ALS/ACLS - Team Response Scenario - Maurice Van Essen [2022/2023] Rated A+

ALS/ACLS - Team Response Scenario - Maurice Van Essen [2022/2023] Rated A+ On rapid assessment, Mr. van Essen is responsive and his airway is patent. He appears pale and distressed. He is diaphoretic. Select the tools to use during the primary assessment to gather more information about Mr. van Essen's clinical condition. 1. Pulse Oximetry 2. Cardiac Monitoring 3. Stethoscope 4. Blood pressure monitoring What is your interpretation of the rhythm on the cardiac monitor? First, identify the rhythm. Mr. van Essen has a narrow-complex supraventricular tachycardia and the rhythm is regular. Mr. van Essen's primary assessment findings are as follows:Blood pressure: 105/70 mmHgPulse: 182 bpmRespirations: 24 breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung sounds: clearBased on Mr. van Essen's clinical presentation and these assessment findings, is his condition stable or unstable? Stable Which intervention would be an appropriate next step in caring for Mr. van Essen? 12-Lead ECG The 12-lead ECG confirms a narrow-complex supraventricular tachycardia with a regular rhythm. Based on Mr. van Essen's current condition, what is the appropriate next action? Attempt vagal maneuvers. Following the vagal maneuver, the team reassesses Mr. van Essen and notes the following:Blood pressure: 105/70 mmHgPulse: 178 bpmRespirations: 24 breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung sounds: clearRhythm: unchangedWhat should the team do next? Initiate pharmacologic therapy What is the correct medication to prepare? Adenosine What is the initial dose of adenosine? 6 mg by rapid IV push, followed by a 10 to 20 mL normal saline flush After administering the initial dose of adenosine, the team reassesses Mr. van Essen and notes the following:Blood pressure: 105/70 mmHgPulse: 178 bpmRespirations: 24 breaths/minTemperature: 98.6°FPulse oximetry: 96%Lung sounds: clearRhythm: unchangedGiven these assessment findings, what is the appropriate next intervention? If the first dose of adenosine does not convert the rhythm, administer 12 mg of adenosine followed by a 10- to 20-mL normal saline flush. Mr. van Essen receives two additional doses of adenosine (12 mg) but the supraventricular tachycardia persists. Mr. van Essen's blood pressure is decreasing and he is beginning to show changes in his level of consciousness. What should the team do next? Initiate synchronized cardioversion - We've reached the limit with adenosine, and Mr. van Essen is showing signs of hemodynamic instability. It's time to cardiovert. The cardiac monitor/defibrillator is biphasic. What initial dose should be used for synchronized cardioversion for Mr. van Essen? The initial recommended dose for synchronized cardioversion of a narrow-complex, regular rhythm is 50 to 100 J.