreased cardiac output related to abnormal cardiac rhythm.
- Knowledge deficit related to procedure and treatment of arrhythmias.
Goals
- The client will maintain vital signs within normal parameters and pulse-oximetry above 94%.
- The client will state understanding of pre-, intra-, and post-operative instructions.
- The client will have a sinus rhythm with normal heart rate.
Interventions
- Assess ECG, vitals, pulse-oximetry continuously during procedure.
- Teach client what to expect pre-, intra- and post-procedure.
- Administer sedatives and anesthetic agents as prescribed.
- Maintain patent airway, keep intubation supplies nearby in case of complications.
- Place monitor in "synchronized" mode ( "in sync").
- Apply gel covered pads to patient on both anterior and posterior chest wall.
- Make sure no person is touching the bed, equipment, or patient prior to delivering electrical impulse.
- Be sure to select a LEAD that captures the QRS most effectively. Do not have it on paddles.
- Monitor telemetry and QRS complex for appropriate capture.
- Be prepared to defibrillate if necessary.
- Monitor telemetry and QRS complex for appropriate capture.
- Post-procedure, monitor telemetry, vitals, pulse-oximetry continuously until fully recovered.
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