An unconscious client is demonstrating pulseless ventricular tachycardia (PVT).The nurse checks the client's pulse and begins cardiopulmonary resuscitation (CPR). The defibrillator and crash cart arrive at the bedside and the client is shocked. Which action should the nurse implement next?
Explanation & Rationale
Rationale: A. Administer epinephrine IV push: Epinephrine is administered after the next cycle of CPR if pulseless ventricular tachycardia persists following defibrillation. It increases coronary perfusion and enhances the likelihood of successful defibrillation but is not given immediately after the first shock. B. Recharge the defibrillator and give one shock: Consecutive shocks without performing CPR in between reduce perfusion and worsen outcomes. Current resuscitation guidelines emphasize immediate chest compressions after each shock before reanalyzing the rhythm or delivering another shock. C. Resume CPR, beginning with compressions: After a defibrillation attempt, the priority is to resume high-quality CPR starting with chest compressions to maintain cerebral and coronary perfusion. CPR should continue for 2 minutes before reassessing the cardiac rhythm or administering medications. D. Administer amiodarone IV push: Amiodarone is indicated for refractory ventricular fibrillation or pulseless ventricular tachycardia after multiple shocks and epinephrine have failed. It is not part of the immediate post-shock action sequence but follows continued CPR and rhythm reassessment.